IVF does not affect child development: Study

Australian research published in PLOS Medicine shows school-aged children have no difference in development and educational outcomes, regardless of if they were conceived spontaneously or through IVF.
 
To conduct their study, researchers reviewed state-wide, linked population data for almost half a million Victorian children.
 
They then assessed developmental and educational outcomes of spontaneous and IVF-conceived children to their results at ages 4–6 via The Australian Early Development Census (AEDC) and at ages 7–9 via the National Assessment Program for Literacy and Numeracy (NAPLAN), finding no differences.
 
Lead author and fertility specialist Dr Amber Kennedy told newsGP this is reassuring news for parents.
 
‘If you have a couple with subfertility and they are considering IVF, this is good news,’ she said.
 
‘If they have a child conceived by IVF, they have the same early childhood outcomes and schooling outcomes as their peers.’
 
The team managed to collate sensitive data from private IVF clinics, Births, Deaths and Marriages (BDM) and the Victorian Perinatal Data Collection (VPDC) via a third-party governmental agency that deidentified the information.
 
‘It’s unique as the exposure data is in the mum’s name while outcomes are in the child’s name,’ Dr Kennedy said.
 
‘It’s probably the biggest data set that has come up with a reassuring finding for IVF-conceived children.
 
‘Some Scandinavian studies between 2018–2020 found that IVF-conceived children did slightly worse in schooling assessments.
 
‘Ours didn’t find that and there are two potential reasons. Firstly, our cohort is more recent and there is some data showing that complications with IVF in perinatal and neonatal periods are reducing over time, so contemporary IVF practices are becoming safer.’
 
Dr Kennedy says this includes reducing rates of ovarian hyperstimulation syndrome (OHSS), reducing embryo transfer to one and using preimplantation genetic testing (PGT).
 
‘Secondly, our statistical methodology was superior,’ she said.
 
‘Using simple regression on our data, we found similar results to Scandinavian studies but when doing causal based analysis, it showed no difference.’
 
Previous studies have shown higher rates of autism, neurological disorders and other congenital abnormalities in IVF-conceived children.
 
Some of this may be related to the medical conditions of parents that impact their fertility, including advanced age.
 
Dr Kennedy says there may also be differences in childhood outcomes relating the type of treatment used in IVF.
 
‘Other studies have shown increased risk of congenital abnormalities in babies conceived by ICSI [intracytoplasmic sperm injection] but the mechanism is thought to be with the quality of the men’s sperm which requires ICSI, as opposed to the method itself,’ she said.
 
Dr Anthea Lindquist, obstetrician and senior author on the same research, told newsGP the team plan to further research ICSI and its effect on children.
 
‘This project was to assess IVF as a whole, but with different techniques [like ICSI] we are keen to tease out the differences,’ she said.
 
Dr Lindquist says when patients come to see her for subfertility, long-term risks are less pressing for them.
 
‘It’s so often an emotional process, the fertility journey,’ she said.
 
‘When we see patients in the early setting, they are interested to know about the risks [of IVF] but they are much more focused on the pregnancy risks.
 
‘The prospect of long-term complications isn’t always there because most of these families are faced with the prospect of no children, or the IVF journey.
 
‘That’s why we can provide reassuring evidence with this research.’
 
Dr Lindquist says part of the prompt for this research was allowing greater access of IVF.
 
‘IVF continues to increase in frequency. For me, there is a growing interest in public IVF services and with that, there’s a lot of stringent evaluation of the existing evidence,’ she said.
 
‘From a public service perspective, there is a lot we don’t know yet and in order for it to be more freely accessible, those questions need to be answered.
 
‘There was a review of IVF services in Victoria late 2019 which identified the gaps in knowledge and what needs to be done to address this.’
 
She says IVF is currently exclusive to those who can afford it and as more evidence is gained, the more likely it is to be publicly funded.
 
The team have the capacity to look at a small cohort of the same children to assess their longer-term educational results but for now, Dr Lindquist says she hopes the findings provide reassurance for doctors and families recommending or proceeding with IVF.
 
‘The fertility journey is very personal and individual, and everyone has their own circumstances,’ Dr Lindquist said.
 
‘Our findings show there is no evidence overall that IVF-conceived children will be worse off at school.
 
‘This is a reassuring, good news story overall.’
 
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