Assisted reproductive technology: reassuring findings on childhood outcomes

By Melanie Hinze

Reassuring new research finds several childhood outcomes  of children conceived  by assisted reproductive technology (ART) to be equivalent to the outcomes of spontaneously conceived children.

An Australian study, published in PLOS Medicine, found that the school-age developmental and educational outcomes for children conceived by in vitro fertilisation (IVF) were equivalent to those of spontaneously conceived children.

The study population included all singleton live births in Victoria between 2005 and 2014 and who had school-age development and educational outcomes assessed. Overall, 585,659 children were included, 11,059 of whom were conceived via IVF.

The study authors assessed childhood developmental vulnerability at school entry (age 4 to 6 years) using the Australian Early Developmental Census. They also assessed the children’s National Assessment Programme – Literacy and Numeracy (NAPLAN) results at age 7 to 9 years.

Compared with spontaneously conceived children, the researchers found no causal effects of IVF conception on the risk of developmental vulnerability at school-entry nor on the NAPLAN overall z-score. These results were seen after adjusting for sex at birth, age at assessment, language background other than English, socioeconomic status, maternal age, parity and education.

Lead author of the study,  Dr Amber Kennedy, an Obstetrician and Gynaecologist at Mercy Hospital  for Women; Fertility Specialist with Newlife IVF; and PhD candidate at the University  of Melbourne, Melbourne, said children conceived by IVF comprised a significant and growing portion of the population worldwide. In Australia, this has grown from 2% of births in the year 2000 to nearly 5% today.

‘Consequently, it is vital to understand the longer term outcomes for this population of children,’ she said.

‘This population-wide study using robust epidemiological methods finds that IVF-conceived children are equivalent to their peers in early schooling, which is highly reassuring for parents and clinicians,’ she added.

In further reassuring news for current and prospective parents and clinicians, research published in the European Heart Journal found no significant differences in cardiometabolic outcomes in children conceived via ART compared with those conceived spontaneously.

The meta-analysis of more than 35,000 children, mostly aged younger than 10 years, found no significant differences in blood pressure, heart rate, triglycerides or hyperglycaemic/ insulin resistance traits between IVF and spontaneously conceived children.

Cardiovascular Epidemiologist, Professor Christopher Reid, who is Director of the Curtin Centre for Clinical Research and Education and Dean of Graduate Research at John Curtin University, Perth, said that this was an important contribution to our understanding of longer term health outcomes in children conceived via ART.

‘It is a well-conducted global meta-analysis which increases the generalisability of the findings, which essentially report similar cardiovascular risk factor profile projections across life spans to spontaneously conceived people,’ he said.

‘These are reassuring findings and further cohort follow up will determine longer term cardiovascular disease event rates and outcomes in these groups,’ he added.

PLOS Med 2023; https://doi.org/10.1371/journal.pmed.1004148.
Eur Heart J 2023; ehac726, https://doi.org/10.1093/eurheartj/ehac726.