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Intracytoplasmic sperm injection: offering hope for a term pregnancyand a healthy child?

BMJ 1997; 315 doi: (Published 15 November 1997) Cite this as: BMJ 1997;315:1245

We need a common approach to definition and detection of birth defects

  1. Allen A Mitchell, Associate directora
  1. a Slone Epidemiology Unit, Boston University School of Medicine, Brookline, MA 02146, USA

    One of the most recent techniques of assisted reproduction, intracytoplasmic sperm injection, offers hope for those suffering from subfertility, and particularly male factor infertility. This hope is tempered by worry, since couples who undergo this procedure might never become pregnant or, if they do, may not carry the pregnancy to term. Added to these known risks are theoretical risks regarding birth defects: intracytoplasmic sperm injection involves fertility drugs, chemical baths, and physical procedures, any of which could increase malformation rates. Moreover, if left to nature, the sperm manipulated by this procedure would probably not produce a pregnancy, and these sperm themselves may carry an increased risk for birth defects.

    Some reassurance about these theoretical concerns was offered recently when researchers from Belgium reported that major birth defects affected only 3.3% (14) of 423 children born after intracytoplasmic sperm injection,1 a rate no higher than in the general population. In the current issue, however, Kurinczuk and Bower provide a less reassuring interpretation.2 Using the classification scheme and data from the highly regarded Western Australia birth defects registry, they note that many major defects in the Belgian series …

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