caa a22 4500 44581764X CHVBK 20180317145233.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1007/s10815-011-9583-z doi (NATIONALLICENCE)springer-10.1007/s10815-011-9583-z A meta-analysis of the impact of IVF and ICSI on major malformations after adjusting for the effect of subfertility [Elektronische Daten] [Alfred Rimm, Alyce Katayama, K. Katayama] Objective: To estimate the effect of assisted reproductive technology (ART) on major malformation (MM) rate in ART offspring independent of the effect of subfertility on MM. Design: Meta-analysis. Methods: This meta-analysis is based on our previously published meta-analysis of observational studies evaluating the relationship between ART treatment and MM rates, as well as recent research by Zhu et al. to estimate the impact of subfertility alone on MM in subfertile couples conceiving spontaneously. Results: The overall odds ratio for MM in our original meta-analysis, in which all studies used apparently inappropriate control groups of "normal” populations, was 1.29 (95% CI 1.01-1.67). Here we attempted to estimate the risk of subfertility and used this estimate to perform an adjusted meta-analysis. Zhu et al. found that about 40% of the odds of MM was due to subfertility. When we took Zhu's finding into account, the adjusted odds ratio in the meta-analysis was 1.01 (95% CI 0.82-1.23). Conclusions: Our study suggests ART does not increase the risk of MM as much as previously reported. More research is needed to quantify the underlying risk of subfertility and separate it from the risk associated with ART. Physicians who counsel subfertile couples should recognize that previous studies of MM rates in ART patients probably overestimated the risk. Springer Science+Business Media, LLC, 2011 Subfertility and major malformations nationallicence ART outcomes nationallicence Meta-analysis nationallicence IVF/ICSI outcomes nationallicence Rimm Alfred Department of Epidemiology and Biostatistics, Case Western Reserve University School of Medicine, Room WG-57, 10900 Euclid Avenue, 44106-4945, Cleveland, OH, USA aut Katayama Alyce Health Law Group, Quarles & Brady LLP, Milwaukee, WI, USA aut Katayama K. Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Advanced Institute of Fertility, Milwaukee, WI, USA aut Journal of Assisted Reproduction and Genetics Springer US; http://www.springer-ny.com 28/8(2011-08-01), 699-705 1058-0468 28:8<699 2011 28 10815 https://doi.org/10.1007/s10815-011-9583-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10815-011-9583-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Rimm Alfred Department of Epidemiology and Biostatistics, Case Western Reserve University School of Medicine, Room WG-57, 10900 Euclid Avenue, 44106-4945, Cleveland, OH, USA aut NATIONALLICENCE 700 1- Katayama Alyce Health Law Group, Quarles & Brady LLP, Milwaukee, WI, USA aut NATIONALLICENCE 700 1- Katayama K. Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Advanced Institute of Fertility, Milwaukee, WI, USA aut NATIONALLICENCE 773 0- Journal of Assisted Reproduction and Genetics Springer US; http://www.springer-ny.com 28/8(2011-08-01), 699-705 1058-0468 28:8<699 2011 28 10815 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer