Practitioner reporting of birth defects in children born following assisted reproductive technology: Does it still have a role in surveillance of birth defects?

Pneumoperitoneum in in-vitro Conceived Quadruplet Neonate: Rare Manifestation of Hirschsprung's Disease--Report of a Case

INTRODUCTION

Hirschsprung's disease is a congenital colonic aganglionosis, usually presented as inability or difficulty in passing of meconium, chronic and persistent obstipation, maleficent feeding, vomiting, distension and lethargy.

CASE PRESENTATION

We presented a case of an in-vitro conceived quadruplet premature neonate who presented with pneumoperitoneum caused by transverse colon spontaneous perforation and microcolon appearance of distal bowel, treated by resection and temporary colostomy turns to be a rare manifestation of Hirschsprung's disease.

CONCLUSION

Assisted reproductive technologies increases chances for multiple pregnancies and may increase chance for major congenital anomalies. Rare manifestation of Hirschsprung's disease is spontaneous pneumoperitoneum which remains a surgical emergency. Delay in recognizing and treatment can significantly worsen prognosis. In neonate with intestinal perforation one should consider Hirschsprung's disease.

Intracytoplasmic sperm injection (ICSI)--what are the risks?

In vitro fertilization used in combination with intracytoplasmic sperm injection allows otherwise sterile couples to become parents. Despite recent studies on the safety of these technologies, there is still only an incomplete picture of the risks associated with the usage of these assisted reproductive techniques to offspring. The risk of multiple gestations continues to be of major concern because of its association with low birth weight, preterm delivery, and increased perinatal mortality. This article outlines the risks associated with in vitro fertilization/intracytoplasmic sperm injection as a well-defined treatment for couples with severe male factor infertility.

Safety of assisted reproduction, assessed by risk of abnormalities in children born after use of in vitro fertilization techniques

Assisted reproductive technologies are increasingly used in the treatment of both male and female infertility. The techniques, including in vitro fertilization, with or without intracytoplasmic sperm injection as an adjunctive treatment, represent a tremendous step forward for infertile couples who previously had no treatment options. As we move towards the 30(th) anniversary of the birth of the first baby conceived by in vitro fertilization, questions about the safety of these procedures linger. We review here the available literature regarding the safety of assisted reproductive technologies; these data are made far more robust by the inclusion of long-term follow-up data from the first generation of children arising after the introduction of these technologies.