Parental subfertility is associated with higher blood pressure in offspring

Increased childhood blood pressure (BP) can lead to increased BP later in life and even small increases have been associated with a higher risk of adult cardiovascular disease. In contrast, lower childhood BP has been associated with more favourable health outcomes. One study found that a 2 mmHg reduction in childhood diastolic BP was associated with a 17% decrease in the prevalence of adult hypertension . This article is protected by copyright. All rights reserved

Porphyrin a as a precursor of heme a in Candida utilis

Background: An increased risk of major congenital abnormalities after IVF and ICSI has been described, but underlying mechanisms are unclear. This study evaluates the effects of ovarian hyperstimulation, the in vitro procedure and time to pregnancy (TTP) - as proxy for the severity of subfertility - on the prevalence of dysmorphic features. Design/methods: Participants were singletons born following controlled ovarian hyperstimulation-IVF/ICSI (COH-IVF/ICSI; n = 66), or modified natural cycle-IVF/ICSI (MNC-IVF/ICSI; n = 56), or to subfertile couples who conceived naturally (Sub-NC; n = 86). Dysmorphic features were assessed according to the method of Merks et al., and are classified into 'minor variants' (minor anomalies or common variants) and 'abnormalities' (clinically relevant or irrelevant abnormalities). We focussed on minor anomalies as they indicate altered embryonic development and because they have the advantage of a higher prevalence. Results: The prevalences of any of the outcome measures were similar in the three groups. One or more minor anomalies, our primary outcome measure, occurred in 50% of COH-IVFACSI, 54% of MNC-IVF/ICSI and 53% of Sub-NC children. TTP in years was significantly associated with abnormalities (adjusted0R= 120; 95%CI = 1.02-1.40). especially with clinically relevant abnormalities (adjustedOR = 1.22; 95%CI = 1.01-1.48). Conclusions: The study indicates that ovarian hyperstimulation and the in vitro procedure are not associated with an increase in dysmorphic features. The positive association between TTP and clinically relevant abnormalities suggests a role of the underlying subfertility and its determinants in the genesis of dysmorphic features. (C) 2012 Published by Elsevier Ireland Lt

Female reproductive ageing : the clinical relation between oocyte quantity and oocyte quality

De positie van de vrouw in de westerse maatschappij is de laatste tientallen jaren fundamenteel veranderd. Vrouwen zijn hoger opgeleid dan vroeger en werken vaker buitenshuis. De introductie van ‘de pil’ in de jaren zestig heeft een sleutelrol gespeeld in de emancipatie van vrouwen: seksualiteit en voortplanting waren niet langer vanzelfsprekend aan elkaar gekoppeld en moederschap werd een keuze. Twee belangrijke consequenties van deze veranderingen zijn een bewuste daling in het aantal kinderen per gezin en uitstel van ouderschap. In Nederland is de gemiddelde leeftijd waarop vrouwen voor het eerst moeder worden gestegen van ruim 24 jaar in de jaren zeventig tot ruim 29 jaar nu. Maar de trend om het moederschap uit te stellen heeft een prijs. Naarmate de leeftijd van de vrouw stijgt, wordt de maandelijkse kans op een zwangerschap kleiner en wordt de kans op een miskraam groter. Dit fenomeen wordt ‘reproductieve veroudering’ genoemd. Het eff ect van een hogere leeftijd van de vader op de voortplanting is zeer klein ten opzichte van het eff ect van een hogere leeftijd van de moeder. Er wordt aangenomen dat de trend om het moederschap uit te stellen leidt tot een toename van vruchtbaarheidsproblemen, ongewenste kinderloosheid of een kleiner gezin dan gewenst. ... Zie: Samenvatting.

Ovarian hyperstimulation and the in vitro fertilization procedure do not influence early neuromotor development; a history of subfertility does

Objective: To evaluate specific effects of ovarian hyperstimulation, the in vitro procedure, and a history of subfertility on neuromotor development at 3 months of age. Design: Prospective, cohort study. Setting: University Medical Center Groningen, The Netherlands. Patient(s): Singletons conceived after controlled ovarian hyperstimulation-IVF/intracytoplasmic sperm injection (COH-IVF: n = 68) or modified natural cycle-IVF/intracytoplasmic sperm injection (MNC-IVF; n = 57), and naturally conceived singletons of subfertile couples (NC; n = 90). Data from a reference population were available (n = 450). Intervention(S): None. Main Outcome Measure(s): Quality of general movements (GMs), classified as normal-optimal, normal-suboptimal, mildly abnormal, or definitely abnormal. Definitely abnormal GMs indicate brain dysfunction, mildly abnormal GMs normal but non-optimal brain function. Result(s): Mildly abnormal and definitely abnormal GMs were observed equally frequently in COH-IVF, MNC-IVF, and NC singletons. The three subfertile groups showed a reduction in GM quality, in particular more mildly abnormal GMs, in comparison with the reference population. Conclusion(s): Singletons born after IVF (with or without ovarian hyperstimulation) are not at increased risk for abnormal GMs compared with naturally conceived peers of subfertile parents. Mildly abnormal GMs occur more often in infants of subfertile parents than in the general population, suggesting that factors associated with subfertility rather than those related to IVF procedures may be associated with less-optimal early neurodevelopmental outcome. These results need confirmation through replication and follow-up at older ages. (Fertil Steril(R) 2010;93:544-53. (C)2010 by American Society for Reproductive Medicine.

Predictive value of general movements' quality in low-risk infants for minor neurological dysfunction and behavioural problems at preschool age

Background: General movement (GM) assessment is a well-established tool to predict cerebral palsy in high-risk infants. Little is known on the predictive value of GM assessment in low-risk populations. Aims: To assess the predictive value of GM quality in early infancy for the development of the clinically relevant form of minor neurological dysfunction (complex MND) and behavioral problems at preschool age. Study design: Prospective cohort study. Subjects: A total of 216 members of the prospective Groningen Assisted Reproductive Techniques (ART) cohort study were included in this study. ART did not affect neurodevelopmental outcome of these relatively low-risk infants born to subfertile parents. Outcome measures: GM quality was determined at 2 weeks and 3 months. At 18 months and 4 years, the Hempel neurological examination was used to assess MND. At 4 years, parents completed the Child Behavior Checklist; this resulted in the total problem score (TPS), internalizing problem score (IPS), and externalizing problem score (EPS). Predictive values of definitely (DA) and mildly (MA) abnormal GMs were calculated. Results: DA GMs at 2 weeks were associated with complex MND at 18 months and atypical TPS and IPS at 4 years (all p <0.05). Sensitivity and positive predictive value of DA GMs at 2 weeks were rather low (13%-60%); specificity and negative predictive value were excellent (92%-99%). DA GMs at 3 months occurred too infrequently to calculate prediction. MA GMs were not associated with outcome. Conclusions: GM quality as a single predictor for complex MND and behavioral problems at preschool age has limited clinical value in children at low risk for developmental disorders. (C) 2016 Elsevier Ireland Ltd. All rights reserved

IVF procedures are not, but subfertility is associated with neurological condition of 9-year-old offspring

In vitro fertilization (IVF) is not associated with neurological abnormalities in offspring's early childhood. Yet, it is unclear whether this is also true for school age. Neither do we know the role of parental subfertility in offspring's neurological development. The present study examined neurological condition at 9 years of 57 singletons born after controlled ovarian hyperstimulation IVF (COH-IVF), 46 singletons born after modified natural cycle IVF (MNC-IVF) and 66 singletons born to subfertile parents after natural conception (Sub-NC). To assess the effect of subfertility, the groups were pooled to form a subfertile group, and compared with a prospectively followed fertile reference group (n = 282). The sensitive Minor Neurological Dysfunction (MND) examination was used, resulting in the detailed Neurological Optimality Score (NOS) and the prevalence of the clinically relevant complex MND. Neurological condition of the three subfertile groups did not differ significantly: median NOS was 53 in each subfertile group and the prevalence of complex MND in the three subfertile groups was 30%, 37% and 36%, respectively. However, the NOS was lower and the prevalence of complex MND higher in children born to subfertile couples than in children of fertile couples (adjusted mean difference [95% CI]: −4.48 [−5.53 to −3.42]) and adjusted OR [95% CI]: 5.13 [2.60–10.16], respectively). We conclude that ovarian hyperstimulation, in vitro procedures, and the combination of both were not associated with a less favourable neurological outcome of 9-year-old singletons. However, the presence of parental subfertility was associated with less favourable neurological outcome of offspring at 9 years follow up