Journal Article Epublish
PubMed: 40717801 DOI: 10.3389/fendo.2025.1630293
Impact of embryo transfer strategies on children health outcomes: a retrospective national cohort study in Taiwan.
Front Endocrinol (Lausanne) 16:1630293
Authors: Chih-Ting Chang, Shih-Feng Weng, Hui-Yu Chuang, Chia-Yi Hsu, Eing-Mei Tsai
Affiliations
- NUWA Fertility Center, Taipei, Taiwan.
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Center for Medical Informatics and Statistics, Office of Research and Development, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Center for Big Data Research, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
- Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Abstract
Objective
To investigate the impact of different assisted reproductive technology (ART) embryo transfer strategies on neonatal and early childhood health outcomes, focusing on fresh versus frozen transfers and cleavage versus blastocyst stages.
Design
Retrospective cohort study analyzing data from Taiwan's national assisted reproduction database (2013-2017).
Methods
The study included 10,803 ART-conceived singleton births and 894,615 naturally conceived singletons. ART groups were categorized by embryo transfer type: fresh cleavage stage, fresh blastocyst, frozen cleavage stage, and frozen blastocyst. Maternal, paternal, and perinatal outcomes were adjusted using inverse probability of treatment weighting (IPTW). Outcomes included major and minor diseases in offspring, such as ADHD, developmental delays, atopic dermatitis, and respiratory diseases.
Results
ART-conceived children had higher rates of major and minor health conditions compared to naturally conceived peers, particularly preterm birth, ADHD, and developmental delay. No significant differences were observed in major disease incidence between frozen and fresh transfers or cleavage and blastocyst stages. The elevated risks in ART-conceived children may reflect the influence of underlying parental infertility rather than ART procedures alone.
Conclusion
While ART is linked to increased risks of certain adverse health outcomes, the choice between embryo transfer strategies has minimal impact on neonatal or early childhood health. These findings underscore the need to optimize ART protocols and perinatal care while addressing the role of parental infertility in shaping offspring health.
MeSH
Blastocyst, Parturition, Infertility, Cohort Studies, Embryo Transfer, Child