Assisted Reproductive Technology (ART) embodies all methods of conception outside of natural conception. It includes stimulation of ovaries and either intrauterine insemination or removal of the eggs and fertilization in the laboratory setting (IVF). In North America, there has been approximately a 50% increase in patients using these therapies over the last decade. We are often asked does In Vitro Fertilization affect child development? Changing demographics, aging populations, accessibility and success all play part.
Although now part of the common lexicon, the longterm effects (if any) of ART remains to be explored. It is known that ART mother’s often inflicted with infertility tend to be older (approximately 34) while those naturally-conceiving their first child, 26 years old. Additionally, multiple gestation, and the previous practice of transferring multiple embryos lead to higher incidences of preterm births. It suggests cause and effect. Preterm birth in itself can be associated with cognitive, motor and language development. However, what remains controversial is if ART itself, deplete of preterm delivery, directly impacts long term neurodevelopment.
The data present is widespread. Investigations by the National Institute of Health (NIH), in reviewing the studies published report that data gaps exist and the findings are completely equivocal. Balayla et. Al. (Neurodevelopmental Outcomes after Assisted Reproductive Technologies. Obstetrics and Gynecology. Vol 129, No 2. 2/2017) compared two groups of 24month olds to assess their neurodevelopment employing standardized and quantitative scales of measure. The comparison was mothers and children born of ART and those of natural conception. This study was controlled for age, maternal medical issues and maternal lifestyle as well as to compare obstetric and neonatal courses. With all groups being equivalent, it is potentially possible to tease out small differences.
There was no difference.
This study was substantiated by another assessment (Upstate KIDS Study) where a child’s developmental progress at age 3 was independent of mode of conception.
These data suggest that ART itself, does not promote neurodevelopmental delays. As fertility practitioners, our goal is to promote a healthful pregnancy inclusive of maternal lifestyle. Additionally, it is important to work toward reduced chances of preterm delivery.
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