1
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Bazzano MV, Köninger A, Solano ME. Beyond defence: Immune architects of ovarian health and disease. Semin Immunopathol 2024; 46:11. [PMID: 39134914 PMCID: PMC11319434 DOI: 10.1007/s00281-024-01021-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 07/23/2024] [Indexed: 08/15/2024]
Abstract
Throughout the individual's reproductive period of life the ovary undergoes continues changes, including cyclic processes of cell death, tissue regeneration, proliferation, and vascularization. Tissue-resident leucocytes particularly macrophages, play a crucial role in shaping ovarian function and maintaining homeostasis. Macrophages crucially promote angiogenesis in the follicles and corpora lutea, thereby supporting steroidogenesis. Recent research on macrophage origins and early tissue seeding has unveiled significant insights into their role in early organogenesis, e.g. in the testis. Here, we review evidence about the prenatal ovarian seeding of leucocytes, primarily macrophages with angiogenic profiles, and its connection to gametogenesis. In the prenatal ovary, germ cells proliferate, form cysts, and undergo changes that, following waves of apoptosis, give rice to the oocytes contained in primordial follicles. These follicles constitute the ovarian reserve that lasts throughout the female's reproductive life. Simultaneously, yolk-sac-derived primitive macrophages colonizing the early ovary are gradually replaced or outnumbered by monocyte-derived fetal macrophages. However, the cues indicating how macrophage colonization and follicle assembly are related are elusive. Macrophages may contribute to organogenesis by promoting early vasculogenesis. Whether macrophages contribute to ovarian lymphangiogenesis or innervation is still unknown. Ovarian organogenesis and gametogenesis are vulnerable to prenatal insults, potentially programming dysfunction in later life, as observed in polycystic ovary syndrome. Experimental and, more sparsely, epidemiological evidence suggest that adverse stimuli during pregnancy can program defective folliculogenesis or a diminished follicle reserve in the offspring. While the ovary is highly sensitive to inflammation, the involvement of local immune responses in programming ovarian health and disease remains to be thoroughly investigated.
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Affiliation(s)
- Maria Victoria Bazzano
- Laboratory of Translational Perinatology, University of Regensburg, Biopark 1-3, D-93053, Regensburg, Germany
| | - Angela Köninger
- University Department of Obstetrics and Gynecology, Clinic St. Hedwig of The Order of St. John, University of Regensburg, Steinmetzstr. 1-3, D-93049, Regensburg, Germany
| | - Maria Emilia Solano
- Laboratory of Translational Perinatology, University of Regensburg, Biopark 1-3, D-93053, Regensburg, Germany.
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2
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Ono M, Kuji N, Ueno K, Kojima J, Nishi H. The Long-Term Outcome of Children Conceived Through Assisted Reproductive Technology. Reprod Sci 2024; 31:583-590. [PMID: 37679558 DOI: 10.1007/s43032-023-01339-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 08/25/2023] [Indexed: 09/09/2023]
Abstract
Assisted reproductive technology (ART) led to the birth of 60,381 infants in 2020 in Japan. This number is set to increase as the future interest in ART is anticipated to rise. Couples receiving ART are monitoring the outcomes of these treatments to see whether any differences exist between babies conceived naturally and those conceived via ART. This study investigated the relationship between the long-term outcome of children born from ART with a focus on physical and psychomotor developments. A large volume of data concerning each relationship with ART was collected from various observational studies. Several findings indicate that, over time, the physical characteristics of babies born by ART, and those born naturally are comparable. However, some reports indicate that, until they reach school age, there may be a small difference in growth. ART and naturally conceived children do not vary in academic achievement or attention deficit hyperactivity disorder. Taken together, it is difficult to conclude with certainty that ART is the source of these differences since they may arise from the child's genetic factors or their environment.
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Affiliation(s)
- Masanori Ono
- Department of Obstetrics and Gynecology, Tokyo Medical University, Shinjuku (Tokyo), Japan.
| | - Naoaki Kuji
- Department of Obstetrics and Gynecology, Tokyo Medical University, Shinjuku (Tokyo), Japan
| | - Keiko Ueno
- Department of Obstetrics and Gynecology, Tokyo Medical University, Shinjuku (Tokyo), Japan
| | - Junya Kojima
- Department of Obstetrics and Gynecology, Tokyo Medical University, Shinjuku (Tokyo), Japan
| | - Hirotaka Nishi
- Department of Obstetrics and Gynecology, Tokyo Medical University, Shinjuku (Tokyo), Japan
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3
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Zhang S, Luo Q, Meng R, Yan J, Wu Y, Huang H. Long-term health risk of offspring born from assisted reproductive technologies. J Assist Reprod Genet 2024; 41:527-550. [PMID: 38146031 PMCID: PMC10957847 DOI: 10.1007/s10815-023-02988-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/02/2023] [Indexed: 12/27/2023] Open
Abstract
Since the world's first in vitro fertilization baby was born in 1978, there have been more than 8 million children conceived through assisted reproductive technologies (ART) worldwide, and a significant proportion of them have reached puberty or young adulthood. Many studies have found that ART increases the risk of adverse perinatal outcomes, including preterm birth, low birth weight, small size for gestational age, perinatal mortality, and congenital anomalies. However, data regarding the long-term outcomes of ART offspring are limited. According to the developmental origins of health and disease theory, adverse environments during early life stages may induce adaptive changes and subsequently result in an increased risk of diseases in later life. Increasing evidence also suggests that ART offspring are predisposed to an increased risk of non-communicable diseases, such as malignancies, asthma, obesity, metabolic syndrome, diabetes, cardiovascular diseases, and neurodevelopmental and psychiatric disorders. In this review, we summarize the risks for long-term health in ART offspring, discuss the underlying mechanisms, including underlying parental infertility, epigenetic alterations, non-physiological hormone levels, and placental dysfunction, and propose potential strategies to optimize the management of ART and health care of parents and children to eliminate the associated risks. Further ongoing follow-up and research are warranted to determine the effects of ART on the long-term health of ART offspring in later life.
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Affiliation(s)
- Siwei Zhang
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, No. 419, Fangxie Rd, Shanghai, 200011, China
| | - Qinyu Luo
- Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University School of Medicine, Hangzhou, China
| | - Renyu Meng
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, No. 419, Fangxie Rd, Shanghai, 200011, China
| | - Jing Yan
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, No. 419, Fangxie Rd, Shanghai, 200011, China
| | - Yanting Wu
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, No. 419, Fangxie Rd, Shanghai, 200011, China.
- Research Unit of Embryo Original Diseases (No. 2019RU056), Chinese Academy of Medical Sciences, Shanghai, China.
| | - Hefeng Huang
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, No. 419, Fangxie Rd, Shanghai, 200011, China.
- Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University School of Medicine, Hangzhou, China.
- Research Unit of Embryo Original Diseases (No. 2019RU056), Chinese Academy of Medical Sciences, Shanghai, China.
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4
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Mertens J, Belva F, van Montfoort APA, Regin M, Zambelli F, Seneca S, Couvreu de Deckersberg E, Bonduelle M, Tournaye H, Stouffs K, Barbé K, Smeets HJM, Van de Velde H, Sermon K, Blockeel C, Spits C. Children born after assisted reproduction more commonly carry a mitochondrial genotype associating with low birthweight. Nat Commun 2024; 15:1232. [PMID: 38336715 PMCID: PMC10858059 DOI: 10.1038/s41467-024-45446-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
Children conceived through assisted reproductive technologies (ART) have an elevated risk of lower birthweight, yet the underlying cause remains unclear. Our study explores mitochondrial DNA (mtDNA) variants as contributors to birthweight differences by impacting mitochondrial function during prenatal development. We deep-sequenced the mtDNA of 451 ART and spontaneously conceived (SC) individuals, 157 mother-child pairs and 113 individual oocytes from either natural menstrual cycles or after ovarian stimulation (OS) and find that ART individuals carried a different mtDNA genotype than SC individuals, with more de novo non-synonymous variants. These variants, along with rRNA variants, correlate with lower birthweight percentiles, independent of conception mode. Their higher occurrence in ART individuals stems from de novo mutagenesis associated with maternal aging and OS-induced oocyte cohort size. Future research will establish the long-term health consequences of these changes and how these findings will impact the clinical practice and patient counselling in the future.
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Affiliation(s)
- Joke Mertens
- Research Group Reproduction and Genetics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Florence Belva
- Center for Medical Genetics, UZ Brussel, Brussels, Belgium
| | - Aafke P A van Montfoort
- Department of Obstetrics & Gynaecology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marius Regin
- Research Group Reproduction and Genetics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Sara Seneca
- Research Group Reproduction and Genetics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Center for Medical Genetics, UZ Brussel, Brussels, Belgium
| | - Edouard Couvreu de Deckersberg
- Research Group Reproduction and Genetics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Herman Tournaye
- Brussels IVF, Center for Reproductive Medicine, UZ Brussel, Brussels, Belgium
- Research Group Biology of the Testis, Faculty of Medicine, Vrije Universiteit Brussel, Brussels, Belgium
| | - Katrien Stouffs
- Research Group Reproduction and Genetics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Center for Medical Genetics, UZ Brussel, Brussels, Belgium
| | - Kurt Barbé
- Interfaculty Center Data Processing & Statistics, Vrije Universiteit Brussel, Brussels, Belgium
| | - Hubert J M Smeets
- Department of Toxicogenomics, Maastricht University, Maastricht, The Netherlands
- MHeNs School Institute for Mental Health and Neuroscience, GROW Institute for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Hilde Van de Velde
- Brussels IVF, Center for Reproductive Medicine, UZ Brussel, Brussels, Belgium
- Research Group Reproduction and Immunology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Karen Sermon
- Research Group Reproduction and Genetics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Christophe Blockeel
- Brussels IVF, Center for Reproductive Medicine, UZ Brussel, Brussels, Belgium
- Department of Obstetrics and Gynaecology, School of Medicine, University of Zagreb, Šalata 3, Zagreb, 10000, Croatia
| | - Claudia Spits
- Research Group Reproduction and Genetics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium.
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5
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Doulgeraki T, Iliodromiti S. Reproductive outcomes in women and men conceived by assisted reproductive technologies. BMJ MEDICINE 2023; 2:e000547. [PMID: 37051027 PMCID: PMC10083816 DOI: 10.1136/bmjmed-2023-000547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 03/27/2023] [Indexed: 04/07/2023]
Affiliation(s)
- Triada Doulgeraki
- Department of Obstetrics and Gynaecology, Barts Health NHS Trust, The Royal London Hospital, London, UK
| | - Stamatina Iliodromiti
- Women's Health Research Unit, Wolfson Institute of Population Health, Queen Mary University of London Barts and The London School of Medicine and Dentistry, London, UK
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6
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Crafa A, Cannarella R, Barbagallo F, La Vignera S, Condorelli RA, Calogero AE. Effects of assisted reproductive techniques on offspring gonadal function: a systematic review and meta-analysis. F&S REVIEWS 2023; 4:152-173. [DOI: 10.1016/j.xfnr.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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7
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Prenatal Exposure to Parental Lifestyle Factors, Diseases, and Use of Medications and Male Pubertal Development: a Review of Epidemiological Studies Published 2017–2022. CURR EPIDEMIOL REP 2023. [DOI: 10.1007/s40471-023-00320-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Beilby KH, Kneebone E, Roseboom TJ, van Marrewijk IM, Thompson JG, Norman RJ, Robker RL, Mol BWJ, Wang R. Offspring physiology following the use of IVM, IVF and ICSI: a systematic review and meta-analysis of animal studies. Hum Reprod Update 2023; 29:272-290. [PMID: 36611003 PMCID: PMC10152177 DOI: 10.1093/humupd/dmac043] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 11/24/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Since the birth of the first baby using IVF technology in 1978, over 10 million children have been conceived via ART. Although most aspects of ARTs were developed in animal models, the introduction of these technologies into clinical practice was performed without comprehensive assessment of their long-term safety. The monitoring of these technologies over time has revealed differences in the physiology of babies produced using ARTs, yet due to the pathology of those presenting for treatment, it is challenging to separate the cause of infertility from the effect of treatments offered. The use of systematic review and meta-analysis to investigate the impacts of the predominant ART interventions used clinically in human populations on animals produced in healthy fertile populations offers an alternative approach to understanding the long-term safety of reproductive technologies. OBJECTIVE AND RATIONALE This systematic review and meta-analysis aimed to examine the evidence available from animal studies on physiological outcomes in the offspring conceived after IVF, IVM or ICSI, compared to in vivo fertilization, and to provide an overview on the landscape of research in this area. SEARCH METHODS PubMed, Embase and Commonwealth Agricultural Bureaux (CAB) Abstracts were searched for relevant studies published until 27 August 2021. Search terms relating to assisted reproductive technology, postnatal outcomes and mammalian animal models were used. Studies that compared postnatal outcomes between in vitro-conceived (IVF, ICSI or IVM) and in vivo-conceived mammalian animal models were included. In vivo conception included mating, artificial insemination, or either of these followed by embryo transfer to a recipient animal with or without in vitro culture. Outcomes included birth weight, gestation length, cardiovascular, metabolic and behavioural characteristics and lifespan. OUTCOMES A total of 61 studies in five different species (bovine, equine, murine, ovine and non-human primate) met the inclusion criteria. The bovine model was the most frequently used in IVM studies (32/40), while the murine model was mostly used in IVF (17/20) and ICSI (6/8) investigations. Despite considerable heterogeneity, these studies suggest that the use of IVF or maturation results in offspring with higher birthweights and a longer length of gestation, with most of this evidence coming from studies in cattle. These techniques may also impair glucose and lipid metabolism in male mice. The findings on cardiovascular outcomes and behaviour outcomes were inconsistent across studies. WIDER IMPLICATIONS Conception via in vitro or in vivo means appears to have an influence on measurable outcomes of offspring physiology, manifesting differently across the species studied. Importantly, it can be noted that these measurable differences are noticeable in healthy, fertile animal populations. Thus, common ART interventions may have long-term consequences for those conceived through these techniques, regardless of the pathology underpinning diagnosed infertility. However, due to heterogeneous methods, results and measured outcomes, highlighted in this review, it is difficult to draw firm conclusions. Optimizing animal and human studies that investigate the safety of new reproductive technologies will provide insight into safeguarding the introduction of novel interventions into the clinical setting. Cautiously prescribing the use of ARTs clinically may also be considered to reduce the chance of promoting adverse outcomes in children conceived before long-term safety is confidently documented.
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Affiliation(s)
- Kiri H Beilby
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
| | - Ezra Kneebone
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
| | - Tessa J Roseboom
- Department of Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, The Netherlands
| | - Indah M van Marrewijk
- The Robinson Research Institute, School of Biomedicine, University of Adelaide, Adelaide, Australia.,Department of Obstetrics and Gynaecology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Jeremy G Thompson
- The Robinson Research Institute, School of Biomedicine, University of Adelaide, Adelaide, Australia.,ARC Centre of Excellence for Nanoscale BioPhotonics, University of Adelaide, Adelaide, Australia
| | - Robert J Norman
- The Robinson Research Institute, School of Biomedicine, University of Adelaide, Adelaide, Australia
| | - Rebecca L Robker
- The Robinson Research Institute, School of Biomedicine, University of Adelaide, Adelaide, Australia
| | - Ben Willem J Mol
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia.,Aberdeen Centre for Women's Health Research, University of Aberdeen, Aberdeen, UK
| | - Rui Wang
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
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9
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Schroeder M, Badini G, Sferruzzi-Perri AN, Albrecht C. The Consequences of Assisted Reproduction Technologies on the Offspring Health Throughout Life: A Placental Contribution. Front Cell Dev Biol 2022; 10:906240. [PMID: 35747691 PMCID: PMC9210138 DOI: 10.3389/fcell.2022.906240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/05/2022] [Indexed: 11/13/2022] Open
Abstract
The use of assisted reproductive technologies (ART) worldwide has led to the conception and birth of over eight million babies since being implemented in 1978. ART use is currently on the rise, given growing infertility and the increase in conception age among men and women in industrialized countries. Though obstetric and perinatal outcomes have improved over the years, pregnancies achieved by ART still bear increased risks for the mother and the unborn child. Moreover, given that the first generation of ART offspring is now only reaching their forties, the long-term effects of ART are currently unknown. This is important, as there is a wealth of data showing that life-long health can be predetermined by poor conditions during intrauterine development, including irregularities in the structure and functioning of the placenta. In the current review, we aim to summarize the latest available findings examining the effects of ART on the cardiometabolic, cognitive/neurodevelopmental, and behavioral outcomes in the perinatal period, childhood and adolescence/adulthood; and to examine placental intrinsic factors that may contribute to the developmental outcomes of ART offspring. Altogether, the latest knowledge about life outcomes beyond adolescence for those conceived by ART appears to suggest a better long-term outcome than previously predicted. There are also changes in placenta structure and functional capacity with ART. However, more work in this area is critically required, since the potential consequences of ART may still emerge as the offspring gets older. In addition, knowledge of the placenta may help to foresee and mitigate any adverse outcomes in the offspring.
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Affiliation(s)
- Mariana Schroeder
- Faculty of Medicine, Institute of Biochemistry and Molecular Medicine, University of Bern, Bern, Switzerland
| | - Gina Badini
- Faculty of Medicine, Institute of Biochemistry and Molecular Medicine, University of Bern, Bern, Switzerland
| | - Amanda N. Sferruzzi-Perri
- Centre for Trophoblast Research, Department of Physiology, Development, and Neuroscience, University of Cambridge, Cambridge, United Kingdom
| | - Christiane Albrecht
- Faculty of Medicine, Institute of Biochemistry and Molecular Medicine, University of Bern, Bern, Switzerland
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10
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Purkayastha M, Roberts SA, Gardiner J, Brison DR, Nelson SM, Lawlor D, Luke B, Sutcliffe A. Cohort profile: a national, population-based cohort of children born after assisted conception in the UK (1992-2009): methodology and birthweight analysis. BMJ Open 2021; 11:e050931. [PMID: 34281932 PMCID: PMC8291329 DOI: 10.1136/bmjopen-2021-050931] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/02/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To generate a large cohort of children born after assisted reproductive technology (ART) in the UK between 1992 and 2009, their naturally conceived siblings (NCS) and matched naturally conceived population (NCP) controls and linking this with health outcome data to allow exploration of the effects of ART. The effects of fresh and frozen embryo transfer on birth weight (BW) were analysed to test the validity of the cohort. PARTICIPANTS Children recorded on the Human Fertilisation and Embryology Authority (HFEA) register as being born after ART between 1992 and 2009, their NCS and matched NCP controls linked to Office for National Statistics birth registration dataset (HFEA-ONS cohort). This cohort was further linked to the UK Hospital Episode Statistics database to allow monitoring of the child's post-natal health outcomes up to 2015 (HFEA-ONS-HES subcohort). FINDINGS TO DATE The HFEA-ONS cohort consisted of 75 348 children born after non-donor ART carried out in the UK between 1 April 1992 and 31 July 2009 and successfully linked to birth registration records, 14 763 NCS and 164 823 matched NCP controls. The HFEA-ONS-HES subcohort included 63 877 ART, 11 343 NCS and 127 544 matched NCP controls further linked to health outcome data. The exemplar analysis showed that children born after fresh embryo transfers were lighter (BW difference: -131 g, 95% CI: -140 to -123) and those born after frozen embryo transfers were heavier (BW difference: 35 g, 95% CI: 19 to 52) than the NCP controls. The within-sibling analyses were directionally consistent with the population control analyses, but attenuated markedly for the fresh versus natural conception (BW difference: -54 g; 95% CI: -72 to -36) and increased markedly for the frozen versus natural conception (BW difference: 152 g; 95% CI: 113 to 190) analyses. FUTURE PLANS To use this cohort to explore the relationship between ART conception and short-term and long-term health outcomes in offspring.
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Affiliation(s)
- Mitana Purkayastha
- Population, Policy & Practice Department, UCL Great Ormond Street Institute of Child Health Population Policy and Practice, London, UK
| | - Stephen A Roberts
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester, UK
| | - Julian Gardiner
- Population, Policy & Practice Department, UCL Great Ormond Street Institute of Child Health Population Policy and Practice, London, UK
- Department of Education, University of Oxford, Oxford, UK
| | - Daniel R Brison
- Department of Reproductive Medicine, St Mary's Hospital, Manchester, UK
| | - Scott M Nelson
- Department of Obstetrics & Gynaecology, School of Medicine, Dentistry & Nursing, Reproductive & Maternal Medicine, University of Glasgow, Glasgow, UK
| | - Deborah Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol Bristol Population Health Science Institute, Bristol, UK
| | - Barbara Luke
- Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Alastair Sutcliffe
- Population, Policy & Practice Department, UCL Great Ormond Street Institute of Child Health Population Policy and Practice, London, UK
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11
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Magnus MC, Wilcox AJ, Fadum EA, Gjessing HK, Opdahl S, Juliusson PB, Romundstad LB, Håberg SE. Growth in children conceived by ART. Hum Reprod 2021; 36:1074-1082. [PMID: 33592626 PMCID: PMC7970724 DOI: 10.1093/humrep/deab007] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/27/2020] [Indexed: 12/27/2022] Open
Abstract
STUDY QUESTION Is the growth pattern of children conceived by ART different compared to naturally conceived children. SUMMARY ANSWER Both ART and underlying parental subfertility may contribute to differences in early childhood growth between children conceived with and without the use of ART. WHAT IS KNOWN ALREADY Children conceived by ART weigh less and are shorter at the time of delivery. The extent to which differences in growth according to mode of conception persist during childhood, and the role of underlying parental subfertility, remains unclear. STUDY DESIGN, SIZE, DURATION We conducted a prospective study population-based study. We studied 81 461 children participating in the Norwegian Mother, Father and Child Cohort Study (MoBa) and 544 113 adolescents screened for military conscription. PARTICIPANTS/MATERIALS, SETTING, METHODS Conception by ART as registered in the Medical Birth Registry. We compared maternally reported length/height and weight among children in MoBa from mid-pregnancy to age 7 according to mode of conception using mixed-effects linear regression. Differences in self-reported height and weight at 17 years of age at screening for military conscription were assessed with linear regression. MAIN RESULTS AND THE ROLE OF CHANCE At birth, children conceived by ART were shorter (boys −0.3 cm; 95% CI, −0.5 to −0.1), girls −0.4 cm; 95% CI, −0.5 to −0.3) and lighter (boys −113 grams; 95% CI, −201 to −25, girls −107 grams; 95% CI, −197 to −17). After birth, children conceived by ART grew more rapidly, achieving both greater height and weight at age 3. Children conceived by ART had a greater height up to age 7, but did not have a greater height or weight by age 17. Naturally conceived children of parents taking longer time to conceive had growth patterns similar to ART children. Children born after frozen embryo transfer had larger ultrasound measures and were longer and heavier the first 2 years than those born after fresh embryo transfer. LIMITATIONS, REASONS FOR CAUTIONS Selection bias could have been introduced due to the modest participation rate in the MoBa cohort. Our reliance on self-reported measures of length/height and weight could have introduced measurement error. WIDER IMPLICATIONS OF THE FINDINGS : Our findings provide reassurance that offspring conceived by ART are not different in height, weight or BMI from naturally conceived once they reach adolescence. STUDY FUNDING/COMPETING INTEREST(S) Research Council of Norway; Medical Research Council; National Institute of Environmental Health Sciences. The authors have no competing interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Maria C Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, 0213 Oslo, Norway.,MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,Bristol Medical School, Population Health Sciences, Bristol, UK
| | - Allen J Wilcox
- Centre for Fertility and Health, Norwegian Institute of Public Health, 0213 Oslo, Norway.,Epidemiology Branch, National Institute of Environmental Health Sciences, NC, USA
| | - Elin A Fadum
- Institute of Military Medicine and Epidemiology, Norwegian Armed Forces Joint Medical Services, Sessvollmoen, Norway
| | - Håkon K Gjessing
- Centre for Fertility and Health, Norwegian Institute of Public Health, 0213 Oslo, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Signe Opdahl
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Petur B Juliusson
- Department of Health Registries, Norwegian Institute of Public Health, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Paediatrics, Haukeland University Hospital, Bergen, Norway
| | - Liv Bente Romundstad
- Centre for Fertility and Health, Norwegian Institute of Public Health, 0213 Oslo, Norway
| | - Siri E Håberg
- Centre for Fertility and Health, Norwegian Institute of Public Health, 0213 Oslo, Norway.,Institute of Military Medicine and Epidemiology, Norwegian Armed Forces Joint Medical Services, Sessvollmoen, Norway
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12
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PCSK9 and Lp(a) levels of children born after assisted reproduction technologies. J Assist Reprod Genet 2019; 36:1091-1099. [PMID: 31079266 DOI: 10.1007/s10815-019-01474-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 05/02/2019] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Proprotein convertase subtilisin/kexin type 9 (PCSK9) and lipoprotein (a) (Lp[a]) levels are associated with cardiovascular risk. To investigate PCSK9 and Lp(a) levels of children born after assisted reproduction technologies (ART) compared with naturally conceived (NC) controls. METHODS In this exposure-matched cohort study, 73 racial-, sex-, and age-matched children (mean age 98 ± 35 months) of ART (intracytoplasmic sperm injection [ICSI] n = 33, classic in vitro fertilization [IVF] n = 40) and 73 NC children were assessed. Blood lipid profile, including PCSK9 and Lp(a) levels, was measured. Children were grouped according to age (< 8 years, 8-10 years, ≥ 10 years). RESULTS In the overall population, PCSK9 levels were related to total cholesterol, low-density lipoprotein, and systolic blood pressure, while Lp(a) levels were related to age, apolipoprotein-B, birth weight, height, waist-to-hip ratio, insulin resistance, insulin, and high-sensitivity C-reactive protein. No significant differences were observed regarding lipid biomarkers between ART and NC children. However, a significant interaction was found between age groups and conception method (p < 0.001) showing that PCSK9 levels increase with age in ART children, while they decline with age in NC offspring. IVF children showed higher levels of adjusted mean Lp(a) than ICSI (13.5 vs. 6.8 mg/dl, p = 0.010) and NC children (12.3 vs. 8.3 mg/dl, p = 0.048). CONCLUSIONS We show that PCSK9 levels increase with age in ART children, indicating a gradual deterioration of lipidemic profile that could lead to increased cardiovascular risk. Moreover, our results indicate that ART method may be of importance given that classic IVF is associated with higher levels of Lp(a).
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13
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Ernst A, Lauridsen LLB, Brix N, Arah OA, Olsen J, Olsen LH, Ramlau-Hansen CH. Parental time to pregnancy, medically assisted reproduction and pubertal development in boys and girls. Hum Reprod 2019; 34:724-732. [PMID: 30753468 PMCID: PMC6443115 DOI: 10.1093/humrep/dez008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 01/02/2019] [Accepted: 01/22/2019] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Does parental fertility, measured by time to pregnancy (TTP), or use of medically assisted reproduction (MAR) affect pubertal development in the offspring? SUMMARY ANSWER Neither TTP nor type of MAR treatment had clinically relevant implications for mean age at achieving individual pubertal milestones or overall timing of puberty in boys and girls. WHAT IS KNOWN ALREADY Parental TTP and MAR have been associated with impaired semen quality in adult sons. Timing of puberty reflects earlier signals of reproductive health, but it remains unclear whether parental fertility or MAR affects pubertal development, especially in the growing generation of children conceived by IVF or ICSI. STUDY DESIGN, SIZE, DURATION In this study, 15 819 children born by mothers in the Danish National Birth Cohort from 2000 to 2003 participated in a nationwide puberty cohort (participation rate = 70%). Parental TTP and use of MAR were reported by mothers in early pregnancy and children’s pubertal development data was self-recorded in web-based questionnaires from 11 years of age and 6 monthly throughout puberty (2012–2018). PARTICIPANTS/MATERIALS, SETTING, METHODS Pubertal development in children (of planned pregnancies, n = 13 285) born by untreated subfecund (TTP: 6–12 months) (n =2038), untreated severely subfeund (TTP: >12 months) (n = 1242), treated subfecund (n = 230) and treated severely subfecund (n = 1234) parents were compared to children born to more fertile parents (TTP: ≤5 months). We estimated mean monthly differences in mean age at achieving individual pubertal milestones (i.e. age at menarche, voice break, first ejaculation and Tanner stages 2, 3, 4 and 5 for breast or genital development and pubic hair growth) and a combined indicator of timing of puberty. Further, we compared mean age at achieving the individual pubertal milestones in children born by use of IVF or ICSI (n = 480) with children born by controlled ovarian stimulation or ovulation induction with or without intrauterine insemination (n = 902). MAIN RESULTS AND THE ROLE OF CHANCE We found tendencies towards slightly later mean age at male pubertal timing and slightly earlier mean age at female pubertal timing among children born by untreated subfecund, treated subfecund, untreated severely subfecund and treated severely subfecund parents. There were no specific patterns with increasing TTP, use of MAR nor type of MAR treatment, and the magnitude of the mean differences for individual milestones and overall timing of puberty were small, i.e. 0.9 months (95% CI: −1.0; 2.8) for first ejaculation and −0.5 months (95% CI: −2.0; 1.0) months for age at menarche in boys and girls, respectively, born by treated severely subfecund parents when compared with children born by more fertile parents. LIMITATIONS, REASONS FOR CAUTION Non-differential misclassification of the self-reported information on parental TTP and pubertal development in the offspring may serve as an alternative explanation of the findings, possibly biasing the estimates towards the null. The information on pubertal development was collected from around 11 years of age and onwards. WIDER IMPLICATIONS OF THE FINDINGS This study adds to the growing body of literature suggesting only limited harmful effects of parental subfecundity and MAR on offspring’s long-term growth and development. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the Danish Council for Independent Research [DFF 4183-00152]; and the Faculty of Health at Aarhus University. The authors have no financial relationships or competing interests to disclose.
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Affiliation(s)
- A Ernst
- Department of Public Health, Section for Epidemiology, Aarhus University, Bartholins Allé 2, Aarhus C, Denmark.,Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles (UCLA), 650 Charles E. Young Drive South, Los Angeles, CA, USA
| | - L L B Lauridsen
- Department of Public Health, Section for Epidemiology, Aarhus University, Bartholins Allé 2, Aarhus C, Denmark
| | - N Brix
- Department of Public Health, Section for Epidemiology, Aarhus University, Bartholins Allé 2, Aarhus C, Denmark.,Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles (UCLA), 650 Charles E. Young Drive South, Los Angeles, CA, USA
| | - O A Arah
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles (UCLA), 650 Charles E. Young Drive South, Los Angeles, CA, USA.,California Center for Population Research, UCLA, 337 Charles E. Young Drive East, Los Angeles, CA, USA.,Center for Health Policy Research, UCLA, 337 Charles E. Young Drive East, Los Angeles, CA, USA
| | - J Olsen
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles (UCLA), 650 Charles E. Young Drive South, Los Angeles, CA, USA.,Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43, Aarhus N, Denmark
| | - L H Olsen
- Department of Urology, Section for Paediatric Urology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 35, Aarhus N, Denmark
| | - C H Ramlau-Hansen
- Department of Public Health, Section for Epidemiology, Aarhus University, Bartholins Allé 2, Aarhus C, Denmark
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14
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Merino PM, Lopez P, Salinas A, Pastene C, Muñoz A, Cassorla F, Codner E. Ovarian Function in Adolescents Conceived Using Assisted Reproductive Technologies. J Pediatr Adolesc Gynecol 2019; 32:117-121. [PMID: 30502496 DOI: 10.1016/j.jpag.2018.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 10/04/2018] [Accepted: 11/22/2018] [Indexed: 11/29/2022]
Abstract
STUDY OBJECTIVE To compare ovarian function between adolescents conceived using assisted reproductive technology (AcART) and adolescents who were conceived spontaneously (AcSP). DESIGN Multicenter study of ovarian function in AcART because of male or tubal infertility. SETTING University Hospital. PARTICIPANTS We evaluated 22 AcART and 53 AcSP at 1-2 years after menarche. The participants were born at term (≥37 weeks of gestation) with normal birth weights (≥2500 g) from singleton pregnancies. INTERVENTIONS None. MAIN OUTCOME MEASURES Differences in ovulation, reproductive hormones, and ovarian morphology. RESULTS AcART had an older age of menarche than that of AcSP, even after adjusting for maternal age at menarche, gestational age, and birth weight (P = .027). AcART had lower incidence of ovulation (P = .021) and higher luteinizing hormone serum levels (P = .01) than those of AcSP. The incidence of oligomenorrhea and the cycle length were similar between AcART and AcSP. AcART had levels of anti-Müllerian hormone, inhibin B, follicle-stimulating hormone, estradiol, and androgens similar to those of AcSP. The ovarian morphology, ovarian volume, and follicle counts were similar in both groups. CONCLUSION AcART had later menarche, lower ovulation rates, and higher luteinizing hormone levels than those of AcSP. Future studies should investigate whether these findings are indicative of a risk of ovarian dysfunction later in life for AcART.
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Affiliation(s)
- Paulina M Merino
- Institute of Maternal and Child Research, School of Medicine, University of Chile, Santiago, Chile.
| | - Patricia Lopez
- Institute of Maternal and Child Research, School of Medicine, University of Chile, Santiago, Chile; Cytogenetics Laboratory, Hospital Clínico San Borja Arriarán, Santiago, Chile
| | - Abril Salinas
- Institute of Maternal and Child Research, School of Medicine, University of Chile, Santiago, Chile
| | - Carolina Pastene
- Department of Obstetrics and Gynecology, Clinica Las Condes, Santiago, Chile
| | - Alex Muñoz
- Institute of Maternal and Child Research, School of Medicine, University of Chile, Santiago, Chile; Cytogenetics Laboratory, Hospital Clínico San Borja Arriarán, Santiago, Chile
| | - Fernando Cassorla
- Institute of Maternal and Child Research, School of Medicine, University of Chile, Santiago, Chile
| | - Ethel Codner
- Institute of Maternal and Child Research, School of Medicine, University of Chile, Santiago, Chile
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15
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Bay B, Lyngsø J, Hohwü L, Kesmodel US. Childhood growth of singletons conceived following in vitro fertilisation or intracytoplasmic sperm injection: a systematic review and meta-analysis. BJOG 2018; 126:158-166. [PMID: 30168249 DOI: 10.1111/1471-0528.15456] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Assisted reproductive techniques are associated with an increased risk of adverse pregnancy outcomes, including low birthweight and intrauterine growth restriction. Yet, the long-term follow-up on the growth of these children is limited. OBJECTIVE To systematically review the literature on post-neonatal height and weight among children conceived following in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment, compared with that of children born after spontaneous conception. SEARCH STRATEGY A systematic computerised literature search using the online databases PubMed, Embase, and Scopus. SELECTION CRITERIA Cohort or case-control studies with an exposed group of singletons conceived following IVF or ICSI along with a control group of spontaneously conceived singletons. DATA COLLECTION AND ANALYSIS Studies were reviewed by at least two authors. Meta-analyses were conducted using Cochrane Review Manager. The quality of the studies was assessed with the Newcastle-Ottawa Scale. MAIN RESULTS Twenty studies were included, with 13 of these eligible for meta-analyses. The meta-analyses compared 3972 children born after IVF/ICSI with 11 012 spontaneously conceived children and revealed no statistically significant difference in child weight [mean difference (MD) in weight of -160 g; 95% confidence interval (95% CI) -360, 3]. When stratifying by age of child at follow-up, we found a significant lower weight in children aged 0-4 years conceived following IVF/ICSI treatment (MD -180 g; 95% CI -320, -4), but this was no longer significant in children from 5 years of age (MD -160 g; 95% CI -580, 260). The pooled analysis revealed no statistically significant difference in childhood height. CONCLUSIONS In vitro fertilisation/ICSI was not associated with long-term weight and height. TWEETABLE ABSTRACT Children born following IVF/ICSI do not have impaired long-term weight or height compared with spontaneously conceived children.
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Affiliation(s)
- B Bay
- The Fertility Clinic, Regional Hospital Horsens, Horsens, Denmark.,Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - J Lyngsø
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | - L Hohwü
- Department of Health Science and Technology, Public Health and Epidemiology Group, Aalborg University, Aalborg, Denmark
| | - U S Kesmodel
- Department of Obstetrics and Gynaecology, Herlev and Gentofte Hospital, Herlev, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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16
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Krieger Y, Wainstock T, Sheiner E, Harlev A, Landau D, Horev A, Bogdanov-Berezovsky A, Walfisch A. Long-term pediatric skin eruption-related hospitalizations in offspring conceived via fertility treatment. Int J Dermatol 2018; 57:317-323. [DOI: 10.1111/ijd.13903] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 10/28/2017] [Accepted: 12/14/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Yuval Krieger
- Department of Plastic Surgery; Soroka University Medical Center; Ben-Gurion University of the Negev; Beer-Sheva Israel
| | - Tamar Wainstock
- Department of Public Health; Faculty of Health Sciences; Ben-Gurion University of the Negev; Beer-Sheva Israel
| | - Eyal Sheiner
- Department of Obstetrics and Gynecology; Soroka University Medical Center; Ben-Gurion University of the Negev; Beer-Sheva Israel
| | - Avi Harlev
- Fertility and IVF Unit; Department of Obstetrics and Gynecology; Soroka University Medical Center; Ben-Gurion University of the Negev; Beer-Sheva Israel
| | - Daniella Landau
- Department of Neonatology; Soroka University Medical Center; Ben-Gurion University of the Negev; Beer-Sheva Israel
| | - Amir Horev
- Department of Dermatology; Soroka University Medical Center; Ben-Gurion University of the Negev; Beer-Sheva Israel
| | - Alexander Bogdanov-Berezovsky
- Department of Plastic Surgery; Soroka University Medical Center; Ben-Gurion University of the Negev; Beer-Sheva Israel
| | - Asnat Walfisch
- Department of Obstetrics and Gynecology; Soroka University Medical Center; Ben-Gurion University of the Negev; Beer-Sheva Israel
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17
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Lewis S, Kennedy J, Burgner D, McLachlan R, Ranganathan S, Hammarberg K, Saffery R, Amor DJ, Cheung MMH, Doyle LW, Juonala M, Donath S, McBain J, Halliday J. Clinical review of 24-35 year olds conceived with and without in vitro fertilization: study protocol. Reprod Health 2017; 14:117. [PMID: 28931409 PMCID: PMC5607609 DOI: 10.1186/s12978-017-0377-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 09/08/2017] [Indexed: 12/13/2022] Open
Abstract
Background Children conceived by assisted reproductive technologies (ART) currently comprise 4% of Australian births. The manipulation of biological parameters related to fertilization and implantation are integral to successful ART but potentially pose a risk to the longer-term health of the offspring. There is consensus that many common adult health problems (particularly cardiovascular, metabolic and respiratory conditions) have their origins in early life, possibly before birth, and that risk trajectories track through childhood until clinical disease manifests in adulthood. Early life epigenetic variation may play a role in this process. However little is known about the long-term health of individuals conceived by ART. In a previous study, based on telephone-interviews, we found that young adults conceived by in vitro fertilization (IVF) had significantly more maternal reported atopic respiratory, endocrine, nutritional, and metabolic conditions than non-IVF conceived matched controls. Here we outline the protocol for a follow-up biomedical assessment of this cohort and a questionnaire to obtain information on potential confounders. Methods We are conducting a clinical review of an existing, well characterised cohort comprising 547 IVF-conceived adults and 549 matched controls. We are measuring cardiovascular intermediate phenotypes, metabolic parameters and respiratory function, complemented by epigenome-wide DNA methylation analysis. A pilot study demonstrated the feasibility of our proposed protocol and its acceptability to participants. Participants attend a 2–3 h clinical assessment and complete a study-specific online questionnaire. Measurements include: 1) cardiovascular phenotypes: carotid artery intima-media thickness and distensibility, retinal vascular calibre, resting blood pressure, pulse wave velocity and pulse wave analysis; 2) respiratory function: spirometry, plethysmography, multiple breath washout; 3) auxology: height, weight, waist circumference, bio-impedance. Blood is collected for 4) biomarkers of cardiometabolic profile including inflammatory markers and 5) epigenetic analysis. Discussion Recruitment for this clinical review is challenging as many of the participants have moved to regional, interstate or international locations. Additionally, many female participants are pregnant or breastfeeding, and are therefore ineligible. Nevertheless, comprehensive strategies have been developed to optimize recruitment. Given the increasing use of IVF and related technologies, the potential long-term consequences for risk of common adult diseases is an important clinical and public health issue.
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Affiliation(s)
- Sharon Lewis
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, 3052, Australia. .,Department of Paediatrics, University of Melbourne, Melbourne, Australia.
| | - Joanne Kennedy
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, 3052, Australia
| | - David Burgner
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, 3052, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Department of Paediatrics, Monash University, Melbourne, Australia
| | - Robert McLachlan
- Hudson Institute of Medical Research, Monash University, Clayton, 3168, Australia.,Monash IVF Group, Richmond, 3121, Australia
| | - Sarath Ranganathan
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, 3052, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Monash IVF Group, Richmond, 3121, Australia
| | - Karin Hammarberg
- Department of Respiratory and Sleep Medicine, The Royal Children's Hospital, Melbourne, Australia.,Victorian Assisted Reproductive Treatment Authority, Melbourne, Australia
| | - Richard Saffery
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, 3052, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - David J Amor
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, 3052, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,The Royal Children's Hospital, Melbourne, Australia
| | - Michael M H Cheung
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, 3052, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Department of Cardiology, The Royal Children's Hospital, Melbourne, Australia
| | - Lex W Doyle
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, 3052, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Research Office, Royal Women's Hospital, Melbourne, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia
| | - Markus Juonala
- Department of Internal Medicine, University of Turku and Division of Medicine Turku University Hospital, Turku, Finland
| | - Susan Donath
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, 3052, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - John McBain
- Reproductive Services, Royal Women's Hospital, Melbourne, Australia
| | - Jane Halliday
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, 3052, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
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18
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Liu ZY, Wang XL, Han TY, Cui YP, Wang XM, Tong XM, Song Y, Wang HJ, Li S. [A survey of pubertal development in children born with assisted reproductive technology]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2017; 19:646-651. [PMID: 28606230 PMCID: PMC7390302 DOI: 10.7499/j.issn.1008-8830.2017.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Accepted: 03/07/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To investigate the status of pubertal development in children born with assisted reproductive technology (ART). METHODS A retrospective analysis was performed on the pubertal development data of children born with ART in Peking University Third Hospital from 1994 to 2003 (ART group). The data in the cross-sectional study "Reports on the Physical Fitness and Health Research of Chinese School Students in 2010" were used as a control. The age at menarche and the age at spermarche were compared between the two groups. The status of pubertal development in the overweight and obese children in the ART group was evaluated to investigate the correlation between pubertal development and body mass index (BMI). RESULTS A total of 200 children born with ART were enrolled in this study, and 72 of them (41 males and 31 females) completed the survey (response rate=36.0%). In the ART group, the mean age at spermarche and the mean age at menarche were 13.9 years (95%CI: 13.7-14.3 years) and 12.2 years (95%CI: 11.8-12.6 years), respectively. There were no significant differences in the age at spermarche and the age at menarche between the ART and control groups (P>0.05). In the ART group, there were no significant differences in the age at spermarche and the age at menarche between the overweight and obese children and the normal weight children (P>0.05). There were also no significant differences in overweight rate and obesity rate between the children in the ART group and the adolescents in Beijing (P>0.05). In the ART group, there was no significant correlation between the age at spermarche or menarche and BMI (P>0.05). CONCLUSIONS No delayed or precocious puberty is observed in children born with ART. This is consistent with the normal control data. And there is no significant correlation between pubertal development and BMI in children born with ART.
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Affiliation(s)
- Zi-Yuan Liu
- Department of Pediatrics, Peking University Third Hospital, Beijing 100191, China.
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19
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Physiological, metabolic and transcriptional postnatal phenotypes of in vitro fertilization (IVF) in the mouse. J Dev Orig Health Dis 2017; 8:403-410. [PMID: 28416032 DOI: 10.1017/s204017441700023x] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Approximately 1-4% of children today are conceived using assisted reproductive technologies (ARTs), including in vitro fertilization (IVF). IVF is considered safe and the great majority of these children are healthy, yet there is increasing physiological and molecular evidence from animal models that ART is associated with postnatal metabolic and cardiovascular alterations. Understanding the mechanisms underlying these changes and determining whether they have biological significance is of paramount importance for optimizing the design of culture conditions and improving the health of ART children across the life course. In this review, we examine the evidence of molecular changes present in adult tissues of rodent offspring generated by preimplantation manipulation of gametes and embryos. Although embryo manipulation in vitro can induce common transcriptional effects in the blastocyst, transcriptional and metabolomic signatures in adult IVF tissues are largely tissue-specific. However, there is pervasive evidence of oxidative stress and metabolic dysfunction, indicating a lasting effect of IVF on molecular physiology.
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20
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Karimi H, Mahdavi P, Fakhari S, Faryabi MR, Esmaeili P, Banafshi O, Mohammadi E, Fathi F, Mokarizadeh A. Altered helper T cell-mediated immune responses in male mice conceived through in vitro fertilization. Reprod Toxicol 2017; 69:196-203. [DOI: 10.1016/j.reprotox.2017.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 03/04/2017] [Accepted: 03/07/2017] [Indexed: 01/28/2023]
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21
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Serum reproductive hormone levels and ultrasound findings in female offspring after intracytoplasmic sperm injection: first results. Fertil Steril 2017; 107:934-939. [PMID: 28292621 DOI: 10.1016/j.fertnstert.2017.02.102] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Revised: 02/07/2017] [Accepted: 02/10/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To compare reproductive hormone levels and antral follicle count in intracytoplasmic sperm injection (ICSI)-conceived offspring and peers born after spontaneous conception. DESIGN Single-center study of the reproductive health at the age of 18-22 years in the worldwide oldest cohort of female ICSI offspring. SETTING University hospital. PATIENT(S) A longitudinally followed cohort of singleton women (n = 71) conceived by means of ICSI because of male infertility and a cross-sectionally recruited group of spontaneously conceived women of the same age (n = 81). INTERVENTIONS(S) None. MAIN OUTCOME MEASURE(S) Differences in serum reproductive hormone levels and ultrasound findings. RESULT(S) Median levels of antimüllerian hormone (AMH), FSH, LH, and DHEAS were similar between ICSI women and their spontaneously conceived counterparts. Median E2 levels in ICSI women taking hormonal contraceptives were higher compared with control women. A minority of ICSI women had AMH levels below the 5th or above the 95th percentile, and ICSI women were not more likely to have AMH levels below the 5th percentile or above the 95th percentile compared with control women. Mean follicle count per ovary was similar between the ICSI and control groups. Furthermore, a similar proportion of women had >19 follicles per ovary (ICSI: 20.9%; control: 20.0%). A strong positive correlation between AMH level and mean follicle count per ovary was found. CONCLUSION(S) In this cohort of 71 young adult women conceived by means of ICSI because of male infertility in their parents, antral follicle count and circulating reproductive hormone levels, including AMH, FSH, LH, and DHEAS, were found to be similar to results from peers born after spontaneous conception.
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22
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Guo XY, Liu XM, Jin L, Wang TT, Ullah K, Sheng JZ, Huang HF. Cardiovascular and metabolic profiles of offspring conceived by assisted reproductive technologies: a systematic review and meta-analysis. Fertil Steril 2017; 107:622-631.e5. [PMID: 28104241 DOI: 10.1016/j.fertnstert.2016.12.007] [Citation(s) in RCA: 140] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 12/08/2016] [Accepted: 12/08/2016] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To evaluate cardiovascular and metabolic features of offspring conceived by in vitro fertilization/intracytoplasmic sperm injection (IVF-ICSI). DESIGN Literature review and meta-analysis. SETTING Not applicable. PATIENT(S) Offspring from IVF-ICSI versus natural conception. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Systolic and diastolic blood pressure (SBP and DBP), cardiovascular function, body mass index (BMI), and lipid and glucose profiles. RESULT(S) We included 19 studies that had recruited 2,112 IVF-ICSI and 4,096 naturally conceived offspring, ranging from childhood to early adulthood. The blood pressure levels of IVF-ICSI offspring were statistically significantly higher than those of naturally conceived offspring (weighted mean differences and confidence intervals: 1.88 mm Hg [95% CI, 0.27, 3.49] for SBP and 1.51 mm Hg [95% CI, 0.33, 2.70] for DBP). In addition, cardiac diastolic function was suboptimal and vessel thickness was higher among IVF-ICSI offspring. Compared with the metabolism of naturally conceived offspring, IVF-ICSI offspring displayed comparable BMI, lower low-density lipoprotein cholesterol levels, and higher fasting insulin levels. CONCLUSION(S) Children conceived by IVF-ICSI manifested a minor yet statistically significant increase in blood pressure without the clustering of increased BMI or impaired lipid metabolism by early adulthood. Our findings indicate a risk of cardiovascular disease among IVF-ICSI offspring, which calls for longer-term follow-ups and further investigation.
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Affiliation(s)
- Xiao-Yan Guo
- Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Zhejiang, People's Republic of China
| | - Xin-Mei Liu
- International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China; Institute of Embryo-Fetal Original Adult Disease, Affiliated to Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Li Jin
- International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China; Institute of Embryo-Fetal Original Adult Disease, Affiliated to Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Ting-Ting Wang
- International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China; Institute of Embryo-Fetal Original Adult Disease, Affiliated to Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Kamran Ullah
- Department of Pathology and Pathophysiology, School of Medicine, Zhejiang University, Zhejiang, People's Republic of China
| | - Jian-Zhong Sheng
- Department of Pathology and Pathophysiology, School of Medicine, Zhejiang University, Zhejiang, People's Republic of China
| | - He-Feng Huang
- Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Zhejiang, People's Republic of China; International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China; Institute of Embryo-Fetal Original Adult Disease, Affiliated to Shanghai Jiao Tong University, Shanghai, People's Republic of China.
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Fruchter E, Beck-Fruchter R, Hourvitz A, Weiser M, Goldberg S, Fenchel D, Lerner-Geva L. Health and functioning of adolescents conceived by assisted reproductive technology. Fertil Steril 2017; 107:774-780. [PMID: 28093195 DOI: 10.1016/j.fertnstert.2016.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 12/06/2016] [Accepted: 12/06/2016] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To evaluate the general health, mental health, and cognitive ability of assisted reproductive technology (ART)-conceived adolescents. DESIGN A nested case-control study within a historic cohort. SETTING Not applicable. PATIENT(S) A total of 253 ART-conceived adolescents born between 1982 and 1993 and 253 matched references according to birth year, gender, and the high-school they attended. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Medical and psychiatric diagnoses, and cognitive ability recorded at the military preinduction screening (ages 16-17 years) and doctor's appointments throughout the military service. RESULT(S) No differences were detected in general and mental health of ART adolescents or cognitive ability, compared with the reference group. Similar results were obtained after stratification for gender and singleton births. The ART adolescents had fewer cases of discharge from military service due to health reasons (4% vs. 8.3%). Follow-up during the military service revealed that male ART adolescents had significantly more doctor's appointments compared with the reference group (23.80 ± 15.59 vs. 19.95 ± 13.79). CONCLUSION(S) Our preliminary results provide reassurance that in the long-run health and functioning of ART-conceived adolescents is not compromised. Further studies with larger cohorts are needed to confirm these results.
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Affiliation(s)
- Eyal Fruchter
- Israeli Defense Force Medical Corps., Department of Psychiatry, Rambam Medical Center; Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Ronit Beck-Fruchter
- Department of Obstetrics and Gynecology, Ha'Emek Medical Center, Afula; Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Ariel Hourvitz
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Mark Weiser
- Department of Psychiatry, Chaim Sheba Medical Center, Tel Hashomer; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Shira Goldberg
- Department of Psychiatry, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Daphna Fenchel
- Department of Psychiatry, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Liat Lerner-Geva
- Women and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center, Tel Hashomer; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Loke YJ, Craig JM. Are the effects of IVF on DNA methylation driven by intracytoplasmic sperm injection and male infertility? Epigenomics 2016; 8:881-4. [PMID: 27366826 DOI: 10.2217/epi-2016-0041] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Affiliation(s)
- Yuk Jing Loke
- Murdoch Childrens Research Institute & Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Flemington Road, Parkville, Victoria 3052, Australia
| | - Jeffrey M Craig
- Murdoch Childrens Research Institute & Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Flemington Road, Parkville, Victoria 3052, Australia
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Hanevik HI, Hessen DO, Sunde A, Breivik J. Can IVF influence human evolution? Hum Reprod 2016; 31:1397-402. [PMID: 27094480 DOI: 10.1093/humrep/dew089] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 03/29/2016] [Indexed: 01/14/2023] Open
Abstract
IVF, a procedure in which pharmacological and technological manipulation is used to promote pregnancy, offers help to infertile couples by circumventing selection at the most fundamental level. Fertility is clearly one of the key fitness-promoting drivers in all forms of sexually reproducing life, and fertilization and pregnancy are fundamental evolutionary processes that involve a range of pre- and post-zygotic screening mechanisms. Here, we discuss the various selection and screening factors involved in fertilization and pregnancy and assess IVF practices in light of these factors. We then focus on the possible consequences of these differences in selection pressures, mainly at the individual but also at the population level, to evaluate whether changes in the reproducing genotype can affect human evolution. The aim of the article is not to argue for or against IVF, but to address aspects of assisted reproduction in an evolutionary context.
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Affiliation(s)
- Hans Ivar Hanevik
- Fertilitetsavdelingen Sor, Telemark Hospital Trust, Porsgrunn, Norway
| | - Dag O Hessen
- Department of Biosciences, University of Oslo, Oslo, Norway
| | - Arne Sunde
- Department of Gynaecology and Obstetrics, Trondheim University Hospital, Trondheim, Norway
| | - Jarle Breivik
- Department of Behavioural Sciences in Medicine, University of Oslo, Oslo, Norway
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Lewis SEM, Kumar K. The paternal genome and the health of the assisted reproductive technology child. Asian J Androl 2016; 17:616-22. [PMID: 25926606 PMCID: PMC4492053 DOI: 10.4103/1008-682x.153301] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
As a number of children born by assisted reproductive technology (ART) are increasing each year across the developed world, the health of such offspring is a matter of public concern. Does the integrity of the paternal genome impact on offspring health? In societal terms, as birth rates fall, and the Western population become unsustainable, do the benefits outweigh the costs of creating and providing for this ART conceived subpopulation? There are little data to date to answer these questions. The long-term health of such children has largely been ignored, and success measured only by early (prebirth) outcomes such as embryo quality or pregnancy. However, there are powerful paradigms such as ageing and smoking that give vital clues as to the potential impact of unhealthy spermatozoa on disease risk, mental and physical health, fertility and mortality of these offspring.
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Affiliation(s)
- Sheena E M Lewis
- Centre for Public Health, Queen's University Belfast, Grosvenor Road, BT12 6BJ,NI, UK
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27
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Early fetal growth in progesterone-treated IVF pregnancies. Arch Gynecol Obstet 2015; 294:63-9. [DOI: 10.1007/s00404-015-3951-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 10/28/2015] [Indexed: 12/21/2022]
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Is subfertility or fertility treatment associated with long-term growth in the offspring? A cohort study. Fertil Steril 2014; 102:1117-23. [DOI: 10.1016/j.fertnstert.2014.06.048] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 06/08/2014] [Accepted: 06/30/2014] [Indexed: 11/16/2022]
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Abstract
BACKGROUND The advances in the world of IVF during the last decades have been rapid and impressive and culture media play a major role in this success. Until the 1980s fertility centers made their media in house. Nowadays, there are numerous commercially available culture media that contain various components including nutrients, vitamins and growth factors. This review goes through the past, present and future of IVF culture media and explores their composition and quality assessment. METHODS A computerized search was performed in PubMed regarding IVF culture media including results from 1929 until March 2014. Information was gathered from the websites of companies who market culture media, advertising material, instructions for use and certificates of analysis. The regulation regarding IVF media mainly in the European Union (EU) but also in non-European countries was explored. RESULTS The keyword 'IVF culture media' gave 923 results in PubMed and 'embryo culture media' 12 068 results dating from 1912 until March 2014, depicting the increased scientific activity in this field. The commercialization of IVF culture media has increased the standards bringing a great variety of options into clinical practice. However, it has led to reduced transparency and comparisons of brand names that do not facilitate the scientific dialogue. Furthermore, there is some evidence suggesting that suboptimal culture conditions could cause long-term reprogramming in the embryo as the periconception period is particularly susceptible to epigenetic alterations. IVF media are now classified as class III medical devices and only CE (Conformité Européene)-marked media should be used in the EU. CONCLUSION The CE marking of IVF culture media is a significant development in the field. However, the quality and efficiency of culture media should be monitored closely. Well-designed randomized controlled trials, large epidemiological studies and full transparency should be the next steps. Reliable, standardized models assessing multiple end-points and post-implantation development should replace the mouse embryo assay. Structured long-term follow-up of children conceived by assisted reproduction technologies and traceability are of paramount importance.
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Affiliation(s)
- Elpiniki Chronopoulou
- Institute for Women's Health, University College London, 86-96 Chenies Mews, London WC1E 6HX, UK
| | - Joyce C Harper
- UCL Centre for PG and D, Institute for Women's Health, University College London, London, UK The Centre for Reproductive and Genetic Health, UCLH, London, UK
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Donjacour A, Liu X, Lin W, Simbulan R, Rinaudo PF. In vitro fertilization affects growth and glucose metabolism in a sex-specific manner in an outbred mouse model. Biol Reprod 2014; 90:80. [PMID: 24621920 DOI: 10.1095/biolreprod.113.113134] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
The preimplantation period is a time of reprogramming that may be vulnerable to disruption. This question has wide clinical relevance since the number of children conceived by in vitro fertilization (IVF) is rising. To examine this question, outbred mice (CF1 × B6D2F1) conceived by IVF and cultured using Whitten medium and 20% O2 (IVFWM group, less optimal) or K simplex optimized medium with amino acids and 5% O2 (IVFKAA group, more optimal and similar to conditions used in human IVF) were studied postnatally. We found that flushed blastocysts transferred to recipient mice provided the best control group (FB group), as this accounted for the effects of superovulation, embryo transfer, and litter size. We observed that many physiological parameters were normal. Reassuringly, IVFKAA offspring did not differ significantly from FB offspring. However, male IVFWM mice (but not females) were larger during the first 19 wk of life and exhibited glucose intolerance. Male IVFWM mice also showed enlarged left heart despite normal blood pressure. Expression of candidate imprinted genes (H19, Igf2, and Slc38a4) in multiple adult tissues did not show differences among the groups; only Slc38a4 was down-regulated following IVF (in both culture conditions) in female adipose tissue. These studies demonstrate that adult metabolism is affected by the type of conditions encountered during the preimplantation stage. Further, the postnatal growth trajectory and glucose homeostasis following ex vivo manipulation may be sexual dimorphic. Future work on the long-term effects of IVF offspring should focus on glucose metabolism and the cardiovascular system.
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Affiliation(s)
- Annemarie Donjacour
- Department of Obstetrics and Gynecology, University of California at San Francisco, San Francisco, California
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Lou H, Le F, Zheng Y, Li L, Wang L, Wang N, Zhu Y, Huang H, Jin F. Assisted reproductive technologies impair the expression and methylation of insulin-induced gene 1 and sterol regulatory element-binding factor 1 in the fetus and placenta. Fertil Steril 2014; 101:974-980.e2. [PMID: 24484994 DOI: 10.1016/j.fertnstert.2013.12.034] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 12/03/2013] [Accepted: 12/18/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To evaluate the cholesterol metabolism linked to assisted reproductive technology (ART) by analyzing the expression levels and DNA methylation patterns of the insulin-induced gene (INSIG), sterol regulatory element-binding protein (SREBP), and SREBP cleavage-activating protein in the fetus and placenta. DESIGN Experimental research study. SETTING An IVF center, university-affiliated teaching hospital. PATIENT(S) Four patients groups were recruited: pregnancies after IVF/intracytoplasmic sperm injection (ICSI) (n = 55), natural pregnancies (n = 40), multifetal reduction after IVF/ICSI (n = 56), and multifetal reduction after controlled ovarian hyperstimulation (COH) (n = 42). INTERVENTION(S) Expression and DNA methylation of INSIG-SREBP- SREBP cleavage-activating protein in the fetus and placenta samples were determined. MAIN OUTCOME MEASURE(S) The expression and DNA methylation patterns were tested by real-time quantitative polymerase chain reaction (PCR) and pyrosequencing. RESULT(S) In the ICSI treatment group, significantly higher levels of triglycerides and apolipoprotein-B were observed in cord blood compared with controls. Meanwhile, in ICSI-conceived fetuses, the expression of INSIG1 was significantly higher, and methylation rates were lower, than in the IVF and control groups. Furthermore, in the placenta, the INSIG1 and SREBF1 transcripts were also significantly higher with lower methylation rates in the ICSI group than in the IVF and control groups. CONCLUSION(S) Our results indicated that the dysregulation of INSIG1 and SREBF1 caused by ART were observed not only in the fetus but also in the placenta, primarily in the ICSI group. However, the long-term sequelae of this dysregulation should be closely followed.
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Affiliation(s)
- Hangying Lou
- Center of Reproductive Medicine, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Key Laboratory of Reproductive Genetics, Ministry of Education, Hangzhou, People's Republic of China
| | - Fang Le
- Center of Reproductive Medicine, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Yingming Zheng
- Center of Reproductive Medicine, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Lejun Li
- Center of Reproductive Medicine, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Liya Wang
- Center of Reproductive Medicine, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Ning Wang
- Center of Reproductive Medicine, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Yimin Zhu
- Center of Reproductive Medicine, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Key Laboratory of Reproductive Genetics, Ministry of Education, Hangzhou, People's Republic of China
| | - Hefeng Huang
- Center of Reproductive Medicine, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Key Laboratory of Reproductive Genetics, Ministry of Education, Hangzhou, People's Republic of China
| | - Fan Jin
- Center of Reproductive Medicine, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China; Key Laboratory of Reproductive Genetics, Ministry of Education, Hangzhou, People's Republic of China.
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Fauser BCJM, Devroey P, Diedrich K, Balaban B, Bonduelle M, Delemarre-van de Waal HA, Estella C, Ezcurra D, Geraedts JPM, Howles CM, Lerner-Geva L, Serna J, Wells D. Health outcomes of children born after IVF/ICSI: a review of current expert opinion and literature. Reprod Biomed Online 2013; 28:162-82. [PMID: 24365026 DOI: 10.1016/j.rbmo.2013.10.013] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 10/03/2013] [Accepted: 10/08/2013] [Indexed: 01/28/2023]
Abstract
The Sixth Evian Annual Reproduction (EVAR) Workshop Group Meeting was held to evaluate the impact of IVF/intracytoplasmic sperm injection on the health of assisted-conception children. Epidemiologists, reproductive endocrinologists, embryologists and geneticists presented data from published literature and ongoing research on the incidence of genetic and epigenetic abnormalities and congenital malformations in assisted-conception versus naturally conceived children to reach a consensus on the reasons for potential differences in outcomes between these two groups. IVF-conceived children have lower birthweights and higher peripheral fat, blood pressure and fasting glucose concentrations than controls. Growth, development and cognitive function in assisted-conception children are similar to controls. The absolute risk of imprinting disorders after assisted reproduction is less than 1%. A direct link between assisted reproduction and health-related outcomes in assisted-conception children could not be established. Women undergoing assisted reproduction are often older, increasing the chances of obtaining abnormal gametes that may cause deviations in outcomes between assisted-conception and naturally conceived children. However, after taking into account these factors, it is not clear to what extent poorer outcomes are due to the assisted reproduction procedures themselves. Large-scale, multicentre, prospective epidemiological studies are needed to investigate this further and to confirm long-term health consequences in assisted-conception children. Assisted reproduction treatment is a general term used to describe methods of achieving pregnancy by artificial means and includes IVF and sperm implantation. The effect of assisted reproduction treatment on the health of children born using these artificial methods is not fully understood. In April 2011, fertility research experts met to give presentations based on research in this area and to look carefully at the evidence for the effects of assisted reproduction treatment on children's health. The purpose of this review was to reach an agreement on whether there are differences in the health of assisted-conception children with naturally conceived children. The researchers discovered no increased risk in birth defects in assisted-conception children compared with naturally conceived children. They found that IVF-conceived children have lower birth weights and higher fat under the skin, higher blood pressure and higher fasting glucose concentrations than naturally conceived children; however, growth, development and cognitive function are similar between groups. A very low risk of disorders of genetic control was observed in assisted-conception children. Overall, there did not appear to be a direct link between assisted reproduction treatment and children's health. The researchers concluded that the cause of some differences in the health of children conceived using assisted reproduction treatment may be due to the age of the woman receiving treatment. Large-scale, research studies are needed to study the long-term health of children conceived using assisted reproduction treatment.
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Affiliation(s)
- B C J M Fauser
- Department of Reproductive Medicine and Gynaecology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
| | - P Devroey
- Center for Reproductive Medicine, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - K Diedrich
- Department of Obstetrics and Gynecology, University Clinic of Schleswig-Holstein, Campus Luebeck, 23538 Luebeck, Germany
| | - B Balaban
- Assisted Reproduction Unit, American Hospital of Istanbul, Guzelbahce Sokak No 20, Nisantasi, Istanbul 34365, Turkey
| | - M Bonduelle
- Centre for Medical Genetics, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | | | - C Estella
- Fundación Instituto Valenciano de Infertilidad (FIVI), Valencia University, and Instituto Universitario IVI/INCLIVA, Parc Científic Universitat de València C/Catedrático Agustín Escardino n(o) 9, Edificio 3, 46980 Paterna, Spain; Departamento de Biología Molecular and Centro de Biología Molecular 'Severo Ochoa' (CSIC-UAM), Universidad Autónoma de Madrid, Madrid, Spain
| | - D Ezcurra
- Global Development and Medical Unit, Merck Serono SA Geneva, Chemin des Mines 9, 1202 Geneva, Switzerland
| | - J P M Geraedts
- Department of Genetics and Cell Biology, Research Institute GROW, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - C M Howles
- Global Development and Medical Unit, Merck Serono SA Geneva, Chemin des Mines 9, 1202 Geneva, Switzerland
| | - L Lerner-Geva
- Woman and Child Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer 52621, Israel
| | - J Serna
- Instituto Valenciano de Infertilidad (IVI) Zaragoza, C/María Zambrano, 31, 50018 Zaragoza, Spain
| | - D Wells
- University of Oxford, Nuffield Department of Obstetrics and Gynaecology, Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK
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Sunde A, Balaban B. The assisted reproductive technology laboratory: toward evidence-based practice? Fertil Steril 2013; 100:310-8. [DOI: 10.1016/j.fertnstert.2013.06.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 06/07/2013] [Accepted: 06/18/2013] [Indexed: 11/16/2022]
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Sergentanis TN, Diamantaras AA, Perlepe C, Kanavidis P, Skalkidou A, Petridou ET. IVF and breast cancer: a systematic review and meta-analysis. Hum Reprod Update 2013; 20:106-23. [PMID: 23884897 DOI: 10.1093/humupd/dmt034] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The effects of controlled ovarian hyperstimulation (COH) for IVF in terms of breast cancer risk remain controversial, despite the hormone-dependent nature of the latter. METHODS Eligible studies up to 15 February 2013 were identified and pooled effect estimates for relative risk (RR) were calculated separately for the investigations using the general population and those using infertile women, as a reference group. Fixed- or random-effects models were implemented and subgroup analyses were performed, as appropriate. RESULTS Eight cohort studies were synthesized, yielding a total cohort size of 1,554,332 women among whom 14,961 incident breast cancer cases occurred, encompassing 576 incident breast cancer cases among women exposed to IVF. No significant association between IVF and breast cancer was observed either in the group of studies treating the general population (RR = 0.91, 95% confidence interval (CI): 0.74-1.11) or infertile women (RR = 1.02, 95% CI: 0.88-1.18), as a reference group. Of note were the marginal associations, protective for pregnant and/or parous women after IVF (pooled effect estimate = 0.86, 95% CI: 0.73-1.01) and adverse for women <30 years at first IVF treatment (pooled effect estimate = 1.64, 95% CI: 0.96-2.80). CONCLUSIONS At present, COH for IVF does not seem to impart increased breast cancer risk. Longer follow-up periods, comparisons versus infertile women, subgroup analyses aiming to trace vulnerable subgroups, adjustment for various confounders and larger informative data sets are needed before conclusive statements for the safety of the procedure are reached.
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Affiliation(s)
- Theodoros N Sergentanis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, 75 M. Asias Str. Goudi, Athens 115 27, Greece
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Abstract
PURPOSE OF REVIEW Biomarkers of prepubertal testicular function have become widely available only in recent years. The aim of this review is to update the knowledge on key biomarkers used to assess hypogonadism in boys. RECENT FINDINGS Sertoli cells are the most representative cells of the prepubertal testis. Anti-Müllerian hormone and inhibin B are essential biomarkers of Sertoli cell function. Also, INSL3 arises as an additional marker of Leydig cell dysfunction. SUMMARY The widespread use of these biomarkers has enhanced our knowledge on the pathophysiology and diagnosis of prepubertal male hypogonadism. Beyond their well known germ-cell toxicity, oncologic treatments may also affect Sertoli cell function. Pathophysiology is not the same in all aneuploidies leading to infertility: while hypogonadism is not evident until mid-puberty in Klinefelter syndrome, it is established in early infancy in Down syndrome. In Noonan syndrome, the occurrence of primary hypogonadism depends on the existence of cryptorchidism, and Prader-Willi syndrome may present with either primary or combined forms of hypogonadism. Prepubertal testicular markers have also provided insights into the effects of environmental disruptors on gonadal function from early life, and helped dissipate concerns about testicular function in boys born preterm or small for gestational age or conceived by assisted reproductive technique procedures.
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Affiliation(s)
- Clara Valeri
- Centro de Investigaciones Endocrinológicas (CEDIE), División de Endocrinología, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina
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Lu YH, Wang N, Jin F. Long-term follow-up of children conceived through assisted reproductive technology. J Zhejiang Univ Sci B 2013; 14:359-71. [PMID: 23645173 PMCID: PMC3650450 DOI: 10.1631/jzus.b1200348] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2012] [Accepted: 03/05/2013] [Indexed: 01/15/2023]
Abstract
Children conceived via assisted reproductive technologies (ART) are nowadays a substantial proportion of the population. It is important to follow up these children and evaluate whether they have elevated health risks compared to naturally conceived (NC) children. In recent years there has been a lot of work in this field. This review will summarize what is known about the health of ART-conceived children, encompassing neonatal outcomes, birth defects, growth and gonadal developments, physical health, neurological and neurodevelopmental outcomes, psychosocial developments, risk for cancer, and epigenetic abnormalities. Most of the children conceived after ART are normal. However, there is increasing evidence that ART-conceived children are at higher risk of poor perinatal outcome, birth defects, and epigenetic disorders, and the mechanism(s) leading to these changes have not been elucidated. Continuous follow-up of children after ART is of great importance as they progress through adolescence into adulthood, and new ART techniques are constantly being introduced.
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Affiliation(s)
- Yue-hong Lu
- Key Laboratory of Reproductive Genetics (Zhejiang), Ministry of Education, and Centre of Reproductive Medicine, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
- Center for Reproductive Medicine, Shaoxing Women and Children’s Hospital, Shaoxing 312000, China
| | - Ning Wang
- Key Laboratory of Reproductive Genetics (Zhejiang), Ministry of Education, and Centre of Reproductive Medicine, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Fan Jin
- Key Laboratory of Reproductive Genetics (Zhejiang), Ministry of Education, and Centre of Reproductive Medicine, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
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Bouillon C, Fauque P. Devenir des enfants issus des techniques d’assistance médicale à la procréation. Arch Pediatr 2013; 20:575-9. [DOI: 10.1016/j.arcped.2013.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 01/30/2013] [Accepted: 02/19/2013] [Indexed: 12/01/2022]
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Feuer S, Camarano L, Rinaudo P. ART and health: clinical outcomes and insights on molecular mechanisms from rodent studies. Mol Hum Reprod 2013; 19:189-204. [PMID: 23264495 PMCID: PMC3598410 DOI: 10.1093/molehr/gas066] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 12/07/2012] [Accepted: 12/11/2012] [Indexed: 12/23/2022] Open
Abstract
Since the birth of the first IVF-conceived child in 1978, the use of assisted reproductive technologies (ART) has grown dramatically, contributing to the successful birth of 5 million individuals worldwide. However, there are several reported associations of ART with pregnancy complications, such as low birthweight (LBW), preterm birth, birth defects, epigenetic disorders, cancer and poor metabolic health. Whether this is attributed to ART procedures or to the subset of the population seeking ART remains a controversy, but the most relevant question today concerns the potential long-term implications of assisted conception. Recent evidence has emerged suggesting that ART-conceived children have distinct metabolic profiles that may predispose to cardiovascular pathologies in adulthood. Because the eldest IVF individuals are still too young to exhibit components of chronic middle-aged syndromes, the use of animal models has become particularly useful in describing the effects of unusual or stressful preimplantation experiences on adult fitness. Elucidating the molecular mechanisms by which embryos integrate environmental signals into development and metabolic gene expression programs will be essential for optimizing ART procedures such as in vitro culture conditions, embryo selection and transfer. In the future, additional animal studies to identify mechanisms underlying unfavorable ART outcomes, as well as more epidemiological reviews to monitor the long-term health of ART children are required, given that ART procedures have become routine medical practice.
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Affiliation(s)
- S.K. Feuer
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, 2356 Sutter St, 7th floor, San Francisco, CA 94115, USA
| | - L. Camarano
- Samuel Merritt University, School of Nursing, Oakland, CA, USA
- Fertility Physicians of Northern California, San Jose, CA, USA
| | - P.F. Rinaudo
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, 2356 Sutter St, 7th floor, San Francisco, CA 94115, USA
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Hart R, Norman RJ. The longer-term health outcomes for children born as a result of IVF treatment: Part I--General health outcomes. Hum Reprod Update 2013; 19:232-43. [PMID: 23449642 DOI: 10.1093/humupd/dms062] [Citation(s) in RCA: 174] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Several million children have been born from in vitro fertilization (IVF) treatment, but limited data exist regarding their health and development beyond the first year of life. It has been alleged that IVF may lead to long-term adverse consequences, in addition to the documented worse perinatal outcome and increased risk of congenital abnormalities in children born resulting from IVF treatment. METHODS A search strategy restricted to studies relating to the medical condition of children of at least 1 year of age born as a result of IVF treatment was performed to include case series, data linkage and prospective studies published 1 January 2000-1 April 2012. RESULTS Limited long-term follow-up data suggest that there is potentially an increase in the incidence of raised blood pressure, elevated fasting glucose, increase in total body fat composition, advancement of bone age and potentially subclinical thyroid disorder in the IVF offspring. Whether these potential associations are related to the IVF treatment per se, the adverse obstetric outcomes associated with IVF treatment or are related to the genetic origin of the children is yet to be determined. CONCLUSIONS This review provides evidence to suggest that the short-term health outcome for children born from IVF treatment is positive. However, it is expected that the cardiovascular and metabolic risk factors found in childhood and tracking into adulthood could be worse in later life, and may be responsible for chronic cardiometabolic disease. These observations need to be addressed by further studies.
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Affiliation(s)
- Roger Hart
- School of Women's and Infant's Health, University of Western Australia, King Edward Memorial Hospital, 374 Bagot Road, Subiaco, Perth, WA 6008, Australia.
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Feuer S, Rinaudo P. Preimplantation stress and development. BIRTH DEFECTS RESEARCH. PART C, EMBRYO TODAY : REVIEWS 2012; 96:299-314. [PMID: 24203919 PMCID: PMC3824155 DOI: 10.1002/bdrc.21022] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 11/12/2012] [Indexed: 02/04/2023]
Abstract
The developmental origins of health and disease hypothesis holds that inappropriate environmental cues in utero, a period marked by tremendous developmental sensitivity, facilitate cellular reprogramming to ultimately predispose disease in adulthood. In this review, we analyze if stress during early stages of development can affect future health. This has wide clinical importance, given that 5 million children have been conceived with assisted reproductive technologies (ART). Because the primary outcome of assisted reproduction procedures is delivery at term of a live, healthy baby, the postnatal effects occurring outside ofthe neonatal period are often overlooked. To this end, the long-term outcome of ART is appropriately the most relevant concern of the field today. Evidence of adverse consequences is controversial. The majority of studies have concluded no obvious problems in IVF-conceived children, although a number of isolated cases of imprinted diseases, cancers, or malformations have been reported. Given that animal studies suggest alteration of metabolic pathways following preimplantation stress, it will be of great importance to follow-up ART individuals as they enter later stages of adult life.
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Affiliation(s)
- Sky Feuer
- Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Reproductive Endocrinology and Infertility, University of California, San Francisco, California 94115
| | - Paolo Rinaudo
- Eli and Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California, San Francisco, California 94143
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Shannon M, Wang Y. Polycystic Ovary Syndrome: A Common But Often Unrecognized Condition. J Midwifery Womens Health 2012; 57:221-30. [DOI: 10.1111/j.1542-2011.2012.00161.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Belva F, Roelants M, Painter R, Bonduelle M, Devroey P, De Schepper J. Pubertal development in ICSI children. Hum Reprod 2012; 27:1156-61. [PMID: 22328555 DOI: 10.1093/humrep/des001] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND To date, information on the pubertal development of adolescents born after ICSI is scarce, since the very first cohort is only now reaching young adulthood. In this study, pubertal development at the age of 14 was characterized in a longitudinally followed cohort of ICSI-conceived teenagers and compared with that of a spontaneously conceived (SC) control group. METHODS Pubertal development was assessed by Tanner staging (breast, genital and pubic hair development) and age at menarche in 217 singleton ICSI-conceived children (116 boys, 101 girls) and 223 SC peers (115 boys, 108 girls). ICSI teenagers were part of a previously published cohort followed since birth; controls were a cross-sectional sample recruited from schools. Differences in pubertal development between ICSI and SC children were analyzed with logistic regression of current status data. RESULTS Mean age at menarche was similar in ICSI and SC girls (13.1 ± 1.2 versus 13.1 ± 1.4 years; P = 0.8). Breast developmental at the age of 14 years was less advanced in ICSI females compared with SC females, even after adjustment for demographic (age, BMI), genetic (maternal age at menarche), social (maternal educational level) and early life factors (birthweight, gestational age and maternal parity) [odds ratio (OR) 0.5; 95% confidence interval (CI) 0.3-0.8]. After adjustment, genital development in the 14-year-old boys was comparable in the ICSI and SC groups (OR 1.1; 95% CI 0.7-1.8), pubic hair development was comparable in the ICSI and SC groups, for both males (OR 0.9; 95% CI 0.7-1.6) and females (OR 0.7; 95% CI 0.4-1.3). CONCLUSIONS We found that pubertal development, characterized by menarche, genital development in males and pubic hair development in males and females, was comparable in the ICSI and SC groups. Breast developmental was less advanced in ICSI females compared with SC peers, even after adjustment for known potential confounders. In order to confirm that progression through subsequent stages of pubertal development occurs on a timely basis in ICSI teenagers, long-term follow-up studies up to adulthood are required.
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Affiliation(s)
- F Belva
- Center for Medical Genetics, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, Brussels 1090, Belgium.
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van Montfoort APA, Hanssen LLP, de Sutter P, Viville S, Geraedts JPM, de Boer P. Assisted reproduction treatment and epigenetic inheritance. Hum Reprod Update 2012; 18:171-97. [PMID: 22267841 PMCID: PMC3282574 DOI: 10.1093/humupd/dmr047] [Citation(s) in RCA: 140] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The subject of epigenetic risk of assisted reproduction treatment (ART), initiated by reports on an increase of children with the Beckwith–Wiedemann imprinting disorder, is very topical. Hence, there is a growing literature, including mouse studies. METHODS In order to gain information on transgenerational epigenetic inheritance and epigenetic effects induced by ART, literature databases were searched for papers on this topic using relevant keywords. RESULTS At the level of genomic imprinting involving CpG methylation, ART-induced epigenetic defects are convincingly observed in mice, especially for placenta, and seem more frequent than in humans. Data generally provide a warning as to the use of ovulation induction and in vitro culture. In human sperm from compromised spermatogenesis, sequence-specific DNA hypomethylation is observed repeatedly. Transmittance of sperm and oocyte DNA methylation defects is possible but, as deduced from the limited data available, largely prevented by selection of gametes for ART and/or non-viability of the resulting embryos. Some evidence indicates that subfertility itself is a risk factor for imprinting diseases. As in mouse, physiological effects from ART are observed in humans. In the human, indications for a broader target for changes in CpG methylation than imprinted DNA sequences alone have been found. In the mouse, a broader range of CpG sequences has not yet been studied. Also, a multigeneration study of systematic ART on epigenetic parameters is lacking. CONCLUSIONS The field of epigenetic inheritance within the lifespan of an individual and between generations (via mitosis and meiosis, respectively) is growing, driven by the expansion of chromatin research. ART can induce epigenetic variation that might be transmitted to the next generation.
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Affiliation(s)
- A P A van Montfoort
- Department of Obstetrics & Gynaecology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.
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Abstract
Metabolic syndrome is reaching epidemic proportions, particularly in developing countries. In this review, we explore the concept-based on the developmental-origin-of-health-and-disease hypothesis-that reprogramming during critical times of fetal life can lead to metabolic syndrome in adulthood. Specifically, we summarize the epidemiological evidence linking prenatal stress, manifested by low birth weight, to metabolic syndrome and its individual components. We also review animal studies that suggest potential mechanisms for the long-term effects of fetal reprogramming, including the cellular response to stress and both organ- and hormone-specific alterations induced by stress. Although metabolic syndrome in adulthood is undoubtedly caused by multiple factors, including modifiable behavior, fetal life may provide a critical window in which individuals are predisposed to metabolic syndrome later in life.
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Affiliation(s)
- Paolo Rinaudo
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California 94115, USA.
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Savage T, Peek J, Hofman PL, Cutfield WS. Childhood outcomes of assisted reproductive technology. Hum Reprod 2011; 26:2392-400. [PMID: 21724570 DOI: 10.1093/humrep/der212] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
There is a large population of children conceived via assisted reproductive technology (ART), which continues to increase worldwide, without a clear understanding of associated long-term outcomes. ART children are more likely to be the result of multiple pregnancies, and thus to be born prematurely or low birthweight. There is growing evidence that ART children are phenotypically and biochemically different from naturally conceived children, but the mechanism(s) leading to these changes have not been elucidated. There is a possible increased risk of rare imprinted gene disorders in these children. However, it remains unclear whether more subtle changes in DNA methylation occur commonly, leading to differences in gene expression and phenotype in ART children. Although an increased risk of cancer among ART children has been reported, the role of ART in the development of cancer has not been demonstrated. Further research and ongoing surveillance of ART children is essential to better understand the possible effects of ART on the long-term health of this population.
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Affiliation(s)
- Tim Savage
- Liggins Institute, University of Auckland, Auckland, New Zealand
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Wilson CL, Fisher JR, Hammarberg K, Amor DJ, Halliday JL. Looking downstream: a review of the literature on physical and psychosocial health outcomes in adolescents and young adults who were conceived by ART. Hum Reprod 2011; 26:1209-19. [DOI: 10.1093/humrep/der041] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Age of onset of polycystic ovarian syndrome in girls may be earlier than previously thought. J Pediatr Adolesc Gynecol 2011; 24:15-20. [PMID: 21262477 DOI: 10.1016/j.jpag.2010.06.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2010] [Revised: 06/08/2010] [Accepted: 06/08/2010] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To study the age at diagnosis of polycystic ovarian syndrome (PCOS) in a pediatric population. To compare risk factors involved in causing PCOS in preadolescent and adolescent girls. To review the current literature on the reported age of PCOS in girls. DESIGN A retrospective chart review and systematic review of the literature. PARTICIPANTS Patients included 58 girls (age ≤ 18 yrs) with a diagnosis of PCOS based on the Rotterdam criteria. Girls were grouped as preadolescents (<13 yrs) or adolescents (13-18 yrs). Clinical and biochemical data were reviewed from the time of diagnosis. MAIN OUTCOME MEASURES Age at diagnosis. Differences in risk factors for PCOS (Ethnicity, obesity, family history of PCOS, birth weight, age at pubarche, thelarche and menarche, evidence of hyperandrogenism and/or insulin resistance) were compared between the two groups. RESULTS There were 26% (15/58) preadolescent girls (9-12 yrs) vs 74% (43/58) adolescents (13-18 yrs). There was no significant difference between the two groups in ethnicity, BMI z-score, family history of maternal PCOS, birth weight, hyperandrogenism, or insulin resistance. Preadolescents with PCOS had significantly earlier onset of pubarche and thelarche than adolescents with PCOS, by 1.9 and 1.5 yrs, respectively (P = 0.018, 0.030). In addition to earlier puberty, PCOS developed 2.1 years sooner after thelarche in preadolescents than in adolescents. (P = 0.008) Preadolescents were significantly taller for age than adolescents (72nd % vs 43rd %) (P = 0.005). A review of the 28 studies published in the last 3 years that included PCOS patients with age <=18 yrs described only 6.4% (27/425) of pediatric subjects with age <13 yrs. Four were primarily pediatric studies that included patients under the age of 13 yrs, with 9.4% (12/127) of the patients <13 yrs. CONCLUSION Increased awareness of PCOS in young females is needed. PCOS may occur at a younger age in girls who develop early pubarche and thelarche. Therefore, the diagnosis and workup should be considered in young girls with risk factors suggestive of PCOS.
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Wagenaar K, van Weissenbruch MM, van Leeuwen FE, Cohen-Kettenis PT, Delemarre-van de Waal HA, Schats R, Huisman J. Self-reported behavioral and socioemotional functioning of 11- to 18-year-old adolescents conceived by in vitro fertilization. Fertil Steril 2011; 95:611-6. [DOI: 10.1016/j.fertnstert.2010.04.076] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2009] [Revised: 04/26/2010] [Accepted: 04/27/2010] [Indexed: 10/19/2022]
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Eckert JJ, Fleming TP. The effect of nutrition and environment on the preimplantation embryo. ACTA ACUST UNITED AC 2011. [DOI: 10.1576/toag.13.1.43.27640] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Delle Piane L, Lin W, Liu X, Donjacour A, Minasi P, Revelli A, Maltepe E, Rinaudo PF. Effect of the method of conception and embryo transfer procedure on mid-gestation placenta and fetal development in an IVF mouse model. Hum Reprod 2010; 25:2039-46. [PMID: 20576634 DOI: 10.1093/humrep/deq165] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Abnormal placentation is a potential mechanism to explain the increased incidence of low birthweight observed after IVF. This study evaluates, in a mouse model, whether the method of conception and embryo transfer affect placentation and fetal development. METHODS IVF blastocysts (CF1 x B6D2F1/J) were cultured in Whitten's medium (IVF(WM), n = 55) or K modified simplex optimized medium with amino acids (IVF(KAA), n = 56). Embryos were transferred to the uteri of pseudo-pregnant recipients. Two control groups were created: unmanipulated embryos produced by natural mating (in vivo group, n = 64) and embryos produced by natural mating that were flushed from uterus and immediately transferred to pseudo-pregnant recipients (flushed blastocysts, FB group, n = 57). At gestation age 12.5 days, implantation sites were collected and fixed; fetuses and placentas were weighed and their developmental stage (DS) evaluated. Placental areas and vascular volume fractions were calculated; parametric statistics were applied as appropriate. RESULTS IVF fetuses showed a modest but significant delay in development compared with FB mice (P < 0.05). In addition, IVF conceptuses were consistently smaller than FB (P < 0.05). Importantly, these differences persisted when analyzing fetuses of similar DS. The placenta/fetus ratio was larger in the IVF group (IVF(WM) 0.95; IVF(KAA) = 0.90) than the FB group (0.72) (P < 0.05 for all comparisons). Gross morphology of the placenta and ratio labyrinth/fetal area were equivalent in the IVF and FB groups, as were percentage of fetal blood vessels, maternal blood spaces and trophoblastic components. CONCLUSIONS In vitro embryo culture affects fetal and placental development; this could explain the lower birthweight in IVF offspring.
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Affiliation(s)
- L Delle Piane
- Obstetric, Gynecology and Reproductive Science Division, University of California San Francisco, San Francisco, CA, USA
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