0830 Outcome after assisted reproduction

Two previous summaries in this series have dealt with the issue of outcome after in-vitro fertility (IVF) procedures such as intracytoplasmic sperm injection (ICSI), gamete intrafallopian transfer (GIFT) and zygote transfer (ZIFT). One of the summaries (0328) comments on the increased incidence of Beckwith-Wiedermann and Angelman syndrome cases, while the other (0747) notes that screening to confirm normal genetics by analysis of a blastomere results in lower pregnancy and live birth rates. A more recent article reports on 2-month outcome of 937 infants born after transfer of cryopreserved embryos vs fresh ICSI and IVF procedures. The important finding of the study was a major malformation rate of 6.4% in cryopreserved ICSI offspring vs cryopreserved IVF (3.1%) and fresh ICSI liveborns (3.4%). A comprehensive Canadian review of pregnancy outcomes after assisted reproductive technology covers all outcomes ranging from multiple pregnancy to chromosomal abnormalities. In the review the comment is repeatedly made that for most of the adverse outcomes it remains unclear whether the increased risks are attributable to the underlying infertility, characteristics of the infertile couple, or use of assisted reproductive techniques. While the details have yet to be fully worked out, what is clear is that the technology, while sought out and valued by affected couples, nevertheless carries with it a small but significant risk of chromosomal, non-chromosomal and various perinatal risks.

Read more:
Hum Reprod 2008; doi:10.1093/humrep/den254
J Obstet Gynaecol Can 2006; 28: 220-50