Achievement Test Performance in Children Conceived by In Vitro Fertilization

L Mains; M Zimmerman; J Blaine; B Stegmann; A Sparks; T Ansley; B Van Voorhis

doi:10.1097/OGX.0b013e31821684ff

Short-term risks to children conceived by in vitro fertilization (IVF) include adverse perinatal outcomes and birth defects. Little data are available on long-term risks in IVF children, especially for subtle measures of cognitive development. The few studies that have investigated cognitive development in these children have been limited by small sample size, short length of follow-up, nonstandard measures of cognitive ability, or lack of appropriate controls.This retrospective cohort study investigated cognitive function in children conceived by IVF. Academic performance was assessed using the Iowa Tests of Basic Skills (ITBS) for grades 3 to 9 and the Iowa Tests of Educational Development (ITED) for grades 9 to 12. Both the tests have been accepted nationally as valid measures of academic achievement. A university database was used to identify IVF children from 8 to 17 years of age. Parents of these children were contacted by mail and made to complete questionnaires on their childrenʼs health, educational development, and the parental level of education. ITBS/ITED scores of enrolled children were obtained for grades 3 to 12 and were compared with the scores of a control group of normally conceived children matched for gender, grade level, calendar year of test administration, and school district. Linear mixed models were used for analysis of the scores.The response rate among parents contacted was 59.4% (295/495), resulting in analysis of 463 children. ITBS/ITED scores were available on 423 of these children (91.4%). For all grades and subtests, the mean scores of IVF children were significantly higher compared with the national average (P < 0.0001) and were higher than the controls for grades 3 to 11. A trend for lower test scores in the IVF children was found among multiple gestations, but the adjusted differences were not statistically significant. Examination of factors that could affect ITBS/ITED scores showed a significant association between scores and motherʼs and fatherʼs level of education, motherʼs age at delivery, divorce, and childʼs body mass index. Cryopreservation of embryos, longer embryo culture, and method of insemination had no significant effect on test scores.These findings suggest that the use of IVF does not have a negative effect on cognitive development of children conceived through this technology. The investigators believe that these data should be reassuring to patients who are considering IVF, but longer studies are also needed.

Achievement Test Performance in Children Conceived by In Vitro Fertilization

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