A US-UK Collaborative Study of the Health of Children Born From In Vitro Fertilization: From Conception Through Young Adulthood

PROJECT SUMMARY Since the birth of the first child from in vitro fertilization (IVF) in the US in 1981, more than ten million babies have been born from this technology, including more than 1.37 million babies annually worldwide. In 2018, IVF births accounted for 2.24% of all US births. Consistent research findings indicate that IVF-conceived pregnancies and IVF-conceived children are at greater risk for a spectrum of adverse perinatal outcomes. A persistent, unresolved issue remains what proportion of the adverse perinatal and child health outcomes after IVF is due to parental factors and what proportion is due to the IVF procedures. In this grant, we are using an early life-course approach to evaluate the growth and health of children born from IVF, from conception through young adulthood. The two primary aims of this proposed renewal are (1) comprehensively evaluate the role of IVF conception on birth defects, cancer, and the co-occurrence of these conditions through large-scale registry linkages and analysis of the neonatal methylome and (2) to evaluate the effect of IVF treatment parameters, specifically the use of ICSI, number of embryos transferred (embryonic and/or fetal loss as plurality at conception versus at birth), oocyte source/state-embryo state combinations, on fetal growth (size at birth) and health (birth defects, cancer, acute and chronic illness, and premature mortality), accounting for parental, socioeconomic, and environmental factors. This proposed study will include a total of more than two million children, including more than 220,000 IVFconceived children born 2004-2022, 43,000 naturally-conceived siblings, and 1.75 million naturally-conceived control children, with 27 million person-years of follow-up, averaging 13.5 years (ranging from birth to age 23), and will provide a comprehensive contemporary picture of child and young adult health after conception by in vitro fertilization.