Adolescents conceived by assisted reproduction do not have deteriorated mental health

December 28, 2021

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Wang does not report any relevant financial information. Please refer to the study for all relevant financial information from the other authors.

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Adolescents conceived using assisted reproductive techniques did not have an increased risk of poor psychiatric health compared to the general population, according to study results published in JAMA Psychiatry.

“Since some researchers argue that emotional stress can contribute to infertility, depression and anxiety may be more common in children born to infertile couples [assisted reproductive technique (ART)] use to further facilitate the passing on of such characteristics to the next generation “, Chen Wang, MPH, from the Department of Medical Epidemiology and Biostatistics at Karolinska Institutet in Sweden, and colleagues wrote. “However, the psychiatric health of children and adolescents conceived through ARTs has not been extensively studied, and previous studies have relied on self-reports and inappropriate model adjustments, including mediators such as premature births.”

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The researchers wanted to fill this research gap by prospectively tracking a nationwide birth cohort. They linked Swedish population registers with the data up to 2018 and included all children (n = 1,221,812; 48.6% girls) who were born in Sweden between January 1994 and December 2006. They completed the follow-up on December 31, 2018 when the participants were 12 to 25 years old. Wang and colleagues used in vitro fertilization with or without intracytoplasmic sperm injection and the transfer of fresh or frozen-thawed embryos as exposures. Clinical diagnoses of mood disorder, including major depression, anxiety, obsessive-compulsive disorder, or suicidal behavior, identified through hospital records and specialist outpatient care, served as the main outcomes and measures. They also identified suicide through death certificates and the use of antidepressants through the dispensing of prescribed drugs.

A total of 31,565 (2.6%) participants were conceived via ART. The results showed that these participants had an increased risk of obsessive-compulsive disorder (HR = 1.35; 95% CI 1.2-1.51) compared to everyone else. However, the adjustment for parental characteristics (adjusted HR = 1.1; 95% CI 0.98-1.24) weakened the association and no longer made it statistically significant. If the analysis was restricted to persons born to couples with known infertility (aHR = 1.02; 95% CI, 0.89-1.17), the association was no longer present. The researchers did not observe an increased risk of depression or suicidal behavior in adolescents conceived by ART compared to other adolescents, regardless of the infertility of the parents. The mode of fertilization did not appear to affect the results. Fresh, but not frozen, embryo transfer correlated with a reduced risk of mood disorders (aHR = 0.9; 95% CI, 0.83-0.97) compared to children of infertile couples who were not conceived by ART. The researchers found that this made frozen embryo transfer less beneficial in direct comparison with fresh embryo transfer.

“The results were reassuring regarding the psychiatric health of adolescents conceived with ART,” wrote Wang and colleagues. “An increased risk of obsessive-compulsive disorder overall compared to all other adolescents can be explained by differences in parental characteristics, and parental use of ARTs could be a candidate for potential screening for this disorder.”

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