Offspring of subfertile couples: neurodevelopmental outcome at preschool age
|PhD ceremony:||Ms P. (Pamela) Schendelaar|
|When:||February 16, 2015|
|Supervisors:||prof. dr. M. (Mijna) Hadders-Algra, Prof. M.J. Heineman|
|Co-supervisor:||Prof. K.J. Middelburg|
|Where:||Academy building RUG|
|Faculty:||Medical Sciences / UMCG|
Fertility treatments such as in vitro fertilization (IVF) are increasingly applied. Theoretically, at least one child in every classroom has been born following IVF and even more children are born to subfertile couples who conceived naturally. Therefore, development and health of these children is of general significance.
In this thesis neurodevelopmental outcome, in terms of neuromotor function, cognition and behaviour, of children born to subfertile couples without and with the application of IVF is evaluated up until 4 years by exploring the influence of IVF-related and subfertility-related aspects, such as ovarian hyperstimulation, the in vitro laboratory procedures and the presence, the underlying cause and the duration of subfertility, the latter reflecting the severity of subfertility. Additionally, the effect of preimplantation genetic screening (PGS, involving embryo biopsy) in addition to IVF on child neurodevelopmental outcome was evaluated.
The main conclusion of this thesis is that subfertility-related aspects rather than IVF-related aspects contribute to worse neurodevelopmental outcome of preschool aged children, with the severity of subfertility being the decisive factor. Moreover, PGS seems to be associated with altered neurodevelopment in twins, but not in singletons.The results of this thesis underline the importance of long-term follow-up of health and development of children born to subfertile couples, without and with the application of IVF. Monitoring and improving the safety and health of subfertile couples and their children is necessary, especially in today’s society were maternal age at child birth, subfertility and the application of IVF are increasing.