Conception by assisted reproductive technology in infants with critical congenital heart disease in Japan

Research Question Although assisted reproductive technology (ART) increases the risk of congenital heart disease (CHD), the relationship between ART and critical CHD (CCHD) that requires early intervention in neonates is unclear. The objective of this study was to investigate the proportion of ART across different types of neonatal CCHD in a Japanese population. Design This study is a retrospective analysis of 418 consecutive infants with CCHDs that required catheter treatment or surgery within the first 28 days of life or ductal-dependent lesions, in two paediatric centres in Japan, between January 2014 and December 2019. The proportion of ART in infants with each type of CCHD was evaluated. We also evaluated the proportion of ART in infants with univentricular heart defect (UVH) compared with those with biventricular heart defect (BVH). Results The study group included 229 boys and 189 girls, with a gestational age of 38±2 weeks. Overall, 61 infants (14.5%) were conceived by fertility treatment with 46 (11.0%) conceived by ART. UVH and BVH were identified in 111 infants (26.6%) and 307 infants (73.4%), respectively. The proportion of infants conceived by ART was significantly higher in UVH (16.2%) than in BVH (9.1%), regardless of maternal age and maternal history of miscarriage. Conclusions The proportion of ART in infants with CCHD, especially UVH, was high. These findings may be an important basis to consider the rationale for performing fetal echocardiography in fetuses conceived by ART.