Effects of infertility duration and aetiology, parental factors and ART on the risk of congenital anomalies: a comprehensive review.

Infertility, affecting one in six people, represents an important global public health issue. Assisted reproductive technology (ART) provides effective treatment options, but concerns remain regarding its safety, particularly in relation to the potential risk of congenital anomalies. This literature review aims to synthesize current evidence on the association between infertility, ART and the occurrence of congenital anomalies. A comprehensive search of the MEDLINE, PubMed and Embase databases was made. In total, 727 references were obtained according to the search criteria. The full text of 393 articles was evaluated, and 143 articles were included in the review. The literature indicates increased risk of congenital anomalies both in individuals with infertility and in those who conceived using ART. Assessing the risk of congenital anomalies in the context of ART is complex due to the presence of numerous confounding factors, some of which are linked to parental characteristics. Notably, some types of congenital anomaly, such as congenital heart defects, genitourinary anomalies and genetic disorders, are reported more frequently in association with ART. In conclusion, the current literature suggests increased risk of congenital anomalies associated with ART. This underscores the need for further research to elucidate the underlying mechanisms and inform clinical strategies aimed at reducing this risk.