Risk of congenital heart defects associated with assisted reproductive technologies

Shirali, S.; Mirlohi, M.; Abyaz, S.
June 2014
Iranian Journal of Reproductive Medicine;Jun2014 Supplement, Vol. 12, p61
Academic Journal
Introduction: Assisted Reproductive Technology (ART) is a fast growing field in the medical world that involves handling eggs, sperm, or both outside the human body. Congenital heart defects (CHD) are the most prevalent birth defects and comprise the most important cause of malformation related infant mortality. Materials and Methods: For study of relationship between ART and CDH we searched in PubMed, sciencdirect, google scholar with key word for ART, CDH, risk factor. Results: Studies demonstrate the presence of cardiac and vascular remodeling in fetuses and infants of pregnancies obtained by ART. Assisted reproductive technologies were specifically associated with significant increases in the odds of malformations of the outflow tracts and ventriculoarterial connections and of cardiac neural crest defects and double outlet right ventricle. In general, we found specific associations between methods of ART and subcategories of CHD. Mechanisms leading to congenital malformations in ART children: Point mutations, IHH and SOX2 mutations (idiopathic hypogonadotrophic hypogonadism), Cystic fibrosis, Chromosomal abnormalities, Ring Y, Aneuploidy, and Epigenetic abnormalities. Conclusion: Cases with CHD were more likely to have been conceived following ART when compared with malformed controls. This higher risk for CHD varied specifically according to the method of ART and the type of CHD and may be due to ART per se and/or the underlying infertility of couples. ART contributes a significant risk of congenital malformation and may be more pronounced for multiples. Accurate counseling for parents considering ART and multidisciplinary coordination of care prior to delivery are warranted.


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