Does assisted reproductive technology cause birth defects?

PURPOSE OF REVIEW: Observational studies have reported small but increased risk of birth defects associated with assisted reproductive technology (ART) pregnancies. We intend to review the current data on this issue to provide essential information for patient counseling. RECENT FINDINGS: There is lack of consensus on whether ART per se increases the risk of birth defects, genetic and imprinting disorders, mostly due to the bias inherent to the observational studies, which suggest 30-40% increased risk of birth defects with ART. Recent reports suggest that apparent risks for adverse outcome following ART may be largely related to parental infertility-linked factors. Criteria used to define birth defects bring challenges as well. SUMMARY: All couples undergoing these procedures should be counseled about the current information suggesting elevated risks of birth defects, genetic abnormalities and imprinting disorders associated with infertility and the infertility treatment with ART. In order to elucidate the controversy whether ART is associated with adverse outcome in the offspring, a multinational collaborative effort is needed, as the required sample size is between 10 000 and 84 000 or more.