Meta-analysis links assisted reproduction to higher congenital heart defect odds

A meta-analysis of 35 observational studies compared 604,641 ART-conceived children or foetuses with more than 42 million naturally conceived controls. ART conception was associated with higher adjusted odds of congenital heart defects, particularly major defects, but the authors found no support for additional foetal echocardiography based on ART alone where routine anomaly screening is offered.

Review included 35 observational studies and 604,641 ART-conceived children or foetuses.
Adjusted odds of any congenital heart defect were 53% higher.
Major defects showed an association; minor-defect evidence was inconclusive.
Authors found no support for ART-only echocardiography alongside routine anomaly screening.

A systematic review and meta-analysis in Human Reproduction Update assessed congenital heart defects (CHDs) after assisted reproductive technology (ART), addressing uncertainty about screening recommendations. It included 29 retrospective cohort studies and six case–control studies comparing 604,641 ART-conceived children or foetuses with 42,021,027 naturally conceived controls. Searches were updated in March 2026; outcomes included overall CHD prevalence and adjusted associations by severity, treatment method and plurality.

Across the cohort studies, pooled CHD prevalence was 2.62% (95% CI 1.14–4.65) after ART and 1.44% (0.49–2.85) after natural conception. Fifteen studies covering 33,019,895 children provided adjusted estimates, yielding a pooled odds ratio of 1.53 (95% CI 1.30–1.79) for any CHD. The association was evident for major CHD (1.77; 1.30–2.41), while evidence for minor CHD was inconclusive (1.62; 0.55–4.81). Subgroup analyses detected no differences by ICSI versus IVF, frozen versus fresh transfer, or singleton versus multiple birth.

Absolute prevalence remained low. The authors concluded that current evidence does not support additional foetal echocardiography solely for ART conception where routine mid-trimester anomaly screening is available. Risk of bias ranged from low to high, and adjustment beyond maternal age varied. These observational data cannot separate effects of ART procedures from underlying infertility and related parental factors. This report is based on the abstract; full text was unavailable.

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Human Reproduction Update: Congenital heart defects in children conceived through assisted reproductive technology: a systematic review and meta-analysis ↗

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