Health and development of ART conceived young adults: a study protocol for the follow-up of a cohort

Abstract

BackgroundUse of assisted reproductive technologies (ART) continues to increase, yet little is known of the longer term health of ART conceived offspring. There are some adverse birth outcomes associated with ART conception but the subsequent developmental trajectory is unclear. Undertaking research in this area is challenging due the sensitive nature of the topic and the time elapsed since birth of the ART conceived young adults. The aim of this report is to describe a research protocol, including design and ethical considerations, used to compare the physical and psychosocial health outcomes of ART conceived young adults aged 18-28 years, with their spontaneously conceived peers.DesignThis is a retrospective cohort study of mothers who conceived with ART in Victoria, Australia and gave birth to a singleton child between 1982 and 1992. A current address for each mother was located and a letter of invitation to participate in the study was sent by registered mail. Participation involved completing a telephone interview about her young adult offspring’s health and development from birth to the present. Mothers were also asked for consent for the researcher to contact their son/daughter to invite them to complete a structured telephone interview about their physical and psychosocial health. A comparison group of women living in Victoria, Australia, who had given birth to a spontaneously conceived singleton child between 1982 and 1992 was recruited from the general population using random digit dialling. Data were collected from them and their young adult offspring in the same way. Regression analyses were used to evaluate relationships between ART exposure and health status, including birth defects, chronic health conditions, hospital admissions, growth and sexual development. Psychosocial wellbeing, parental relationships and educational achievement were also assessed. Factors associated with the age of disclosure of ART conception were explored with the ART group only.DiscussionThe conceptualization and development of this large project posed a number of methodological, logistical and ethical challenges which we were able to overcome. The lessons we learnt can assist others who are investigating the long-term health implications for ART conceived offspring.

When the Ideal Meets the Feasible: Constructing a Protocol for Developmental Assessment at Early School-Age

“…In the current study, with respect to school achievement, comparisons with class peers were requested under the assumption that major disparities would be noticeable to the parents. This approach was also used by Wilson et al in a follow-up study of young adults conceived by assisted reproductive technologies ( 33 ). Questionnaires employing parent report of children's behavioral problems have been widely used and validated ( 34 – 36 ).…”

Clinical review of 24–35 year olds conceived with and without in vitro fertilization: study protocol

“…Potential participants are the IVF-conceived (IVF) and non IVF-conceived (control) young adults who participated in the previous study [ 21 , 22 ] and who consented to be contacted for further research. Participants are required to be able to attend MCRI for all aspects of the clinical review.…”

“…We have extensive information regarding participants’ health, development and well-being from the 150-item telephone interview they completed in the first study. At that time their mothers also completed an 80-item telephone interview about the first 18 years of participants’ lives [ 21 , 22 ]. Detailed data are available on young adult physical health, quality of life, diet, psychosocial health, pubertal milestones, sexual relationships, reproductive health, education and occupation.…”

“…In a previous study, using telephone-interviews, we compared the health and wellbeing of 547 singleton young adults (aged 18–28 years) born following in vitro fertilization (IVF) with 549 matched controls [ 21 , 22 ]. Maternally reported data indicated that IVF-conceived singletons had a significant increase in respiratory atopy relative to matched controls after adjusting for confounders [ 21 ].…”

Long‐term follow‐up of intra‐cytoplasmic sperm injection‐conceived offspring compared with in vitro fertilization‐conceived offspring: a systematic review of health outcomes beyond the neonatal period

“…The limited research involving ART‐conceived adolescents and young adults suggests some physiological differences in their physical health (e.g. higher blood pressure) compared to spontaneously conceived (SC) peers (Wilson et al ., ). Their psychosocial outcomes, however, appear similar (Wilson et al ., ) and most IVF‐conceived children develop into healthy young adults (Halliday et al ., ).…”