Project details

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Is twin birth after IVF associated with a higher risk for neurodevelopmental impairment?

Keywords:
IVF neurological development child outcome

Researchers:
Prof. dr. M. Hadders-Algra
J. Seggers

Nature of the research:
Data-analysis of already collected longitudinal data of a birth cohort of children born after IVF.

Fields of study:
gynaecology pediatrics neurology

Background / introduction
The increasing use of in vitro fertilization (IVF), with or without intracytoplasmic sperm injection (ICSI), over the past thirty years has allowed many thousands of subfertile couples to fulfil their wish to have a child. Nowadays, up to 4% of newborns in Europe is conceived with IVF. Due to IVF (with or without ICSI) also the number of twins has increased substantially.
In general, twin birth is associated with preterm birth, lower birth weight and its associated perinatal problems. Being member of a twin is also associated with an increased risk for neurodevelopmental disorders, such as cerebral palsy. It is however, not clear whether twin birth after IVF is associated with a similar increased risk (compared to singleton birth after IVF). In singletons, IVF-procedures do not seem to affect neurodevelopmental outcome till the age of 4 years. However, we recently found that twin birth after IVF which also involved preimplantation genetic screening was associated with altered neurodevelopmetnal outcome at 4 years.
Research question / problem definition
Is twin birth after IVF associated with an increased of neurodevelopmental impairment at 2 and 4 years compared to singleton birth after IVF?
Workplan
Determinants:
Twin birth, IVF, ICSI

Outcome:
In about 50 twins and about 60 singletons born after IVF detailed data on neurodevelopmental outcome have been collected at the ages of 2 years and 4 years.

Using linear and logistic regression models we will compare neurodevelopmental outcome at age 2 and age 4 in twins with that singletons.

Project may be carried out as Master Thesis project and/or as part of MD/PhD trajectory
References
Andersen AN, Goossens V, Bhattacharya S, Ferraretti AP, Kupka MS, de Mouzon J and Nygren KG. Assisted reproductive technology and intrauterine inseminations in Europe, 2005: results generated from European registers by ESHRE. Hum Reprod 2009:24:1267-1287
Middelburg KJ, Heineman MJ, Bos AF, Hadders-Algra M. Neuromotor, cognitive, language and behavioural outcome in children born following IVF or ICSI – a systematic review. Hum Reprod Update 2008; 14: 219-31.
Pinborg A. IVF/ICSI twin pregnancies: risks and preventionHum Reprod Update. 2005 Nov-Dec;11:575-93.
Schendelaar P, Middelburg KJ, Bos AF, Heineman MJ, Kok JH, La Bastide-van Gemert S, Seggers J, Van den Heuvel ER, Hadders-Algra M. The effect of preimplantation genetic screening on neurological, cognitive and behavioural development in 4-year-old children: follow-up of a RCT. Hum Reprod 2013; 28:1508-18.
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