Health of offspring of subfertile couples

In vitro fertilization (IVF) allows subfertile couples to achieve pregnancy resulting in the birth of a child. A couple is considered subfertile when not succeeding to get pregnant within 12 months after the start of unprotected intercourse. During IVF the early environment of the oocyte and embryo are altered. This may influence fetal development so that it results in increased vulnerability for health related problems in later life. This implies that IVF components, such as the in vitro culture procedure, controlled ovarian hyperstimulation (COH), the underlying parental subfertility and preimplantation genetic screening (PGS) all could affect the health of IVF offspring.

COH induces the growth of multiple follicles, bypassing the natural selection of the development of one dominant follicle. During the in vitro culture procedure and PGS oocytes, sperm and embryos are handled outside the human body. In PGS a single cell is taken away from the embryo to be screened for abnormalities. This thesis evaluates the possible long-term effects of the IVF procedures and PGS on the health of IVF offspring up until the age of 9 years.

Overall, the results of our studies regarding IVF procedures and PGS are reassuring. We found no differences in cardiovascular risk profile or asthma prevalence between singletons conceived after IVF and naturally conceived children to subfertile couples. Yet, we did find that children conceived with IVF are at increased risk for wearing glasses on medical indication, and that subfertility is associated with a less favourable cardiovascular risk profile in the offspring.