Reproductive planning in times of Zika: getting pregnant or delaying plans? The opinion of the Brazilian Society of Assisted Reproduction Committee - a basis for a bioethical discussion.

Although the causality between Zika virus, microcephaly, and other central nervous system disorders has been taken for granted by the scientific community, many uncertainties remain. The gap of knowledge at the moment is large enough to remove part of the confidence physicians have on the advice given to patients - and infertile women in particular - on their reproductive plans. Pretreatment serologic screening is a possible strategy to offer more confidence for individuals choosing to bear children regardless of the Zika virus, but the tests currently available do not seem to be sufficiently adequate. Until now, there is no formal recommendation to avoid pregnancy solely because of the Zika virus outbreak, and the choice of becoming pregnant has been regarded as a personal decision to be made by each woman and her family.

Incidence and anatomy of cardiac malformations in children conceived by assisted reproduction techniques - A review.

The aim of this study is to identify the occurrence of cardiac malformations occurred in children conceived by assisted reproduction techniques (ART) in the international literature in Medline database from 1999 to 2012. The search returned data on 32,000 births, whose 21,000 were conceived naturally and 11,000 were conceived by ICSI and/or IVF. The incidence of cardiac malformations in general population situations was 0.4%. The incidence of cardiac malformations by ART was 1.8% from ICSI and IVF. Among the situations of conceived naturally was observed 88 cases of cardiac malformations, which were: Atrial Septal Defect: 26 cases 29.55%, Change in the interventricular septum: 18 cases 20.45%, coarctation of the aorta: 13 cases 14.77%, aortic stenosis: 11 cases 12.5%, tetralogy of Fallot: 5.68% 5 cases, stenosis of the pulmonary trunk: 5 cases 5.68% other: 11.37% 10 cases. In cases of cardiac malformations in children conceived by IVF and ICSI, 198 cases were found, which were: CIA: 58 cases 29.30%, Change in the interventricular septum: 37 cases 18.69%, coarctation of the aorta: 20 cases 10.10%, aortic stenosis: 18 cases 9.09%, tetralogy of Fallot: 11 cases 5.55%, stenosis of the pulmonary trunk: 6 cases 3.03%, Other: 48 cases 24.24%. There remain opened questions about infertility and risk factors involving ART. Further research is clearly required. Health care providers should counsel infertile couples seeking assisted reproduction by IVF and technology.