Authors: Schendelaar, P.; Middelburg, K.J.; Bos, A.F.; Heineman, M.J.; Jongbloed-Pereboom, M.; Hadders-Algra, M.

Source: Human Reproduction, Volume 26, Number 3, 7 March 2011 , pp. 703-712(10)

Publisher: Oxford University Press

Abstract:

BACKGROUND

Up to 4% of children are born following assisted reproduction techniques (ART) yet relatively little is known on neurodevelopmental outcome of these children after 18 months of age. Only a limited number of long-term follow-up studies with adequate methodological quality have been reported. Our aim was to evaluate the effects of ovarian hyperstimulation, IVF laboratory procedures and a history of subfertility on neurological condition at 2 years.

METHODS

Singletons born after controlled ovarian hyperstimulation IVF (COH-IVF, n= 66), modified natural cycle IVF (MNC-IVF, n= 56), natural conception in subfertile couples (Sub-NC, n= 87) and in fertile couples (reference group, n= 101) were assessed (using Hempel approach) by neurological examination at 2 years of age. This resulted in a neurological optimality score (NOS), a fluency score and the prevalence of minor neurological dysfunction (MND). Primary outcome was the fluency score, as fluency of movements is easily affected by subtle dysfunction of the nervous system.

RESULTS

Fluency score, NOS and prevalence of MND were similar in COH-IVF, MNC-IVF and Sub-NC children. However, the fluency score (P< 0.01) and NOS (P< 0.001) of the three subfertile groups were higher, and the prevalence of MND was lower (P= 0.045), than those in the reference group.

CONCLUSIONS

Neurological condition of 2 year olds born after ART is similar to that of children of subfertile couples conceived naturally. Moreover, subfertility does not seem to be associated with a worse neurological outcome. These findings are reassuring, but we have to keep in mind that subtle neurodevelopmental disorders may emerge as children grow older.

Keywords: IVF; children; neurodevelopmental outcome; minor neurological dysfunction; follow-up

Document Type: Research article

DOI: http://dx.doi.org/10.1093/humrep/deq377

Publication date: 2011-03-07

More about this publication?

• Human Reproduction features full-length, peer-reviewed papers reporting original research, clinical case histories, as well as opinions and debates on topical issues. Papers published cover the scientific and medical aspects of reproductive physiology and pathology, endocrinology, andrology, gonad function, gametogenesis, fertilization, embryo development, implantation, pregnancy, genetics, genetic diagnosis, oncology, infectious disease, surgery, contraception, infertility treatment, psychology, ethics and social issues. The highest scientific and editorial standard is maintained throughout the journal along with a rapid rate of publication.

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• In this Subject: Anatomy & Physiology ,  Obstetrics & Gynecology
• By this author: Schendelaar, P. ;  Middelburg, K.J. ;  Bos, A.F. ;  Heineman, M.J. ;  Jongbloed-Pereboom, M. ;  Hadders-Algra, M.

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