scholarly journals Cardiometabolic Differences in Children Born After in Vitro Fertilization: Follow-Up Study

2008 ◽  
Vol 93 (5) ◽  
pp. 1682-1688 ◽  
Author(s):  
Manon Ceelen ◽  
Mirjam M. van Weissenbruch ◽  
Jan P. W. Vermeiden ◽  
Flora E. van Leeuwen ◽  
Henriette A. Delemarre-van de Waal

Abstract Context: Increasing evidence suggests that adverse conditions during early prenatal life are associated with cardiometabolic dysfunction in postnatal life. In vitro fertilization (IVF) conception may be an early prenatal life event with long-term health consequences. Objective: Our objective was to investigate several cardiometabolic measures in 8- to 18-yr-old IVF singletons and spontaneously conceived controls born from subfertile parents. Design and Setting: This follow-up study was conducted at the VU University medical center, Amsterdam, The Netherlands. Participants: Blood pressure was examined in 225 IVF-conceived children and 225 age- and gender-matched spontaneously conceived control children. Several indicators of insulin resistance were studied in a pubertal subpopulation (131 IVF children and 131 controls). Main Outcome Measures: Blood pressure, fasting glucose, and fasting insulin were determined. Results: Systolic and diastolic blood pressure levels were higher in IVF children than controls (109 ± 11 vs. 105 ± 10 mm Hg, P < 0.001; and 61 ± 7 vs. 59 ± 7 mm Hg, P < 0.001, respectively). Children born after IVF were also more likely to be in the highest systolic and diastolic blood pressure quartiles (odds ratio = 2.1, 95% confidence interval 1.4, 3.3; odds ratio = 1.9, 95% confidence interval 1.2, 3.0, respectively). Furthermore, higher fasting glucose levels were observed in pubertal IVF children (5.0 ± 0.4 vs. 4.8 ± 0.4 mmol/liter in controls; P = 0.005). Blood pressure and fasting glucose differences could not be explained by current body size, birth weight, and other early life factors or by parental characteristics, including subfertility cause. Conclusions: These findings highlight the importance of continued cardiometabolic monitoring of IVF-conceived children and might contribute to current knowledge about periconceptional influences and their consequences in later life.

1987 ◽  
Vol 4 (1) ◽  
pp. 46-50 ◽  
Author(s):  
Sandra R. Leiblum ◽  
Ekkehard Kemmann ◽  
Daniel Colburn ◽  
Samuel Pasquale ◽  
Ann Marie DeLisi

2021 ◽  
Author(s):  
Chun-Xiao Wei ◽  
liang zhang ◽  
Cong-Hui Pang ◽  
Ying-Hua qi ◽  
Jian-Wei Zhang

Abstract BackgroundThe outcome of in vitro fertilization-embryo transfer is often determined according to follicles and estradiol levels following gonadotropin stimulation. However, there is no accurate indicator to predict pregnancy outcome, and it has not been determined how to choose subsequent drugs and dosage based on the ovarian response. This study aimed to make timely adjustments to follow-up medication to improve clinical outcomes based on the potential value of estradiol growth rate. MethodsSerum estradiol levels were measured on the day of gonadotrophin treatment (Gn0), four days later (Gn4), seven days later (Gn7), and on the trigger day (HCG). The ratio was used to determine the increase in estradiol levels. According to the ratio of estradiol increase, the patients were divided into four groups: group A1 (Gn4/Gn0≤6.44), group A2 (6.44˂Gn4/Gn0≤10.62), group A3 (10.62˂Gn4/Gn0 ≤21.33), and group A4 (Gn4/Gn0>21.33); group B1 (Gn7/Gn4≤2.39), group B2 (2.39˂Gn7/Gn4≤3.03), group B3 (3.03˂Gn7/Gn4≤3.84), and group B4 (Gn7/Gn4>3.84). We analyzed and compared the relationship between data in each group and pregnancy outcome. ResultsIn the statistical analysis, the estradiol levels of Gn4 (P = 0.029, P = 0.042), Gn7 (P< 0.001, P = 0.001), and HCG (P< 0.001, P = 0.002), as well as the ratios of Gn4/Gn0 (P = 0.004, P = 0.006), Gn7/Gn4 (P = 0.001, P = 0.002), and HCG/Gn0 (P< 0.001, P< 0.001) both had clinical guiding significance, and the lower one significantly reduced the pregnancy rate. The outcomes were positively linked to groups A (P = 0.040, P = 0.041) and B (P = 0.015, P = 0.017). The logistical regression analysis revealed that group A1 (OR = 0.440 [0.223–0.865]; P = 0.017, OR = 0.368 [0.169–0.804]; P = 0.012) and B1 (OR = 0.261 [0.126–0.541]; P< 0.001, OR = 0.299 [0.142–0.629]; P = 0.001) had opposite influence on outcomes. ConclusionMaintaining a serum estradiol increase ratio at least above 2.39 on Gn7/Gn4 may result in a higher pregnancy rate. When estradiol growth is not ideal, gonadotrophin dosage should be adjusted appropriately to ensure the desired outcome.


1994 ◽  
Vol 9 (6) ◽  
pp. 1097-1101 ◽  
Author(s):  
A. Raoul-Duval ◽  
M. Bertrand-Servais ◽  
H. Letur-Könirsch ◽  
R. Frydman

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