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Early childhood development not associated with infertility treatment
Infertility treatment, regardless of type, did not affect children’s development through 3 years, after accounting for plurality, according to study data published in JAMA Pediatrics.
“Many studies … have investigated neurodevelopmental outcomes with assisted reproductive technology (ART) but the evidence remains equivocal and largely based on a few follow-up studies conducted outside of the United States,” Edwina H. Yeung, PhD, ScM, of the division of intramural population health research at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and colleagues wrote. “We designed the Upstate KIDS Study to specifically assess the association between the mode of conception and children’s development through age 3 years. Our findings are particularly important for communicating with U.S. couples seeking infertility treatment.”
The researchers conducted a prospective cohort study from 2008 to 2014, with sampling based on infertility treatment and plurality. The study focused on infants born between 2008 and 2010 in New York — excluding New York City — whose parents completed developmental screenings during the first 3 years. The researchers enrolled 4,824 mothers of 5,841 children, including 1,830 children conceived using infertility therapy and 2,074 twins.
Parents were asked to complete Ages and Stages Questionnaires — measuring for fine motor, gross motor, communication, personal-social functioning and problem-solving ability — at 4, 8, 12, 18, 24, 30 and 36 months of age.
Fertility treatment was reported by 1,422 mothers. Using ovulation induction with or without intrauterine insemination was not associated with failing any developmental domain (adjusted OR = 1.33; 95% CI, 0.94-1.89).
The investigators also wrote that ART was associated with an increased risk for failing any developmental domain (aOR = 1.81; 95% CI, 1.21-2.72), specifically personal-social functioning (aOR = 2.03; 95% CI, 1.15-3.59) and problem-solving (aOR = 2.33; 95% CI, 1.15-4.74). These results were found, however, only when singletons and twins were assessed collectively. After stratifying by plurality — adjusting for birth weight among singletons or twins — no statistically significant associations were observed between fertility treatment and failing any developmental domains.
Seventy-three children had a developmental disability, including language, learning or speech disorders (n = 49), autism spectrum disorder (n = 17), attention-deficit/hyperactivity disorder and its subtypes (n = 16), cognitive deficits (n = 6), cerebral palsy (n = 2) and sensory impairments (n = 2). Frequency of disability did not differ significantly by exposure to infertility treatment.
“We found no evidence suggesting that children’s development through age 3 years … is associated with any type of infertility treatment in comparison with children conceived without such treatments after accounting for plurality,” Yeung and colleagues wrote. “The elevated probability of delay associated with multiple births remains a risk to be weighed given the higher twinning rate after use of ART.” – by Jason Laday
Disclosure: The researchers report no relevant financial disclosures.
