How are they Doing? Neurodevelopmental Outcomes at School-age of Children Born Following Assisted Reproductive Treatments

Adel Farhi ¹ Saralee Glasser ¹ Galit Hirsh-Yechezkel ¹ Shay Frank ² Louise Brinton ³ Bert Scoccia ⁴ Raphael Ron-El ⁵ Lidia V. Gabis ² Raoul Orvieto ⁶ Liat Lerner-Geva ^1,7

¹Gertner Institute for Epidemiology & Health Policy Research Ltd., Women & Children's Health Research Unit, Israel
²Weinberg Child Development Center, Safra Children’s Hospital, Sheba Medical, Israel
³Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Cancer Institute, Rockville, MD, Israel
⁴Division of Reproductive Endocrinology & Infertility, University of Illinois College of Medicine, Chicago, Illinois, USA, University of Illinois College of Medicine, USA
⁵Infertility & IVF Unit, Department of Obstetrics & Gynecology, Assaf Harofe Medical Center, Israel
⁶Department of Obstetrics and Gynecology, IVF Unit, Sheba Medical Center, Israel
⁷Sackler School of Medicine, Tel Aviv University, Israel

Aims: To evaluate neurodevelopmental outcomes of school-age children conceived by assisted reproductive technologies (ART) compared to spontaneously-conceived (SC) children.

Method: In this prospective cohort study, telephone interviews were conducted with 759 mothers of children conceived by ART or spontaneously (358 ART and 401 SC) when the children were aged 7-9 years. The mothers provided information regarding the child`s health and development, and responded to questionnaires with respect to the neurodevelopmental aspects, including the Developmental Coordination Disorder Questionnaire, Short Sensory Profile, Child Symptom Inventory (CSI-4), and Autism Spectrum Screening Questionnaire (ASSQ).

Results: Maternal responses regarding motor development and sensory processing disorders revealed no significant differences between the study groups. Maternal report of diagnosed attention deficit hyperactive disorder (ADHD) revealed a non-significant increased risk among ART children, after adjusting for maternal age, child sex and preterm (OR_adj 1.45; 95%; CI 0.81-2.61). There were no differences between the groups on the CSI-4-ADHD scale for children who had not been diagnosed. Six children had been diagnosed with autistic syndrome disorders (ASD), five of whom were in the ART group. Of those not diagnosed, no difference was found between the groups on the ASSQ.

Conclusion: No major significant differences were found in the neurodevelopmental outcomes among ART children, as compared to SC children. Further larger studies are needed to arrive at definite conclusions, particularly regarding ADHD and ASD.