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.

Céline Dion Pregnant with Embryo Frozen for Eight Years

 Céline Dion, known for belting out pop songs with window-rattling power, will be fine-tuning her repertoire of lullabies with the news today that she’s pregnant with her second child.

It’s an arrival Dion mused about almost nine years ago when she was expecting her first baby, Rene-Charles.

When Rene-Charles was conceived through in vitro fertilization at a world-renowned New York clinic, Dion told interviewers at the time that a sibling was already in the works.

The pop megastar and her husband, Rene Angelil, got the good news of the latest infant on Monday after undergoing another round of fertility treatments.

“Celine is very, very happy,” Murielle Blondeau, a spokeswoman for Dion, said today when she confirmed the pregnancy.

“Celine and Rene are full of joy. It’s been a big dream for Celine to have a second child.”

Although Rene-Charles and the new baby are siblings, fertility experts say they are not twins. Identical twins are created from a single embryo that splits in the womb while fraternal twins come from different embryos that are carried at the same time.

Dr. Seang Lin Tan, a world-renowned fertility expert at the McGill University Reproductive Centre in Montreal, said there are documented cases where frozen embryos have been successfully used after two decades.

“There have been babies born who are healthy after the embryos have been frozen for 20 years,” he said.

Dion’s first pregnancy was well-documented, unlike that of fellow music megastar Shania Twain, who virtually disappeared while waiting to give birth around the same time.

The revelation that Dion was pregnant with Rene-Charles followed a jaw-dropping announcement that she would retire from performing to have a family.

She gave interviews about her pregnancy in which she chatted about how the frozen eggs might one day become a “brother or sister” to Rene-Charles, and she appeared in a series of photos showcasing her protruding belly.

Dion has said that she and her husband turned to medical science to help conceive because Angelil had been diagnosed with cancer in 1999.

After a neck tumour was removed, he was treated with radiation and chemotherapy which are known to affect fertility. Angelil’s cancer went into remission.

Dr. Zev Rosenwaks, who counselled the couple on their fertility options, told The Canadian Press in a 2000 interview that Dion had an intracytoplasmic sperm injection, in which a single sperm is injected into the egg.

Rosenwaks, who works with the Weill Cornell fertility clinic, said in the interview that Angelil had previously frozen his sperm.

The second fertilized egg was frozen five days after conception and stored at the New York clinic, Dion said in the television interview.

Tan said there is no real concern about Dion giving birth at age 41 and he noted the embryos were also frozen when she was much younger.

He said he hopes Dion’s pregnancy will draw attention to in vitro fertilization.

“Apparently when she got pregnant the first time, the popularity of in vitro in Canada went up quite a bit,” he said.

Source: thestar.com

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Worldwide report shows an increase in Assisted Reproduction

An estimated 250,000 babies are born in one year

Assisted reproductive technology (ART) is responsible for an estimated 219,000 to 246,000 babies born each year worldwide according to an international study. The study also finds that the number of ART procedures is growing steadily: in just two years (from 2000 to 2002) ART activity increased by more than 25%.

The study, which is published online in Europe’s leading reproductive medicine journal Human Reproduction, gives figures and estimates for the year 2002, the most recent year for which world figures are available. A total of 1563 clinics in 53 countries provided data for the report, but data were missing from several other countries, mostly in Asia, Africa, Oceania and the West Indies. The authors estimated that these missing countries probably performed between 10-20% of ART procedures, and they took this into account when they calculated the total number of ART babies born worldwide.

Professor Jacques de Mouzon, a specialist in public health at INSERM (Paris, France), led the International Committee for Monitoring Assisted Reproductive Technology (ICMART) that compiled the report. He said: “This is the eighth world report on ART produced by ICMART since 1989, and is useful because, even if it is imperfect, it gives data that can inform debate and decision-making on issues such as availability and the benefits and risks of this important medical practice. It allows us to make comparisons between countries and regions, and to analyse trends by comparing with previous reports.

“There are several important points to highlight. There has been a constant increase in ART activity: it increased by more than 25% in the two years since the previous report for the year 2000. This is due not only to an increase in the number of countries participating in this report but also to an increase in ART activity in most individual countries.

“However, there are wide variations between countries in the availability and quality of ART. There are several reasons for this, such as fertility rates, women’s age, insurance cover, the national economy, but the most important is certainly inequality in access to healthcare and ART. In Western Europe it is easier for people to access good healthcare, and funding for ART tends to be more generous than in developing countries. This raises the question of developing so called ‘low cost’ ART in low-income countries; it would probably mean lower success rates (the problem would be to define what rates would be acceptable), but greater access to treatment. In addition, treatment is usually more aggressive in developing countries and in all countries where ART is expensive for patients, leading to the consequent problems of multiple births, ovarian hyperstimulation syndrome and the need for foetal reductions.”

Availability of ART varied from two cycles per million inhabitants (Ecuador) to 3688 per million in Israel.

Other key findings from the study include:

1. A large increase in the use of ICSI (intracytoplasmic sperm injection) as opposed to conventional IVF (in vitro fertilisation) worldwide. Since 2000 it increased from 54% to 61% in North America, 46% to 54% in Europe, and in 2002 it had reached 76% in Latin America and more than 92% in the Middle East.

2. Pregnancy and delivery rates have increased for both fresh and frozen embryo cycles despite a decrease in the number of embryos transferred. More than 601,250 ART cycles worldwide resulted in delivery rates after IVF, ICSI and frozen embryo transfer (FET) of 22%, 21% and 15% respectively per aspiration (attempt at egg retrieval). This compares with delivery rates after IVF, ICSI and FET in 2000 of nearly 19%, 20% and 12% respectively.

3. When cycles using fresh embryos were combined with frozen embryo cycles, the cumulative delivery rate per aspiration was 26%.

4. Cumulative delivery rates per aspiration varied among countries, ranging from 14% to 39%. While Tunisia and Libya reported the highest rates at 39%, this represented only a few fertility centres in each country. Therefore, the USA, where reports cover almost all fertility centres in the country, had the highest rate at 37.5%.

5. The transfer of multiple embryos has decreased, leading to a small decline in multiple births. The percentage of four or more embryo transfers decreased from 15.4% in 2000 to 13.7% in 2002. The proportion of twin and triplet pregnancies decreased from 26.5% to 25.7%, and from 2.9% to 2.5% respectively.

6. There has been a 47% increase in the proportion of FET cycles, which is due mainly to the decrease in the number of embryos transferred at one time, with any left over being frozen for future attempts.

Prof de Mouzon said: “It is difficult to explain the reasons behind the increase in ICSI as we have no reason to believe there has been a similar increase in the rise in male infertility, and ICSI has not been demonstrated to improve treatment results for infertility that is not caused by infertile men. It could be because more infertile men are agreeing to seek treatment, that the diagnosis of male infertility is improving, that male infertility per se is increasing (due to exposure to sperm-damaging compounds in the environment), that fertility teams turn to ICSI more rapidly when conventional IVF fails, or that ICSI is still viewed as more efficient, even in the absence of scientific proof, which may be the major factor in Latin America and the Middle East. I suspect the overall explanation is probably a mixture of several of these factors.”

The increased use of frozen embryo cycles was very good news because it improved cumulative pregnancy and delivery rates and helped reduce the number of multiple embryo transfers and multiple births, he said.

“Our report shows that delivery rates per aspiration increased in 2002 even though the average number of embryos transferred was reduced. For example, in Australia where a mean average of 1.8 embryos were transferred, the delivery rate per aspiration was 19.5% for fresh cycles and 29.4% for fresh and frozen cycles together. This should encourage countries to implement embryo transfer policies that reduce the risk of multiple births,” said Prof de Mouzon.

The authors warn that variation in data quality, in addition to differences in practices, legislation, guidelines, culture and religion, means that comparisons between countries “must be done with caution”.

SOURCE: www.eshre.com 

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