Dados do Trabalho

Title

IS THERE ANY RELATION OF ASSISTED REPRODUCTION TECHINIQUES AND CONGEITAL ANOMALIES?

Objective

Therefore, this study aims to investigate the incidence of CA in live births from assisted human reproduction.

Methods

This is a bibliographic review made from scientific articles indexed in Portuguese and English, between the years 2006 to 2023 in the databases available for access to PubMed, Scielo and the Health System; The search was done through the key words "congenital anomaly" and "assisted reproduction". Publications from all areas of knowledge were selected, which resulted in 14 articles, 8 articles remained, of which they were used in the course of this work.

Results

According to the Health System, CAs are a group of structural or functional changes that occur during intrauterine life and that can be detected before, during or after the birth of the fetus, these changes are mainly of genetic origin, in addition to possible infectious, nutritional or environmental causes [2]. The Information System on Live Births (SINASC) points out that about 25 thousand Brazilian live births are registered annually with some type of CA, for this reason Law No. 13,685, of June 25, 2018 regulates, in Brazil, the CAs as compulsory in SINASC [3]. A study done by the State Medical University of Botucatu with the Child Development Monitoring Center of Ribeirão Preto compared the rates of live births conceived by intracytoplasmic sperm injection (ICSI) with the general population that has some of the CAs and found that about 2.9% of this first group progressed with some major congenital malformation (MCM), This value when compared with the second group shows references close to the expected of 2.6% [4]. In agreement with this, a study conducted in 2012 demonstrated that babies conceived by ART have a significant risk of presenting some congenital anomaly when compared to children who are conceived naturally, with an OR of 1.37; this same study showed that between in vitro fertilization (IVF) and ICSI, there is no significant difference in the rates of CAs [5]. In 2012 the American Association of Pediatrics pointed out that about 9% of IVF cases had CAs, which showed an increase of 2.3% in relation to natural pregnancies where 6.6% of children in this same profile were found [6]. A 2019 study in India compared the prevalence of CAs in ART pregnancies with those of spontaneous conceptions and pointed out that births resulting from IVF or ICSI pregnancies do not tend to have a higher rate of birth defects [7]. In 2021 epidemiology and health services released a list of priority CAs for surveillance, pointing out as such: neural tube defects, microcephaly, congenital heart defects, oral clefts, genital organ anomaly, limb defect, abdominal wall defect and Down syndrome, respectively [2;8].

Conclusion

Different studies are still conflicting regarding the differentiation of the rates of congenital malformation in groups submitted to ART. The slightly increased rates in certain studies may come from the surveillance modality adopted in the country, in addition to early detection in pregnancies after IVF or ICSI; in Brazil, compulsory notification and greater monitoring of epidemiological surveillance have been shown to be important to establish public policies for care, education and health care. Given these points, a study with a larger sample size is necessary for a better understanding of the prevalence, incidence and relation of ART with CAs.

Keywords

Congenital Anomaly; Assisted Reproduction