Assisted reproductive technology may increase childhood glycemic, CV risks
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Children conceived after in vitro fertilization or intracytoplasmic sperm injection are more likely to have metabolic dysfunction during childhood than those conceived without assistive technology, according to study data.
“Offspring born after assisted reproductive technology had higher risk of metabolism dysfunction in childhood manifested as higher glucose level, decreased insulin sensitivity and secretion, and arterial stiffness,” Linlin Cui, MD, PhD, of the Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University in Jinan, China, and colleagues wrote in a study published in Diabetologia. “The underlying mechanism is still unknown, but exposure to in vitro environment during the early phase of embryo development might play a critical role.”
From November 2017 to February 2019, researchers recruited 380 children conceived through IVF or intracytoplasmic sperm injection at the Center for Reproductive Medicine at Shandong Provincial Hospital. Parents were invited to have their family participate during a routine medical exam. All children were aged 6 to 10 years at the time of the invitation and had no cardiovascular or endocrine diseases. All of those in the assisted reproductive technology group were matched by age at birth, current age and sex with children who were naturally conceived.
Researchers recorded sociodemographic and lifestyle information height, weight, BMI and blood pressure at baseline. Blood samples were used to measure fasting blood glucose, fasting insulin, cholesterol and apolipoprotein levels. An ultrasound scan was used to assess vasculature structure.
Children conceived with assisted reproductive technology had higher mean FBG (beta = 0.49; 95% CI, 0.42-0.55) and fasting insulin (beta = 0.28; 95% CI, 0.2-0.35) than children who were naturally conceived. The assisted reproductive technology group also had higher mean homeostasis model assessment of insulin resistance (HOMA-IR; beta = 0.38; 95% CI, 0.3-0.46), lower homeostasis model assessment of beta-cell function (HOMA-B; beta = –0.19; 95% CI, –0.27 to –0.11), lower total cholesterol (beta = –0.42; 95% CI, –0.55 to –0.29) and lower ApoA (beta = –0.17; 95% CI, –0.21 to –0.13) than the naturally conceived group. Children in the assisted reproductive technology cohort had greater mean carotid intima-media thickness than the control group (beta = 0.13; 95% CI, 0.12-0.13). Results were similar in children who were conceived through IVF vs. intracytoplasmic sperm injection, as well as fresh embryo transfer vs. frozen embryo transfer.
After dividing the assisted reproductive technology group into a low BMI group of less than 23 kg/m2 and a high BMI group of 23 k/m2 or greater, both groups had higher FBG, HOMA-IR and carotid intima-media thickness; and lower HOMA-B, total cholesterol and ApoA than the naturally conceived group. Researchers also divided the reproductive technology group by reason for parental infertility: tubal factor, polycystic ovary syndrome, male factor or unexplained infertility. All four subgroups had higher carotid intima-media thickness, FBG, insulin and HOMA-IR, and lower total cholesterol and ApoA than children in the control group.
“Increased metabolic and cardiovascular risk profiles in children conceived by assisted reproductive technology is of importance at the individual level as well as for the whole of society,” researchers wrote. “Continuous monitoring and early intervention should be fully considered for this group of the population.”
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