A US-UK Collaborative Study of the Health of Children Born From In Vitro Fertilization: From Conception Through Young Adulthood

美英合作研究体外受精出生的儿童的健康状况：从受孕到成年

• 批准号: 10749238
• 负责人: BARBARA Joan LUKE
• 金额: $ 63.46万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2028-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10749238
• 关键词: Accounting; Acute; Adult; Age; Assisted Reproductive Technology; Authorization documentation; Autologous; Birth; Birth Order; Birth Weight; Cerebral Palsy; Child; Child Health; Childbirth; Childhood; Chronic Disease; Clinic; Collaborations; Conceptions; Congenital Abnormality; Country; Data; Databases; Defect; Development; Dropout; Embryo; Embryo Loss; Embryo Transfer; Embryology; Environmental Risk Factor; Epigenetic Process; Ethnic Origin; Fertilization; Fertilization in Vitro; First Births; Follow-Up Studies; Growth; Health; Heart Abnormalities; Height; Human; Individual; Infant; Intracytoplasmic Sperm Injections; Knowledge; Left; Life; Life Cycle Stages; Link; Lymphocyte Activation; Malignant Neoplasms; Malignant neoplasm of liver; Methodology; Morbidity - disease rate; Neonatal; Neonatal Mortality; Neurologic; Oocytes; Outcome; Parents; Pattern; Perinatal; Persons; Pregnancy; Premature Mortality; Procedures; Process; Race; Registries; Reporting; Research; Research Personnel; Risk; Role; Sample Size; Siblings; Societies; Socioeconomic Factors; Source; Survivors; Syndrome; System; Technology; Time; Twin Multiple Birth; Weight; adverse outcome; authority; early childhood; embryo cryopreservation; ethnic diversity; experience; fetal loss; follow-up; high risk; methylome; middle childhood; mortality; neonatal morbidity; obesity in children; oocyte cryopreservation; perinatal outcomes; racial diversity; respiratory; sex; young adult; Accounting; Acute; Adult; Age; Assisted Reproductive Technology; Authorization documentation; Autologous; Birth; Birth Order; Birth Weight; Cerebral Palsy; Child; Child Health; Childbirth; Childhood; Chronic Disease; Clinic; Collaborations; Conceptions; Congenital Abnormality; Country; Data; Databases; Defect; Development; Dropout; Embryo; Embryo Loss; Embryo Transfer; Embryology; Environmental Risk Factor; Epigenetic Process; Ethnic Origin; Fertilization; Fertilization in Vitro; First Births; Follow-Up Studies; Growth; Health; Heart Abnormalities; Height; Human; Individual; Infant; Intracytoplasmic Sperm Injections; Knowledge; Left; Life; Life Cycle Stages; Link; Lymphocyte Activation; Malignant Neoplasms; Malignant neoplasm of liver; Methodology; Morbidity - disease rate; Neonatal; Neonatal Mortality; Neurologic; Oocytes; Outcome; Parents; Pattern; Perinatal; Persons; Pregnancy; Premature Mortality; Procedures; Process; Race; Registries; Reporting; Research; Research Personnel; Risk; Role; Sample Size; Siblings; Societies; Socioeconomic Factors; Source; Survivors; Syndrome; System; Technology; Time; Twin Multiple Birth; Weight; adverse outcome; authority; early childhood; embryo cryopreservation; ethnic diversity; experience; fetal loss; follow-up; high risk; methylome; middle childhood; mortality; neonatal morbidity; obesity in children; oocyte cryopreservation; perinatal outcomes; racial diversity; respiratory; sex; young adult

PROJECT SUMMARY Since the birth of the first child from in vitro fertilization (IVF) in the UK in 1978 and in the US in 1981, more than ten million babies have been born from this technology, including more than 1.37 million babies annually worldwide. In 2018, IVF births accounted for 2.24% of all US births and 3.1% of all UK births. Consistent research findings indicate that IVF-conceived pregnancies and IVF-conceived children are at greater risk for a spectrum of adverse perinatal outcomes. A persistent, unresolved issue remains what proportion of the adverse perinatal and child health outcomes after IVF is due to parental factors and what proportion is due to the IVF procedures. In the US, the national IVF database, the Society for Assisted Reproductive Technology Clinic Outcome Reporting System is left-censored at 2004; it is not feasible to obtain data on earlier cycles. In addition, the US has few national databases to facilitate tracking children’s health over time. To overcome these limitations, we are partnering with researchers in the UK in this proposed study. The UK system, under the Human Fertilisation and Embryology Authority, can track individuals treated as early as 1991, linking all adults treated and all children conceived with IVF to a number of national databases. Through this collaboration, we seek to draw upon the strengths of each country: in the UK, longer follow-up and more linked health databases; in the US, more annual IVF cycles and births; and more racial and ethnic diversity. The long-term health of children conceived with IVF is still not clearly understood. Follow-up studies of the growth and health of IVF-conceived children have been limited by small sample sizes, high drop-out rates, and methodological issues, with many knowledge gaps remaining. In this proposed renewal, we are seeking to overcome these limitations using an early life-course approach to evaluate the growth and health of children born from IVF, from conception through childhood, and for the UK component, through adulthood. The two primary aims of this proposed renewal are (1) comprehensively evaluate the role of IVF conception on birth defects, cancer, and the co-occurrence of these conditions through large-scale registry linkages and analysis of the neonatal methylome and (2) to evaluate the effect of IVF treatment parameters, specifically the use of ICSI, number of embryos transferred (embryonic and/or fetal loss as plurality at conception versus at birth), oocyte source/state-embryo state combinations, on child growth (size at birth, and height and weight at ages 4-5 and 10-11) and health (birth defects, cancer, acute and chronic illness, and premature mortality), accounting for parental, socioeconomic, and environmental factors. This proposed study will include a total of more than 4.75 million children, including more than 458,000 IVF- conceived children born 1991-2018, 88,000 naturally-conceived siblings, and 4.2 million naturally-conceived control children, with 80.6 million person-years of follow-up, averaging 14.4 years in the US (ranging from birth to age 22) and 18.3 years in the UK (ranging from birth to age 36), and will provide a comprehensive contemporary picture of child health after conception by in vitro fertilization.

项目摘要 自从1978年英国和1981年在美国的第一个孩子出生以来 这项技术已经诞生了一亿婴儿，包括每年超过137万婴儿 全世界。 2018年，IVF出生占美国所有出生的2.24％，占英国所有出生的3.1％。一致的研究 调查结果表明，IVF构想的怀孕和IVF构想的儿童面临更大的风险 不良围产期结果。持续的，未解决的问题仍然是不良围产期的比例 IVF后的儿童健康结果是由于父母因素以及IVF程序造成的比例。 在美国，国家IVF数据库，辅助生殖技术诊所成果 报告系统于2004年进行左右；获得早期周期的数据是不可行的。此外，美国 随着时间的推移，很少有国家数据库来促进跟踪儿童健康。为了克服这些限制，我们 在这项拟议的研究中与英国的研究人员合作。英国系统，在人类的施肥下 和胚胎学授权，可以追踪1991年受到治疗的个人，将所有接受治疗的成年人和所有儿童联系起来 与IVF一起构思为许多国家数据库。通过这项合作，我们试图借鉴 每个国家的优势：在英国，随访时间更长，健康数据库更具联系；在美国，更多年一年 IVF周期和出生；以及更多的种族和种族多样性。与IVF构想的儿童的长期健康 仍然没有清楚地理解。关于IVF构思儿童的成长和健康的后续研究已经 受小样本量，高辍学率和方法论问题的限制，并有许多知识差距 其余的。在此拟议的续约中，我们正在寻求使用早期生命过程来克服这些局限性 评估IVF，从概念到儿童时期以及 对于英国组成部分，整个成年。该提议的续约的两个主要目的是（1） 全面评估IVF概念对先天缺陷，癌症的作用以及这些的共同发生 通过大规模注册表的条件和新生甲基组的分析和（2）评估 IVF治疗参数的影响，特别是使用ICSI，转移的胚胎数量（胚胎和/或） 胎儿损失作为概念与出生时的多数损失），卵母细胞来源/状态 - 欧洲状态组合，对儿童 生长（出生时大小，4-5岁和10-11岁的身高和体重）和健康（先天缺陷，癌症，急性和 慢性疾病和过早死亡），占父母，社会经济和环境因素。 这项拟议的研究将包括超过475万儿童，包括超过458,000 IVF- 构想的儿童出生于1991 - 2018年，有88,000个自然构思的兄弟姐妹和420万自然构思 对照儿童，有8060万人的随访年度，在美国平均14。4年（从出生到不等） 到22岁）在英国（从出生到36岁之间），并将提供全面的 当代儿童健康概念的概念图片。