OP04.09: Impact of assisted reproductive techniques on congenital heart disease: insights from a tertiary care centre and literature review

We aim to define if there is any correlation between congenital heart disease (CHD) and assisted reproductive techniques (ART) techniques, considering subcategories of CHD based on anato-embryological criteria, and the severity of the disease. This retrospective cohort study included singleton euploid fetuses conceived spontaneously and by ART referred for fetal echocardiography to IRCCS Sant'Orsola-Malpighi Polyclinic, Bologna, between January 2005 and November 2023. The authors carried out a review of the literature from 2004 to 2024 using PubMed/MEDLINE and Scopus bibliographic databases. Fetal CHDs were classified into six anato-embriological categories: left ventricle outflow tract diseases; conotruncal abnormalities (CNTRA); valvular diseases; right heart anomalies (RHA); atrioventricular septal defects; heart rhythm diseases. CHDs were further graded according to the severity of lesions in severe (life-threatening lesions), moderate (diseases requiring expert care) or mild (asymptomatic disease). Among 1109 cases, 1006 were spontaneous, 65 were conceived through intracytoplasmic sperm injection (ICSI) and 38 through in vitro fertilization (IVF). CHD's prevalence was significantly higher in ART-conceived fetuses (92.2%) than in spontaneous pregnancies (62.5%) (RR = 1,5). Severe CHD was more frequent in ART pregnancies (62.1%) compared to natural ones (38.7%) (RR = 2,3). ICSI-conceived fetuses had a higher risk of severe CHD (69.2%, RR = 1.8), CNTRA (RR = 1.6) and RHA (RR = 3.5) compared to IVF and natural conception. Conversely, IVF pregnancies exhibited a significant higher risk of mild CHD (RR = 2.8). This study highlights a relevant association between conception techniques, type and severity of CHD among fetuses ART-conceived. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.