Ovarian hyperstimulation, the in vitro culture procedure, and a combination of these 2 methods as a part of the process of in vitro fertilization (IVF) are not linked to the development of asthma or rhinitis in children aged 9 years. In The Netherlands, 2 parallel prospective studies on the subject were conducted, with the results published in the European Journal of Pediatrics.
The investigators sought to differentiate the possible effects of ovarian hyperstimulation from that of the in vitro culture procedure on asthma and rhinitis reported among children aged 9 years who had been conceived through the use of IVF. The study included 3 groups of singletons: those conceived with ovarian hyperstimulation-IVF (COH-IVF: n=95); those conceived with modified natural-cycle IVF (MNC-IVF: n=48); and those conceived naturally to subfertile couples (Sub-NC: n=68).
All of the parents completed the validated Dutch adaptation of the asthma questionnaire from the International Study of Asthma and Allergies in Childhood (ISAAC). The ISAAC questionnaire contains questions about asthma, eczema, and rhinitis. There were no differences in the prevalence of asthma among the 3 groups: COH-IVF: 8% (8 of 48); MNC-IVF: 0% (0 of 0); and Sub-NC: 6% (4 of 68). Study results were not altered by the adjustment for confounders.
Among the strengths of the current study are the use of the validated ISAAC-based questionnaire and the design of the study, which permits separate assessments of the effects of the in vitro culture procedure and ovarian hyperstimulation on a child’s health. Use of the subfertile control group in the study prevents overestimating the impact of IVF.
A major limitation of the current study is that the sizes of the 3 groups are relatively small — in particular, the MNC-IVF arm, thus preventing the researchers from drawing firm conclusions. Additionally, the lack of a fertile control group precludes rendering a conclusion on the impact of subfertility in this study.
The investigators concluded that children aged 9 years who were born to parents who had undergone IVF had a similar prevalence of asthma compared with children aged 9 years who had been conceived naturally by subfertile couples.
Kuiper DB, Koppelman GH, la Bastide-van Gemert S, et al. Asthma in 9-year-old children of subfertile couples is not associated with in vitro fertilization procedures [published online August 6, 2019]. Eur J Pediatr. doi:10.1007/s00431-019-03436-2