Highlights from ASRM09: ART Outcomes: IVF Kids Are Healthy, Smart and Well-Behaved, although Multiple Gestation Leads to Lower Scores on the Iowa Test of Basic Skills
ASRM,
28 October 2009

Atlanta, GA – Research presented at ASRM’s 65th Annual Meeting addressed questions about how ART might affect the development of the children who result.

Surveying parents, University of Pennsylvania researchers found that children conceived with IVF showed the same number of abnormal childhood behaviors as children conceived without IVF as measured by a validated behavioral assessment instrument. Women who delivered a child at the University of Pennsylvania Hospital between 2000 and 2005 were invited to answer a questionnaire and the Child Behavior Checklist. In total, those who responded had 105 IVF-conceived children and 108 control children. The groups were not different with respect to child age, pregnancy complications, birth weight, gestational age or maternal education. There were statistically significant differences in parental age and family size that are not clinically significant. There were no significant differences between the groups in the prevalence of individual behavioral symptoms. The prevalence of any behavioral symptom was similar between children conceived with (10.5%) and without IVF (10.2%).

In the largest report on achievement test performance of IVF-conceived children to date, researchers from the University of Iowa used scores from the Iowa Tests of Basic Skills (ITBS) to compare achievement test performance of singletons, twins and triplet children conceived through IVF. The IVF database at the University of Iowa Hospital Center was mined for cycles resulting in children presently between eight and 17 years old. Questionnaires on the childrens’ health and education and parents’ education were mailed to parents and 295 couples having 462 children agreed to participate. Of the children, 49% were singletons; 40% were twins and 11% were triplets. Third grade ITBS scores were used to compare the performance of singletons, twins and triplets. Although multiple gestation appears to have a slight detrimental effect on standardized test performance, the overall scores were high and the differences between singletons, twins and triplets were small.

Parents’ infertility influences birthweight and size whether their children are conceived through IVF or spontaneously. Although research suggests that babies born as a result of IVF are smaller and have more adverse outcomes than spontaneously conceived children, the underlying health of the parents may play a role in their offspring’s health regardless of the mode of conception. In a retrospective study, researchers at the University of Washington School of Medicine analyzed data from patients receiving an infertility diagnosis who had a live singleton birth at the hospital between 1999 and 2009. Well-dated spontaneous conceptions were analyzed along with pregnancies from ovulation induction (OI) and from fresh, non-donor IVF cycles. They found that the ART-conceived babies were larger in early gestation than OI and spontaneously conceived babies yet in mid-gestation, ART babies were smaller than spontaneously-conceived and equal in size to OI babies. By the time of delivery, OI conceived babies were smaller than babies conceived spontaneously or through ART. Ultimately, singleton IVF babies were not smaller compared to singletons born to spontaneously conceiving infertility patients.

Elizabeth Ginsburg, MD, President of SART, remarked, “The health and development of children born through ART has always been of great concern. While further study is needed on the ways parents’ underlying conditions and fertility treatments may affect children’s development, we can be reassured that overall, ART children appear to be healthy.”

In vitro maturation (IVM) of eggs is a developing technique which allows IVF to be done without ovarian stimulation. Because data are limited on the outcomes for children born from this treatment, French researchers have embarked on an ongoing prospective observational study.

Thirty-five children born from 32 IVM pregnancies were included in the group and compared to IVF/ICSI children matched for maternal age, gestational age and singleton or twin birth. Children were clinically examined at one year of age. The researchers found that at one year of age, children resulting from IVM procedures do not differ significantly in developmental or clinical respects from children conceived using IVF/ICSI.





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