One of the lingering questions that remains in modern infertility treatments is whether children conceived through in vitro fertilization (IVF) -- when a woman’s egg is fertilized with a man’s sperm in a laboratory setting outside of the womb -- grow up as healthy as those conceived the more traditional way.
A new study that set out to find the answer suggests that while IVF young adults participants were similar to, and sometimes doing better than their counterparts, when it came to risk factors for chronic diseases, they were up to 11 times more likely to be diagnosed with certain psychological disorders, such as clinical depression and attention deficit hyperactivity disorder (ADD/ADHD).
“Overall, the study showed good health and good adjustment of the ‘young IVF adults'...and although ADD was higher, the young adults were productive, attained good levels of education/jobs, and performed above average physical exercise,” said Sergio Oehninger, M.D., Ph.D., the medical director of the Jones Institute for Reproductive Medicine, and one of the authors of the study.
The study, published in February 2010 issue of Fertility and Sterility, surveyed 173 young adults, ages 18 to 26, who are members of the oldest generation of IVF births in the U.S . All were delivered between 1981 and 1990 at the Eastern Virginia Medical School's Jones Institute of Reproductive Medicine, which was also where the first U.S. IVF baby was born in 1981.
Some Other Highlights of the Study:
Smoking was less prevalent in IVF young adults but IVF females reported more instances of binge drinking (five or more drinks in a two-hour period) and alcohol use.
However, over two-thirds of the IVF young adults reported being diagnosed with a physical or psychological problem, most often relating to psychiatric conditions, vision problems and asthma or allergies.
More than 33 percent of study participants reported being diagnosed with ADD/ADHD, which is higher than the estimated three to five percent known to affect the general population. The same was true of the rate of depression among IVF study participants, which came in around 16 percent, compared with the 13 percent of adolescents and young adults up to 25 who are typically affected.
What is the Link Between IVF and ADD/ADHD?
While the study was not able to identify the cause of the higher incidence in ADD/ADHD, depression and binge drinking, behavioral problems could stem from either a high level of stress from parents undergoing IVF or from parents who were “overprotective” of their children, said Hind A. Beydoun, Ph.D., one of the authors of the study.
Couples where one or more members have ADD/ADHD and believe that conceiving through IVF may increase their future child’s risk for getting ADD/ADHD should not be discouraged. According to researchers, this study did not examine parental characteristics so they could not make any conclusions on whether children were more at risk for getting ADD/ADHD if their parents were first diagnosed. “We do not know the real percentages of ADD in a larger sample size, it could just be that IVF parents simply take children to the doctor more frequently (more cases can be diagnosed that way), or this may truly reflect that IVF families are stressed (like we know for infertility and cancer in general),” Oehninger said.
Prior to this study, researchers were unsure what impact the differences IVF babies experience during the early stages of embryonic development -- which affect a person's risk of chronic health conditions such as cancer or heart disease -- would have later on in life. Another piece to the puzzle that spurred researchers to conduct this study was that IVF often leads to multiple births, which increases the likelihood of preterm delivery, low birthrate, and fetal growth restrictions, all of which can also negatively affect children’s long-term development.
Because in vitro fertilization is a relatively recent procedure, earlier studies have focused only on the short-term outcomes following IVF births into infancy, childhood and adolescence.
More studies need to be conducted, cautioned the researchers, because of several limitations in their study. For instance, while 560 young adults were eligible and conducted for the study, only 173 responded. Also, parents who undergo IVF are often more affluent than the general population and this could explain some of the higher rates in diagnosis, as they may be more likely to be able to afford to pay for diagnosing treating conditions like ADD/ADHD. There was also no actual control group tested. Instead, researchers compared respondents to a subsample of the National Health and Nutrition Examination Survey of 1,315 young adults surveyed between 1999 and 2004.
