Evaluation of young adults conceived via IVF shows them to be “happy and well adjusted”

A study published on-line this month in the journal Fertility and Sterility shows that young adults conceived via IVF were generally as happy and well adjusted as their peers.

Researchers at Eastern Virginia Medical School’s Jones Institute of Reproductive Medicine questioned a cohort of young adults conceived in that program’s clinic between 1981 and 1990. The Jones Institute was a pioneering center for reproductive medicine, achieving the first IVF birth in the United States in 1981. Researchers contacted the young adults via their parents and received a 31 percent (n=173) response rate to their 90 item questionnaire.

The results showed that when compared to other young adults, the IVF conceived were found to be “healthy and well adjusted with no prevalence of increased susceptibility to chronic diseases.” However the reported incidence of clinical depression and especially ADD/ADHD were higher among IVF offspring.

“This is a significant study and one of a number of long term outcomes studies that are currently being done.” Said James Goldfarb, President of the Society for Assisted Reproductive Technology (SART). “It is comforting to see that the data bears out what we have believed, that children conceived via IVF are generally as healthy as other children, even as those children become adults. While the findings of increased depression and ADD/ADDH is notable, other studies have not shown these increases. We need to continue to do the research that will allow us to discover if there are any areas of concern for IVF children. ” Dr. Goldfarb added.

For more information about In Vitro Fertilization (IVF) please do not hesitate to contact us.

USA and International Trends in Assisted Reproductive Technology (ART)

Atlanta, GA – Data released at the American Society for Reproductive Medicine Annual Meeting in Atlanta compares ART trends in the US with those around the world. Using data collected through the International Committee Monitoring ART (ICMART), investigators examined data from 2000- 2004. They found that delivery rates in the US were stable at 31% while they improved in Europe from 16% to 22%.

The delivery rate was maintained in the US even as the number of embryos transferred declined from 3.0 to 2.7 embryos per transfer, and the US triplet rate was cut in half from 4.3% to 2.6%. Only Sweden saw a marked reduction in its twin rate over the period, going from 21.8% to only 5.6%.

The same investigators used 2004 data to examine how economic factors influence the risk and benefit calculations of patients and physicians. They found that in countries where government provides free access to Assisted Reproductive Technology (ART) treatment, the utilization rate for those treatments is much higher. For example, in France there were 2,008 cycles for every million inhabitants, while in the US there were only 357 cycles per million people. Improved access not only raises the utilization rate, but changes outcomes, as well. The number of embryos transferred per cycle and the resulting high order multiple births are highest in those countries that do not provide free access.

This relationship was seen within countries, as well. In the USA, individual states with mandatory insurance coverage for IVF treatments saw different results than states without such a mandate. Researchers at the Yale University School of Medicine found that the number of embryos transferred per cycle, cancellation rate, twin rate and multiple live birth rate were all higher in mandated states than in non-mandated ones.

“These studies make it clear that policies that promote access to infertility treatment also promote making those treatments safer and more effective,” stated Elizabeth Ginsburg, MD, President of the Society for Assisted Reproductive Technology (SART).

Contact us for more information about Assisted Reproductive Technology (ART) treatment; Doctor Andrés Juárez Villanueva and Doctor Gustavo Gallardo will be glad to help you.

IVF Kids Are Healthy, Smart and Well-Behaved

Atlanta, GA – Research presented at ASRM’s 65th Annual Meeting addressed questions about how Assisted Reproductive Technology (ART) might affect the development of the children who result.

Surveying parents, University of Pennsylvania researchers found that children conceived with In Vitro Fertilization (IVF) showed the same number of abnormal childhood behaviors as children conceived without IVF as measured by a validated behavioral assessment instrument. Women who delivered a child at the University of Pennsylvania Hospital between 2000 and 2005 were invited to answer a questionnaire and the Child Behavior Checklist. In total, those who responded had 105 IVF-conceived children and 108 control children. The groups were not different with respect to child age, pregnancy complications, birth weight, gestational age or maternal education. There were statistically significant differences in parental age and family size that are not clinically significant. There were no significant differences between the groups in the prevalence of individual behavioral symptoms. The prevalence of any behavioral symptom was similar between children conceived with (10.5%) and without IVF (10.2%).

In the largest report on achievement test performance of IVF-conceived children to date, researchers from the University of Iowa used scores from the Iowa Tests of Basic Skills (ITBS) to compare achievement test performance of singletons, twins and triplet children conceived through IVF. The IVF database at the University of Iowa Hospital Center was mined for cycles resulting in children presently between eight and 17 years old. Questionnaires on the childrens’ health and education and parents’ education were mailed to parents and 295 couples having 462 children agreed to participate. Of the children, 49% were singletons; 40% were twins and 11% were triplets. Third grade ITBS scores were used to compare the performance of singletons, twins and triplets. Although multiple gestation appears to have a slight detrimental effect on standardized test performance, the overall scores were high and the differences between singletons, twins and triplets were small.

Parents’ infertility influences birthweight and size whether their children are conceived through IVF or spontaneously. Although research suggests that babies born as a result of IVF are smaller and have more adverse outcomes than spontaneously conceived children, the underlying health of the parents may play a role in their offspring’s health regardless of the mode of conception. In a retrospective study, researchers at the University of Washington School of Medicine analyzed data from patients receiving an infertility diagnosis who had a live singleton birth at the hospital between 1999 and 2009. Well-dated spontaneous conceptions were analyzed along with pregnancies from ovulation induction (OI) and from fresh, non-donor IVF cycles. They found that the ART-conceived babies were larger in early gestation than OI and spontaneously conceived babies yet in mid-gestation, ART babies were smaller than spontaneously-conceived and equal in size to OI babies. By the time of delivery, OI conceived babies were smaller than babies conceived spontaneously or through ART. Ultimately, singleton IVF babies were not smaller compared to singletons born to spontaneously conceiving infertility patients.

Elizabeth Ginsburg, MD, President of SART, remarked, “The health and development of children born through ART has always been of great concern. While further study is needed on the ways parents’ underlying conditions and fertility treatments may affect children’s development, we can be reassured that overall, ART children appear to be healthy.”

In vitro maturation (IVM) of eggs is a developing technique which allows IVF to be done without ovarian stimulation. Because data are limited on the outcomes for children born from this treatment, French researchers have embarked on an ongoing prospective observational study.

Thirty-five children born from 32 IVM pregnancies were included in the group and compared to IVF/ Intracytoplasmic Sperm Injection (ICSI) children matched for maternal age, gestational age and singleton or twin birth. Children were clinically examined at one year of age. The researchers found that at one year of age, children resulting from IVM procedures do not differ significantly in developmental or clinical respects from children conceived using IVF/ICSI.

Accelerated Fertility Treatment Leads to Shortened Time to Pregnancy and Charge Savings

For couples beginning infertility treatments, an accelerated path to IVF omitting the gonadotropin-stimulated artificial insemination cycles that conventionally precede assisted reproductive technology results in a shorter time to pregnancy. The accelerated treatment program also results in lower average charges per delivery.

Couples with unexplained infertility seeking treatment at Boston IVF or Harvard Vanguard Medical Associates were screened for eligibility to participate in the randomized, controlled trial. Eligibility criteria included: trying to conceive for 12 months without prior fertility treatment (excepting up to three cycles of clomiphene without intrauterine insemination (IUI)); a female partner 21 to 39 years old with sufficient ovarian reserve and without pelvic pathology; and adequate sperm concentration in the male partner.

Couples enrolled in the study followed either a conventional course of treatment or an accelerated course until they achieved pregnancy or elected to stop treatment. The conventional treatment included three IUI cycles stimulated with clomiphene citrate for ovulation induction, followed by three FSH-stimulated IUI cycles, then up to six cycles of IVF. The accelerated treatment plan omitted the FSH-stimulated cycles and went to IVF after three clomiphene-stimulated IUIs. The couples were followed from the date of their enrollment until the closing date of the study. Charge data obtained from insurers included all healthcare items and services for women during the trial- from the time of randomization through hospital discharge of mother and baby after delivery, or until one year after completing treatment without pregnancy.

Of 503 couples enrolled, 64% delivered at least one baby by the end of the study. Babies were born to 150/247 couples in the conventional treatment group and to 171/256 couples in accelerated treatment. The time to pregnancy was significantly shortened for the couples in the accelerated arm of the study. Those couples achieved pregnancy in an average of eight months compared with an average time to pregnancy of 11 months for couples in the conventional arm.

Insurance charge data were collected for 448 participating couples. Average charges per delivery were $9,800 lower in the accelerated arm than for conventional treatment. Savings of $2,624 per couple were observed in the accelerated treatment arm.

Foregoing gonadotropin-stimulated IUI eliminated not only the charges for that treatment from overall charges, but also reduced the risk of multiple conception and the increased charges associated with multiple pregnancies and births.

Elizabeth Ginsburg, President of the Society for Assisted Reproductive Technology, commented, “This is a very important study that will likely influence physicians to reduce the number of stimulated inseminations for patients with unexplained infertility. Adoption of such an accelerated course of treatment could result in many patients conceiving in less time with less expense.”