0904 Assisted reproduction and neurodevelopment

Given that assisted reproduction increasingly involves unnatural medical interference in what should be a natural process of fertilization, implantation and intrauterine growth and development, it is not surprising that researchers continue to study outcomes of apparently-successful pregnancies. Several summaries in this series have commented on results of such studies (see 0328; 0747; 0830; 0834) with conclusions ranging from an increase in the incidence of Beckwith-Wiedermann and Angelman syndromes, to lower pregnancy rates with blastomere sampling for confirmation of genetic normality, and increased congenital abnormalities when cryopreserved embryos are used vs fresh. More recently, attention was drawn to the need to compare products of assisted reproduction vs products of unassisted reproduction in the same couples rather than comparison against normal couples. The latter is inappropriate, and differences that are found in such comparisons disappear when outcomes in the same couples are compared. The most recent data appear to be focusing on short to medium term neurodevelopmental outcome using various tests of cognition, language and motor development, as well as screening for conditions such as autism and cerebral palsy. These studies are fairly consistently reporting good outcome, and although cerebral palsy rates may be increased, the increase appears to be due to prematurity and not the method of assisted reproduction.

Read more:
Arch Pediatr Adolesc Med 2009; 1 63: 72-83
Hum Reprod Update 2008; 14: 219-31
Pediatrcis 2005; 115: e283-9
Topic: Assisted reproduction and neurodevelopment