The cognitive and socio-emotional development of 5-year-old children born after PGD

Heijligers, Malou; Verheijden, L M M; Jonkman, Lisa M.; Sangen, Marijati; Meijer‐Hoogeveen, M.; Arens, Yvonne; Hoeven, M.A.H.B.M. van der; Die-Smulders, C.E.M. de

doi:10.1093/humrep/dey302

Cited by 15 publications

(18 citation statements)

References 46 publications

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“…13,14 Studies on the growth and neurocognitive development of children followed up until the age of 5 years following PGT have shown reassuring outcomes compared with children conceived following IVF or natural conception, indicating that embryo biopsy did not lead to longer term risks. [15][16][17] There has been consistent evidence of a higher risk of monozygotic twinning following ART compared with natural conception, 1.4% following ART versus 0.4% following natural conception; the high incidence with ART is in agreement with current study findings. 18,19 This increased risk has been attributed to various underlying factors and processes involved in ART, such as ICSI, assisted hatching, embryo biopsy for pre-implantation genetic testing for aneuploidies (PGT-A), monogenic disorders (PGT-M) and structural chromosomal rearrangements (PGT-SR), extended embryo culture and embryo cryopreservation.…”

Section: Discussionsupporting

confidence: 88%

“…Studies have shown no increased risk of preterm birth or low birthweight following PGT compared with non‐PGT IVF treatment . Studies on the growth and neurocognitive development of children followed up until the age of 5 years following PGT have shown reassuring outcomes compared with children conceived following IVF or natural conception, indicating that embryo biopsy did not lead to longer term risks . There has been consistent evidence of a higher risk of monozygotic twinning following ART compared with natural conception, 1.4% following ART versus 0.4% following natural conception; the high incidence with ART is in agreement with current study findings .…”

Section: Discussionmentioning

confidence: 99%

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Zygotic splitting following embryo biopsy: a cohort study of 207 697 single‐embryo transfers following IVF treatment

Kamath

Antonisamy

Sunkara

2019

BJOG

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Objective To evaluate the risk of monozygotic splitting with embryo biopsy during in vitro fertilisation (IVF). Design A cohort study. Setting Anonymised assisted reproductive technology national data from the Human Fertilisation and Embryology Authority, UK. Population Women undergoing single‐embryo transfer (SET) following either pre‐implantation genetic testing (PGT) involving embryo biopsy or IVF without PGT. Methods Data on women undergoing SET either following PGT and non‐PGT IVF treatment in 2000–2016 were analysed to compare the risk of zygotic splitting and monozygotic twining. Logistic regression analysis was performed adjusting for potential confounders. Main outcomes Monozygotic spitting, monozygotic twin birth. Results Data comprising a total of 207 697 SET cycles (4544 following PGT and 203 153 following non‐PGT IVF) were analysed. The live birth rate per embryo transfer was 31.9% (95% confidence interval [CI] 30.5–33.2%) following PGT and 26.9% (95% CI 26.7–27.1%) following non‐PGT IVF. The incidence of zygotic splitting following PGT was 2.4% (95% CI 1.7–3.3%) versus 1.5% (95% CI 1.4–1.6%) following non‐PGT IVF. There was a significantly higher risk of zygotic splitting with PGT versus non‐PGT IVF cycles (odds ratio [OR] 1.64, 95% CI 1.19–2.27). The higher risk of zygotic splitting with PGT cycles remained significant after adjusting for potential confounders (adjusted OR 1.51, 95% CI 1.06–2.15). Conclusions The present study demonstrated an increased risk of monozygotic splitting with embryo biopsy. Given the current sparse literature, it is important to accumulate further evidence to validate the findings. Tweetable abstract A likely increased risk of monozygotic splitting following embryo biopsy.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Zygotic splitting following embryo biopsy: a cohort study of 207 697 single‐embryo transfers following IVF treatment

Kamath

Antonisamy

Sunkara

2019

BJOG

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“…One could compare this policy to the use of a preimplantation genetic diagnosis (PGD) to avoid sex-linked diseases by selecting embryos of a particular chromosomal sex. However, the aforementioned risks of MR may be more substantial than those of the embryonic cell biopsies performed in PGD (Heijligers et al 2018). In addition, this policy of only transferring male embryos could send a problematic message to society that only male children, as the first generation, should be placed at the risk of potential MR hazards (Ishii and Palacios-González 2017).…”

Section: Intergenerational Follow-up and Transfer Of Exclusively Malementioning

confidence: 99%

Should Long-Term Follow-up Post-Mitochondrial Replacement be Left up to Physicians, Parents, or Offspring?

Ishii

2019

The New Bioethics

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UK law permits parents to use mitochondrial replacement (MR) to have genetically-related children without serious mitochondrial disease. However, long-term follow-up is required for each case. Whether this follow-up should be left to physicians, parents, or offspring has not been established. Due to the experimental status of MR, physicians must inform parents of the risks and the importance of follow-up tailored to a specific mitochondrial disease. Given that the use of MR is a responsible exercise of reproductive freedom, parents should ensure that the follow-up is performed properly and in the best interests of their offspring. On becoming legally competent, the resulting children should be entitled to refuse follow-up provided that the prevention of mitochondrial disease with no adverse effects has been evident till then. This offspring-centred long-term follow-up approach might also be applied to the use of MR for infertility treatment, even though the primary endpoint is healthy live births.

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“…In long-term follow-up that aims to examine long-term treatment effects, medical tests may consist of analysing blood samples or saliva specimen and investigating reproductive health by analysing semen samples or examining female reproductive organs. Psychological tests may include analysing cognitive, motor and language developments, behaviour problems and socioemotional development, and the parent-child relationship (Zhan et al, 2013;Heijligers et al, 2018). In practice, such tests include IQ tests, interviews and questionnaires.…”

Section: Introductionmentioning

confidence: 99%

Follow-up in the field of reproductive medicine: an ethical exploration

Jans

Dondorp

Bonduelle

et al. 2020

Reproductive BioMedicine Online

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The cognitive and socio-emotional development of 5-year-old children born after PGD

Abstract: NCT 02 149485.

Cited by 15 publications

References 46 publications

Zygotic splitting following embryo biopsy: a cohort study of 207 697 single‐embryo transfers following IVF treatment

Zygotic splitting following embryo biopsy: a cohort study of 207 697 single‐embryo transfers following IVF treatment

Should Long-Term Follow-up Post-Mitochondrial Replacement be Left up to Physicians, Parents, or Offspring?

Follow-up in the field of reproductive medicine: an ethical exploration

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