***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Abstract 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 prospect i ve 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 OBJECTIVE To determine the growth and physical outcome at 2 years of age for children born after assisted reproductive techniques in the state of Victoria . DESIGN Using a case-matched control study between January 1991 and July 1993 , 314 children ( 196 singletons , 47 sets of twins , 8 sets of triplets ) conceived after in vitro fertilization ( IVF ) and related techniques at the Monash IVF and Royal Women 's Hospital Reproductive Biology Unit and 150 control children ( 113 singletons , 17 sets of twins , 1 set of triplets ) r and omly selected from the general population using the Victorian Perinatal Data Collection Unit records were enrolled to be examined for minor dysmorphic and major organ abnormalities . Singleton and twin cases were matched for plurality and gestation and date of birth . Triplets were not matched . RESULTS IVF status was not a significant independent factor for physical outcomes , including malformation rates , nor for days of hospitalization postdischarge and operations . There was no significant interaction between IVF status and mean percentiles for weight and head circumference . The IVF group had a greater mean length percentile . Twins in both groups had significantly poorer physical outcomes than singletons on some measures . CONCLUSION This study did not demonstrate an independent IVF effect on the growth and physical outcome of children at 2 years of age when matched for plurality and gestation . The poor outcomes where noted were related to the effects of multiple births . These findings must be viewed in context of the response rates and therefore representativeness of the data . The need for longitudinal studies is demonstrated BACKGROUND While intrauterine insemination ( IUI ) , a simple , inexpensive and non-invasive technique , is the most used assisted reproduction technology ( ART ) worldwide , the risk of major birth defects following IUI is paradoxically not well documented . METHODS Retrospective cohort study performed in Burgundy , France , over a 9-year period which consisted of the cross analysis of two prospect i ve data bases , the Burgundy perinatal network data base and the data base of the assisted conception units in Burgundy . A total of 1348 ART singletons [ in vitro fertilization technologies ( IVFT ) :  n= 903 ;  IUI :  n= 445 ] matched with 4044 infants conceived naturally , 552 ART twins ( IVFT :  n= 362 ; IUI : n= 190 ) matched with 1656 twins who were conceived naturally . The major birth defects were categorized according to the European Surveillance of Congenital Anomalies classification EUROCAT . RESULTS Compared with naturally conceived singletons , singletons born after IUI and IVFT had a higher prevalence of major congenital malformations , with adjusted odd ratios ( AOR ) of 2.0 [ 95 % confidence interval ( CI ) 1.0 - 3.8 ] and 2.0 ( CI 1.3 - 3.1 ) ; 3.6 and 4.2 % of infants born , respectively . All twins and unlike-sex twins born after IVFT but not IUI , have an increased prevalence of major birth defects compared with naturally conceived twins ; AOR of 3.0 ( CI 1.6 - 5.6 ) and 3.7 ( CI 1.1 - 16.9 ) , respectively . When comparing IUI with IVFT , no differences were observed for singletons ( AOR 1.0 ; CI 0.4 - 2.2 ) , all twins ( AOR 0.4 ; CI 0.1 - 1.2 ) and unlike-sex twins ( AOR 0.3 ; CI 0.1 - 4.5 ) . CONCLUSIONS The risk of major birth defects in singletons conceived through IUI was increased over naturally conceived singletons . This risk was no different from that observed after IVFT OBJECTIVE To study the occurrence of major congenital anomalies ( CAs ) among children born after IVF ( IVF , microinjections , and frozen embryo transfers ) and after ovulation inductions with or without insemination ( other assisted reproductive technologies [ ART ] ) .  DESIGN Register-based study . SETTING Data regarding CAs were obtained from the Register of Congenital Malformations . PATIENT(S ) Children from IVF ( n = 4,559 ) , children from other ART ( n = 4,467 ) , and controls ( n = 27,078 , a r and om sample of naturally conceived children ) from the Medical Birth Register . INTERVENTION(S ) In vitro fertilization and other ART treatment in ordinary practice . MAIN OUTCOME MEASURE(S ) Rate of major CAs . Children from IVF and other ART were compared with control children , both overall and by plurality , controlling for confounding factors by logistic regression . RESULT ( S ) For IVF children , the adjusted odds ratio ( OR ) was 1.3 ( 95 % confidence interval [ CI ] , 1.1 - 1.6 ) . Stratifying by gender and plurality showed that the risk was only increased for boys , and the risk was decreased for multiple IVF girls ( OR = 0.5 , 95 % CI 0.2 - 0.9 ) . The crude OR of major CA for other ART children was 1.3 ( 95 % CI 1.1 - 1.5 ) , but adjusted differences by gender and plurality were statistically insignificant . CONCLUSION ( S ) In vitro fertilization was associated with an increased risk for major CAs among singleton boys and a decreased risk among multiple girls . The risk after other ART was only slightly increased OBJECTIVE To determine pregnancy course and major malformation rate  after intracytoplasmic sperm injection ( ICSI ) .  DESIGN Prospect i ve , controlled , multicenter , nationwide German cohort study . SETTING Tertiary infertility centers in Germany . PATIENT(S ) Three thous and three hundred seventy-two children and fetuses and 8,016 children and fetuses after the 16th week of gestation in pregnancies after ICSI and natural conception , respectively . INTERVENTION(S ) St and ardized prospect i ve follow-up . MAIN OUTCOME MEASURE(S ) Major malformation rate . RESULT ( S ) The major malformation rate was 8.7 % ( 295/3,372 ) for the ICSI cohort and 6.1 % ( 488/8,016 ) for the population -based control cohort ( relative risk , 1.44 [ 1.25 - 1.65 ] ) . After adjustment for risk factors , the risk declined ( adjusted odds ratio , 1.24 [ 95 % CI , 1.02 - 1.50 ] ) . Regarding singletons , there was a significant difference for birth weight and gestational age , with a higher number of preterm and low birth weight children in pregnancies achieved after ICSI . CONCLUSION ( S ) Children who are born after intracytoplasmic sperm injection have an increased risk of a major congenital malformation compared with those born after spontaneous conception . This risk is mainly due to paternal and maternal risk factors , which are more prevalent in couples who use ICSI for reproduction . An infertility-linked risk is highly probable for the observed findings . A technique-related risk , however , can not be ruled out OBJECTIVE To examine infant outcome of singletons born after cryopreservation of embryos ( Cryo ) .  DESIGN National population -based controlled follow-up study . SETTING Denmark , 1995 - 2007 . PATIENT(S ) The study population was 957 Cryo singletons ( Cryo-IVF , n=660 ; Cryo-ICSI , n=244 ; Cryo-IVF/-ICSI , n=53 ) . The first control group was all singletons born after fresh IVF or intracytoplasmic sperm injection ( ICSI ) during the same period ( IVF  , n=6904 ; ICSI , n=3425 ) . The second control group comprised a r and om sample of non-assisted reproductive technology ( ART ) singletons ( n=4800 ) . INTERVENTION(S ) All observations were obtained from national registers . MAIN OUTCOME MEASURE(S ) Low birth weight ( LBW ; < 2500 g ) , preterm birth ( PTB ; < 37 weeks ) , congenital malformations , mortality , and morbidity . RESULT ( S ) Birth weight was higher in Cryo ( mean=3578 g , SD=625 ) versus fresh ( mean=3373 g , SD=648 ) and in Cryo versus non-ART ( mean=3537 g , SD=572 ) , and this was also the case for first birth only . Lower adjusted risk of LBW ( odds ratio [OR]=0.63 ; 95 % confidence interval [ CI ] , 0.45 - 0.87 ) and PTB ( OR=0.70 ; 95 % CI , 0.53 - 0.92 ) was observed in Cryo versus fresh . Similar LBW and PTB rates were observed when comparing Cryo with non-ART , but the perinatal mortality rate was doubled in Cryo ( 1.6 % ) compared with non-ART ( 0.8 % ) singletons , and the adjusted risks of very preterm birth ( < 34 weeks ) and neonatal admittance were also significantly increased . No significant differences in the prevalence rates of birth defects , neurological sequelae , malignancies , and imprinting-related diseases were observed between the Cryo and the two control groups . However higher malformation and cerebral palsy rates were observed in the total Fresh vs. non-ART group . CONCLUSION ( S ) Cryo singletons have better neonatal outcome than offspring after fresh ET but poorer compared with non-ART singletons Prevention of congenital cardiovascular defects has been hampered by a lack of information about modifiable risk factors for abnormalities in cardiac development . Over the past decade , there have been major breakthroughs in the underst and ing of inherited causes of congenital heart disease , including the identification of specific genetic abnormalities for some types of malformations . Although relatively less information has been available on noninherited modifiable factors that may have an adverse effect on the fetal heart , there is a growing body of epidemiological literature on this topic . This statement summarizes the currently available literature on potential fetal exposures that might alter risk for cardiovascular defects . Information is summarized for periconceptional multivitamin or folic acid intake , which may reduce the risk of cardiac disease in the fetus , and for additional types of potential exposures that may increase the risk , including maternal illnesses , maternal therapeutic and nontherapeutic drug exposures , environmental exposures , and paternal exposures . Information is highlighted regarding definitive risk factors such as maternal rubella ; phenylketonuria ; pregestational diabetes ; exposure to thalidomide , vitamin A cogeners , or retinoids ; and indomethacin tocolysis . Caveats regarding interpretation of possible exposure- outcome relationships from case-control studies are given because this type of study has provided most of the available information . Guidelines for prospect i ve parents that could reduce the likelihood that their child will have a major cardiac malformation are given . Issues related to pregnancy monitoring are discussed . Knowledge gaps and future sources of new information on risk factors are described . ( Circulation . 2007;115:2995 - 3014 . 
    Output:
    
Fetuses conceived with IVF/ICSI methods are at an increased risk of developing CHD compared with those conceived spontaneously .