A population-based study of the effect of infertility and its treatment on child health and development

Lead Research Organisation: University of Oxford
Department Name: National Perinatal Epidemiology Unit

Abstract

Infertility affects about one in seven couples in the UK. The development of infertility treatments such as IVF has helped many couples to conceive. As well as looking at short-term success rates such as becoming pregnant and giving birth, it is important to assess the safety of infertility treatments, including any possible longer term effects on the child.

Our study will look at the effects of infertility and its treatment on a range of child health and development outcomes. We will use data from a national study of over 19,000 babies born in the UK. Parents of these children were interviewed when the children were aged 9 months, 3 years and 5 years. The parents were asked about many things including the child?s health and development. The interviewers performed standard assessments on the children which assessed how well they were developing for their age.

We will compare three groups of children: those who resulted from ?a usual time to conception? (those whose parents did not have difficulties conceiving); those who resulted from ?a prolonged time to conception? (those whose parents had difficulties conceiving but managed to conceive without treatment); and those who were conceived following infertility treatment. We will assess whether the health and development in these three groups of children varies.

The team for this study has the experience necessary to ensure that this research will be high quality and relevant to those who are having or considering infertility treatment. The results will be published in medical journals. We will liaise with the Human Fertilisation and Embryology Authority and Infertility Network UK to ensure that our findings are reported to those who will find them useful.

Technical Summary

Background: Infertility affects about one in seven couples in the UK. An average of 22% of infertile women surveyed in developed countries have undergone infertility treatment. These treatments are not without short-term risks to the child, such as an increased risk of being born preterm or of low birth weight. An effect of infertility and it?s treatment on longer-term child health and development is less clear.

Objectives: The aim of this study is to elucidate the separate effects of infertility and its treatment on a range of child health and development outcomes measured at age 3 and 5 years in a national cohort study. We will compare three groups of children: those who resulted from ?a usual time to conception?; those who resulted from ?a prolonged time to conception?; and those who were conceived following infertility treatment.

Study design: The study is a population-based cohort study using the Millennium Cohort Study (MCS) datasets at Sweeps 1 (age 9 months), 2 (age 3 years) and 3 (age 5 years). Data are available on infertility and its treatment, and a wide range of health and development outcomes and potential confounders. Data were collected by a home interview with the child?s parents. Behaviour and development were assessed by the British Ability Scales, the Bracken Basic Concept Scale, the Strengths and Difficulties Questionnaire, and the Sally-Anne False Belief Task.

Analysis and study power: The study outcomes will be compared between the three comparison groups using logistic and linear regression. The mechanism for any observed effects will be explored by assessing the role of confounders and effect modifiers, and using life course methods. The numbers in each comparison group at Sweep 2 are known (n=13,822 for usual time to conception, n=582 for prolonged time to conception, n=401 for infertility treatment). The study has at least 80% power to detect small to moderate, clinically important effects for most study outcomes.

Exploitation: The co-applicants for this study have the expertise and experience necessary to ensure that the research conducted is rigorous, high quality, clinically relevant and completed within the proposed timetable. The results will be published in peer-reviewed journals and posted on the MCS website. We will liaise with the Human Fertilisation and Embryology Authority and Infertility Network UK regarding dissemination, including a lay summary of our findings.
 
Description Career Development Award
Amount £669,931 (GBP)
Funding ID MR/L019671/1 
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom
Start 08/2014 
End 11/2020
 
Description Case study on UK Data Archive website 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Type Of Presentation Poster Presentation
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact We were asked to describe our study as a case study for other potential users of the Millennium Cohort Study data. The website describing our case study is:

http://www.esds.ac.uk/resources/datainuse/casestudy.asp?id=8

Not aware of any impact yet.
Year(s) Of Engagement Activity 2011
 
Description Media interest following publication of 2 journal articles 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Type Of Presentation Poster Presentation
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact Two of our publications (one in 2011 and one in 2012) were press released and generated media interest. This included coverage in newspapers (e.g. The Telegraph), the BBC website and the New Scientist. There were also interviews broadcast on local radio and the BBC World Service.

Some interest from members of the public but no noticable impact so far.
Year(s) Of Engagement Activity 2011
 
Description Media interest in the asthma paper 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Interview with the BBC World Service
Interviews with other journalists e.g. Telegraph

Nothing as yet
Year(s) Of Engagement Activity 2012
URL http://There are many e.g. http://www.bbc.co.uk/news/health-20606756