Is intracytoplasmic sperm injection (ICSI) associated with higher incidence of congenital anomalies? A single center prospective controlled study in Egypt.

Objective: To compare the incidence of congenital anomalies by ultrasound in intracytoplasmic sperm injection (ICSI) pregnancies and in spontaneous pregnancies with correlation to the neonatal outcome.

Methods: This is a prospective comparative study carried out in Kasr Al Aini Hospital Cairo University from January 2010 to December 2012, comparing 739 pregnant women conceived through ICSI and 843 pregnant women conceived spontaneously as regard to incidence of congenital anomalies, multiple pregnancy, preterm labor, cesarean section and neonatal outcome.

Results: The number of anomalies diagnosed by antenatal ultrasound in ICSI group was 14 (1.62%) while in spontaneous group was 13 (1.51%). The number of anomalies detected by postnatal examination in ICSI group was 20 (2.31%) while in spontaneous group was 16 (1.86%) (Odds ratio [OR] 1.438; 95% confidence interval [CI] 0.739-2.796). ICSI group was associated with higher incidence of twins 12.7% (p < 0.001), preterm labor 3.8% (p 0.022), preterm premature rupture of membranes 4.6% (p 0.001), cesarean section 74.1% (p < 0.001) and neonatal deaths 10.4% (p < 0.001).

Conclusion: ICSI was associated with higher incidence of multiple pregnancy and cesarean section, with no difference in the incidence of congenital anomalies compared to spontaneous conception.