Fertility treatment does not adversely affect cardiovascular health of offspring, international study suggests

A large study looking at the effects of fertility treatment has found no robust difference in blood pressure, heart rate, lipids, and glucose measurements between children conceived naturally and those conceived using assisted reproductive technologies (ART).

The University of Bristol-led study, published in European Heart Journal today [6 February 2023] sought to address concerns around whether fertility treatment leads to adverse cardiometabolic health in offspring. The data sample included 8,600 children from Bristol’s Children of the 90s study, a world-leading health study which has followed pregnant women and their offspring since 1991.

Since the first birth of a child by in vitro fertilisation (IVF), questions have been raised about the health risks to children conceived this way, however previous studies are limited by small sample size, short follow-up, and unsatisfactory comparison groups.

The study, led by an international research group from the Assisted Reproductive Technology and Health (A.R.T-Health) Partnership, looked at data from 35,000 European, Singaporean, and Australian offspring. It was large enough to study whether conception by ART affected blood pressure, pulse rate, lipids or glucose from childhood to young adulthood (up to early 20s).

The researchers found that blood pressure, heart rate, and glucose levels were similar in children conceived using ART and their naturally conceived peers. The team also found that those who were conceived by ART had slightly higher cholesterol levels in childhood, which did not persist to adulthood, and some indication of slightly higher blood pressure in adulthood.

Dr Ahmed Elhakeem, Research Fellow in Epidemiology in Bristol Medical School: Population Health Sciences (PHS) at the University of Bristol, and lead study author, said: “This is the largest study of its kind, and could not be conducted without data from studies such as Children of the 90s. Parents conceiving or hoping to conceive through assisted reproductive technology and their offspring should be reassured that cardiometabolic health appears to be comparable in ART-conceived and naturally conceived children. Studies with longer follow-up would now be beneficial to examine how results might change across adulthood.”

Deborah Lawlor, Professor of Epidemiology, MRC Investigator and British Heart Foundation Chair and senior author from Bristol Medical School: PHS, added: “This important research is only possible through large scale international collaboration and longitudinal health studies, where participants contribute health data throughout their entire lives. We are particularly grateful to the European Research Council, British Heart Foundation and UK National Institute for Health Research for making this possible and to all of the study participants and researchers.”

Peter Thompson, Chief Executive, The Human Fertilisation and Embryology Authority (HFEA), said: “Each year around 60,000 patients use fertility services in the UK in the hope of one day having a family of their own. Those patients should be reassured by this study which shows that the heart health of children born from assisted reproduction technologies, like IVF, are no different from children conceived naturally.

“Science and research move rapidly in the fertility sector but it is widely acknowledged that more large scale studies like this are needed to continually drive improvements in care. Health outcomes in children conceived using assisted reproductive technologies are a high priority for the HFEA and we monitor the latest research and provide information for patients and professionals. Anyone considering fertility treatment in the UK should visit www.hfea.gov.uk for high quality impartial information on treatment options and licensed clinics.”

The study was funded by the European Research Council under the European Union’s Horizon 2020 research and innovation program, Medical Research Council (MRC), British Heart Foundation (BHF) and National Institute for Health and Care Research Bristol Biomedical Research Centre (NIHR Bristol BRC).

Paper: ‘Long-term cardiometabolic health in people born after assisted reproductive technology: a multi-cohort analysis’ by Ahmed Elhakeem et al. in European Heart Journal

ENDS

Notes to editors

A copy of the embargoed paper is available on request. Once the embargo lifts, the paper will be available at: https://doi.org/10.1093/eurheartj/ehac726

* A total of 14 longitudinal cohort studies with participants from Europe (11 cohorts), Australia (2 cohorts), and Singapore (1 cohort) were included in this study.

About Children of the 90s

Based at the University of Bristol, Children of the 90s, also known as the Avon Longitudinal Study of Parents and Children (ALSPAC), is a long-term health research project that enrolled more than 14,000 pregnant women in 1991 and 1992.  It has been following the health and development of the parents, their children and now their grandchildren in detail ever since.  It receives core funding from the Medical Research Council, the Wellcome Trust and the University of Bristol. Find out more at www.childrenofthe90s.ac.uk

 About the National Institute for Health and Care Research
The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:

• Funding high quality, timely research that benefits the NHS, public health and social care;
• Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;
• Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;
• Attracting, training and supporting the best researchers to tackle complex health and social care challenges;
• Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;
• Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.

NIHR is funded by the Department of Health and Social Care. Its work in low- and middle-income countries is principally funded through UK Aid from the UK government.

About the National Institute for Health and Care Research Bristol Biomedical Research Centre (NIHR Bristol BRC)

The National Institute for Health and Care Research Bristol Biomedical Research Centre’s (NIHR Bristol BRC) innovative biomedical research takes science from the laboratory bench or computer and develops it into new drugs, treatments or health advice. Its world-leading scientists work on many aspects of health, from the role played by individual genes and proteins to analysing large collections of data on hundreds of thousands of people. Bristol BRC is unique among the NIHR’s 20 BRCs across England, thanks to its expertise in ground-breaking population health research.

About the A.R.T-Health Partnership
The A.R.T-Health Partnership is a multidisciplinary collaborative research project involving researchers from over 40 studies worldwide. The mission of the A.R.T-Health Partnership to provide robust evidence on the effects of pregnancy conception by ART, compared with natural conception, on mothers and offspring health from pregnancy through to early adulthood.

We welcome any researcher with data and interest in joining the A.R.T-Health Partnership and collaborating on future research to get in touch by contacting Dr Ahmed Elhakeem and Professor Deborah Lawlor.