Objective-An association between assisted reproductive technique (ART) and specific imprinting mutations, such as Beckwith-Wiedemann syndrome (BWS), has recently been documented. Based on experiments in farm animals that demonstrated an association between alterations in culture media during ART and large offspring syndrome, we hypothesized that the culture media could be implicated as a common factor among the children with BWS conceived after ART.
Design-Retrospective case series.Setting-Registry from Academic Medical Center.
Patient(s)-Nineteen children born after ART were identified within the registry.Main Outcome Measure(s)-Demographics of patients, type of ART, culture media, IVF parameters.Result(s)-Twelve of the 19 medical records from the reproductive endocrine centers were successfully obtained. Ten of 12 mothers of children with BWS had IVF, but no single, consistent culture media was used in this group. Half of the patients underwent IVF with intracytoplasmic sperm injection (ICSI; n = 5), whereas the other half had routine IVF. One child was conceived through clomiphene citrate (CC) stimulation and artificial insemination, whereas another patient conceived through gonadotropin stimulation with intrauterine insemination (IUI). The gonadotropin dosage and quantity of embryos transferred also varied significantly. The only consistent finding was that all 12 women received some type of ovarian stimulation medication. An association between assisted reproductive technology (ART) and congenital malformation syndromes associated with imprinting defects has recently been documented (4, 5). Three groups have reported an increased rate of ART conceptions among children with BWS (5-7). Only one of these studies prospectively determined the incidence of ART in children with BWS (5). Combined data from two studies suggest that approximately 4% of the children with BWS were born after ART (5, 7).
HHS Public AccessAngelman syndrome, a congenital malformation syndrome characterized by mental retardation, motor defects, and lack of speech is associated with imprinting abnormalities and ART (MIM 105830) (4). Angelman syndrome occurs in children with imprinting abnormalities of a gene cluster on chromosome 15 resulting in a loss of function of the maternal allele of ubiquitin-protein ligase E3A (UBE3A) (MIM 601623) (8). Three children with Angelman syndrome have been reported who were conceived after IVF with intracytoplasmic sperm injection (ICSI) lending further support for the association between congenital malformation syndromes with imprinting mutations and ART (4, 9).Results from two embryo experiments conducted in cows and mice led to this proposed study. First, Thompson et al. (10) demonstrated that they could decrease the frequency of large offspring syndrome (LOS) in farm animals after ART by changing the protein supplementation in the culture medium from sera to albumin and amino acids. The LOS refers to a syndrome that occurs after ART in sheep and cows and is associated with macrosomia, polyhyd...