Does infertility treatment increase risk of developmental delay?

Results of a prospective cohort study show that developmental delay is no more likely in children conceived through infertility treatments than in those conceived naturally. The report, say the lead authors from the National Institute of Child Health and Human Development, is among the first to consider this outcome in births that did not involve assisted reproductive technology (ART).

Included in the cohort were infants born between 2008 and 2010 in New York State except New York City whose parents had completed developmental screening instruments through 36 months of age. Of the 5841 children represented, 1830 were conceived via infertility treatment and 2074 were twins.

Categorization of infertility treatments into ART and ovulation induction/intrauterine insemination was via maternal self-report. Use of ART was validated by linkage with the Society for Assisted Reproductive Technology-Clinical Outcome Reporting System.

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Of the 4824 mothers in the cohort, 1422 (mean age 34.1 years) underwent infertility treatment. Overall, infertility treatment was not associated with risk of a child failing any developmental domain (adjusted odds ratio [aOR], 1.33; 95% CI, 0.94-1.89). ART was linked with increased risk of failing any developmental domain only when singletons and twins were evaluated together (aOR, 1.81; 95% CI, 1.21-2.72) and the association was further attenuated by adjustment for birth weight (aOR, 1.26; 95% CI, 0.82-1.93). Looking at rates of referral of singletons for evaluation by developmental specialists, the authors found no differences between those born following ART and those whose conceptions did not involve infertility treatment (21.2% and 20.7%, respectively).