Dr. Potter on ICSI and birth defects
Quote:
Originally Posted by
Possible pink?
Hi Dr. Potter,
Another question. I am thinking that I should not have told my Mom about our plans to pursue IVF for GS, however I did and am too late. My mom called today, freaking out because she read an article that originated in the NYT about research that indicates that babies born with IVF and especially with ICSI were at a 28% greater risk for birth defects. The article did give a sample size of over 300,000 but it did not say if the study controlled for age or multiples so this may play a role...
Anyway are you aware that there is a 28% increased chance of birth defects on IVF (specifically using ICSI) babies than not.
We are cycling with you in October and I know you have experience with ICSI
Thanks so much for your help!
We have certainly not seen any increase in birth defects in our patients. There are reports of increased chromosomal abnormalities with ICSI but these are generally deletions on the Y chromosome that are inherited from the father and not caused by the ICSI but are in fact the cause of the low sperm count that caused ICSI to be used. The problem with this and other reports like it are that they generally are written by epidemiologists. Epidemiologist will often, as in this article, start with a conclusion and assemble the data to support it. It does not take into account the reporting bias that occurs when you compare fertility patients to the unselected pool of all births. These rates of abnormalities where much higher than we saw in the MicroSort clinical trial or that are seen in the US so I am not sure what their definition of a birth defect was defined or how they selected who was part of the study populations. This is not the first such report from this source. It also does not address the way patients were selected for ICSI versus those that were conventional. It further seems to imply causation from association which is the typical sin of the epidemiologist. I would wait to see if other reports are available. The majority of IVF cycles in the US are ICSI at this point. We are not seeing this. I hope that this helps. Here a link to the article:
[url=http://www.nejm.org/doi/full/10.1056/NEJMoa1008095]
