Los tratamientos de esterilidad se asocían a mayor número de malformaciones

Los niños concebidos con tratamientos para la esterilidad tienen el riesgo de malformaciones multiplicado por 2 a 4 veces en comparación con los concebidos sin tratamientos. Los resultados epidemiológicos han sido presentedos por Jennita Reefhuis del U.S. Centers for Disease Control and Prevention.

Por ejemplo, los riesgos de comunicación cardiaca (persistencia de un orificio innecesario en la vida extrauterina) se multiplica por 2 o por 3. El labio leporino también se multiplica por 2 o por 3. Las malformaciones dgestivas se multiplican por 4. A pesar de estas cifras, los casos de malformaciones son un número reducido. De todas maneras, muchas parejas no reciben información sobre los riesgos de las técnicas de reproducción asistida y se acumulan malformaciones para las generaciones posteriores. Muchas de las malformaciones no son letales. Globalmente se calcula que el 3% de los casos tienen algún problema.

Reefhuis J, Honein MA, Schieve LA, Correa A, Hobbs CA, Rasmussen SA; and the National Birth Defects Prevention Study. Assisted reproductive technology and major structural birth defects in the United States. Hum Reprod. 2008 Nov 16.

BACKGROUND With >1% of US births occurring following use of assisted reproductive technology (ART), it is critical to examine whether ART is associated with birth defects. METHODS We analyzed data from the National Birth Defects Prevention Study, a population-based, multicenter, case-control study of birth defects. We included mothers of fetuses or live-born infants with a major birth defect (case infants) and mothers who had live-born infants who did not have a major birth defect (control infants), delivered during the period October 1997-December 2003. We compared mothers who reported ART use (IVF or ICSI) with those who had unassisted conceptions. Multiple logistic regression was used to adjust for the following confounders: maternal race/ethnicity, maternal age, smoking and parity; we stratified by plurality. RESULTS ART was reported by 1.1% of all control mothers, and by 4.5% of control mothers 35 years or older. Among singleton births, ART was associated with septal heart defects (adjusted odds ratio [aOR] = 2.1, 95% confidence intervals [CI] 1.1-4.0), cleft lip with or without cleft palate (aOR = 2.4, 95% CI 1.2-5.1), esophageal atresia (aOR = 4.5, 95% CI 1.9-10.5) and anorectal atresia (aOR = 3.7, 95% CI 1.5-9.1). Among multiple births, ART was not significantly associated with any of the birth defects studied. CONCLUSIONS These findings suggest that some birth defects occur more often among infants conceived with ART. Although the mechanism is not clear, couples considering ART should be informed of all potential risks and benefits.

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