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This activity is intended for obstetricians/gynecologists/women's health clinicians, family medicine/primary care clinicians, pediatricians, public health and prevention officials, nurses, pharmacists, physician assistants, and other members of the healthcare team who care for women undergoing in vitro fertilization (IVF) and their offspring.
The goal of this activity is for learners to be better able to describe the causal effect of IVF conception on primary school-age childhood developmental and educational outcomes compared with outcomes after spontaneous conception.
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CME / CE Released: 3/17/2023
Valid for credit through: 3/17/2024, 11:59 PM EST
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Since the first successful in vitro fertilization (IVF) birth in 1978, > 8 million babies globally have been born following IVF conception. Studies of long-term IVF outcomes have reported conflicting results.
Health and sociodemographic factors differ between parents of IVF-conceived and spontaneously conceived children. In particular, increased maternal age and higher education are linked with use of fertility treatment and with better early childhood outcomes Such factors must be considered when evaluating the association between mode of conception and childhood outcomes.
In vitro fertilization has been around long enough that researchers can now compare developmental and academic achievements between these children and peers at school age.
Amber Kennedy, MBBS, and colleagues did just that. They found little difference in these milestones between a total of 11,059 IVF-conceived children and 401,654 spontaneously conceived children in a new study.
"Parents considering IVF and health care professionals can be reassured that the school age developmental and educational outcomes of IVF-conceived children are equivalent to their peers," said Kennedy, lead author and obstetrician and gynecologist at Mercy Hospital for Women at the University of Melbourne, Australia.
The findings were published January 24 in the journal PLOS Medicine.
"Overall, we know that children born through IVF are doing fine in terms of health, but also emotionally and cognitively. So I wasn't surprised. I live in this world," said Ariadna Cymet Lanski, PsyD, chair of the American Society for Reproductive Medicine Mental Health Professional Group, who was not affiliated with the study.
Some previous researchers linked conception via IVF to an increased risk for congenital abnormalities, autism spectrum disorder, developmental delay, and intellectual disability.
Asked why the current study did not find increased risks, Kennedy said, "Our population included a relatively recent birth cohort, which may explain some differences from previous studies as IVF practices have evolved over time."
An estimated 8 million people worldwide have been conceived through IVF since the first birth in 1978, the researchers said. In Australia, this has grown from 2% of births in the year 2000 to now nearly 5% or 1 in 20 live births, Kennedy said. "Consequently, it is important to understand the longer-term outcomes for this population of children."
Along with senior author Anthea Lindquist, MBBS, Kennedy and colleagues studied 585,659 single births in Victoria, Australia, between 2005 and 2014. They did not include multiple births such as twins or triplets.
The investigators compared 4697 children conceived via IVF and 168,503 others conceived spontaneously using a standard developmental measure, the Australian Early Developmental Census (AEDC). They also assessed 8976 children in the IVF group and 333,335 other children on a standard educational measure, the National Assessment Program-Literacy and Numeracy (NAPLAN).
For example, the developmental census measures developmental vulnerability. Kennedy and colleagues found a 0.3% difference in favor of IVF-conceived children, which statistically was no different than zero.
Similarly, the researchers reported that IVF conception had essentially no effect on overall literacy score, with an adjusted average difference of 0.03.
Lanski said the results should be reassuring for people considering IVF: "I can see the value of the study."
Not all IVF techniques are the same, and the researches want to take a deeper dive to evaluate any distinctions among them. For example, Kennedy said, "We plan to investigate the same school-aged outcomes after specific IVF-associated techniques."
PLoS Med. 2023;20:e1004148.[1]