O-26: Comparison of Congenital Malformation of Infants Conceived by Assisted Reproductive Techniques versus Infants with Natural Conception in Tehran

Background: In many countries, 1% to 3% of newborn infants are conceived by Assisted Reproductive Techniques (ART). Despite the success of ART, there is concern about the risk of congenital malformations among these infants. We report our experience to determine whether use of ART is associated with an increase in major congenital malformations or adverse pregnancy outcomes Materials and Methods: We performed a historical cohort study of major congenital malformations (MCM) in 978 births from January 2008 to December 2010. The data for this analysis were derived from Tehran's ART linked data file. In our study, the risk of congenital malformations was compared in 326 ART infants and 652 naturally conceived (NC) infants. Results: We found 56 infants with major congenital malformations: these included 29 NC infants (4.4%) and 27 ART infants (8.3%). In comparison with NC infants, ART infants had a significant 1.94-fold increased risk of MCM. After adjustment for sex, maternal age, stillbirth, abortion and type of delivery, we found a significant difference in risk (OR=2.04, 95% CI: 0.92-4.5). The preva lence rate for the ICSI group was 6.5% for the IVF group was 15.9% or 2.73-fold higher than ICSI group (p=0.018 and 95% CI: 1.18-6.3). Conclusion: Our study shows an overall increase in major congenital malformations after ART when compared with naturally conceived births. This is consistent with other similar studies. We also found evidence of a difference in risk of MCM between IVF and ICSI. When examining the type of malformations, musculoskeletal and urogenital abnormalities were the most frequently reported MCMs in ART infants. Musculoskeletal, cardiovascular and endocrine abnormalities have been reported more commonly in ART infants than in NC infants. More visual, nervous and genetic disorders were reported in NC infants than in ART infants.