The physical development of children born with the use of assisted reproductive technologies

BACKGROUND. Today, about 0.1% of the world’s population is born using assisted reproductive technology (ART). According to the National Register of ART, in our country these children represent approximately 1.5% of all children born annually. Despite such a high percentage, data on the physical development of children born using ART is contradictory.

AIMS. The aim of the study is to compare the clinical and anthropometric measurements of children born with the help of ART with those of children conceived naturally, in different age groups.

MATERIAL AND METHODS. The study included 88 children born as the result of the use of ART (Group 1) and 117 children conceived naturally (Group 2). Statistical indicators were evaluated from birth to the onset of puberty. Anthropometric measurements for both groups were analyzed, factoring for multiple pregnancy: length/height, SDS length/height, body weight, SDS body weight, body mass index (BMI), and SDS BMI, at birth and at the times of examination of each child. The levels of insulin-like growth factor-1 (SDS IGF-1) in children of both groups were also determined.

RESULTS. SDS length and SDS weight at birth in children born to a singleton pregnancy were 0.82 [0.1; 1.83] and 0.17 [–0.53; 0.9] in Group 1, and 0.5 [–0.35; 1.75] and –0.11 [–0.94; 0.635] in Group 2 (p = 0.62 and 0.37, respectively). In children less than 1 year of age, 1 year to 3 years, and 3 to 11 years, there was no difference of SDS length/height and SDS BMI (p = 0.3 and 0.9; p=0.29 and 0.29; p=0.85 and 0.6, respectively).

CONCLUSION. Children born from a singleton pregnancy in both groups were comparable in terms of anthropometric measurements both at birth (adjusted for gestational age), and at different ages. The levels of IGF-1 in children born as a result of the use of ART did not differ from those in children conceived naturally.

assisted reproductive technologies, children, physical development, length/height, weight, BMI, SDS IGF-1

1. Faddy MJ, Gosden MD, Gosden RG. A demographic projection of the contribution of assisted reproductive technologies to world population growth. Reprod Biomed Online. 2018;36(4):455-458. doi: https://doi.org/10.1016/j.rbmo.2018.01.006

2. Belva F, Henriet S, Liebaers I, et al. Medical outcome of 8-year-old singleton ICSI children (born >or=32 weeks’ gestation) and a spontaneously conceived comparison group. Hum Reprod. 2007;22(2):506-515. doi: https://doi.org/10.1093/humrep/del372

3. Lu YH, Wang N, Jin F. Long-term follow-up of children conceived through assisted reproductive technology. J Zhejiang Univ Sci B. 2013;14(5):359-371. doi: https://doi.org/10.1631/jzus.B1200348

4. Koivurova S, Hartikainen AL, Gissler M, et al. Post-neonatal hospitalization and health care costs among IVF children: a 7-year follow-up study. Hum Reprod. 2007;22(8):2136-2141. doi: https://doi.org/10.1093/humrep/dem150

5. Kai CM, Main KM, Andersen AN, et al. Serum insulin-like growth factor-I (IGF-I) and growth in children born after assisted reproduction. J Clin Endocrinol Metab. 2006;91(11):4352-4360. doi: https://doi.org/10.1210/jc.2006-0701

6. Ceelen M, van Weissenbruch MM, Prein J, et al. Growth during infancy and early childhood in relation to blood pressure and body fat measures at age 8-18 years of IVF children and spontaneously conceived controls born to subfertile parents. Hum Reprod. 2009;24(11):2788-2795. doi: https://doi.org/10.1093/humrep/dep273

7. Meddeb L, Pauly V, Boyer P, et al. Longitudinal growth of French singleton children born after in vitro fertilization and intracytoplasmic sperm injection. Body mass index up to 5 years of age. Rev Epidemiol Sante Publique. 2017;65(3):197-208. doi: https://doi.org/10.1016/j.respe.2017.03.001

8. Lofqvist C, Andersson E, Gelander L, et al. Reference values for IGF-I throughout childhood and adolescence: a model that accounts simultaneously for the effect of gender, age, and puberty. J Clin Endocrinol Metab. 2001;86(12):5870-5876. doi: https://doi.org/10.1210/jcem.86.12.8117

9. Chen M, Heilbronn LK. The health outcomes of human offspring conceived by assisted reproductive technologies (ART). J Dev Orig Health Dis. 2017;8(4):388-402. doi: https://doi.org/10.1017/S2040174417000228

10. Miles HL, Hofman PL, Peek J, et al. In vitro fertilization improves childhood growth and metabolism. J Clin Endocrinol Metab. 2007;92(9):3441-3445. doi: https://doi.org/10.1210/jc.2006-2465

11. Green MP, Mouat F, Miles HL et al. Anthropometric and endocrine differences exist between children conceived after the transfer of a fresh or thawed embryo compared to naturally conceived controls. Aust N Z J Obstet Gynaecol. 2010;50:25.

12. Амирова А.А., Назаренко Т.А., Мишиева Н.Г. Факторы, влияющие на исходы ЭКО (обзор литературы). // Проблемы репродукции. – 2010. – №1. – С. 68-74. [Amirova AA, Nazarenko TA, Mishieva NG. Factors influencing the IVF outcome (a review Modern reproductive technologies. 2010;(1):68-74. (In Russ.)]

13. Современные медико-социальные проблемы неонатологии. / Под ред. Баранова А.А., Яцык Г.В. – М.: ПедиатрЪ, 2014. [Baranov AA, Yatsyk GV, editors. Sovremennye mediko-sotsial’nye problemy neonatologii. Moscow: Pediatr; 2014. (In Russ.)]

14. Klemetti R, Sevon T, Gissler M, Hemminki E. Health of children born after ovulation induction. Fertil Steril. 2010;93(4):1157-1168. doi: https://doi.org/10.1016/j.fertnstert.2008.12.025

15. Ombelet W, Martens G, De Sutter P, et al. Perinatal outcome of 12,021 singleton and 3108 twin births after non-IVF-assisted reproduction: a cohort study. Hum Reprod. 2006;21(4):1025-1032. doi: https://doi.org/10.1093/humrep/dei419

16. Barker DJP. Fetal origins of cardiovascular disease. Ann Med. 1999;31(sup1):3-6. doi: https://doi.org/10.1080/07853890.1999.11904392

17. Giorgetti C, Vanden Meerschaut F, De Roo C, et al. Multivariate analysis identifies the estradiol level at ovulation triggering as an independent predictor of the first trimester pregnancy-associated plasma protein-A level in IVF/ICSI pregnancies. Hum Reprod. 2013;28(10):2636-2642. doi: https://doi.org/10.1093/humrep/det295

18. Wennerholm UB, Henningsen AK, Romundstad LB, et al. Perinatal outcomes of children born after frozen-thawed embryo transfer: a Nordic cohort study from the CoNARTaS group. Hum Reprod. 2013;28(9):2545-2553. doi: https://doi.org/10.1093/humrep/det272

19. Vidal M, Vellve K, Gonzalez-Comadran M, et al. Perinatal outcomes in children born after fresh or frozen embryo transfer: a Catalan cohort study based on 14,262 newborns. Fertil Steril. 2017; 107(4):940-947. doi: https://doi.org/10.1016/j.fertnstert.2017.01.021

20. Ishihara O, Araki R, Kuwahara A, et al. Impact of frozen-thawed single-blastocyst transfer on maternal and neonatal outcome: an analysis of 277,042 single-embryo transfer cycles from 2008 to 2010 in Japan. Fertil Steril. 2014;101(1):128-133. doi: https://doi.org/10.1016/j.fertnstert.2013.09.025

21. Luke B. Pregnancy and birth outcomes in couples with infertility with and without assisted reproductive technology: with an emphasis on US population-based studies. Am J Obstet Gynecol. 2017;217(3):270-281. doi: https://doi.org/10.1016/j.ajog.2017.03.012