Whither IVF assisted birth or spontaneous conception? Parenting anxiety, styles and child development in Jamaican families

Does conception spontaneously or with ART affect postpartum parenting behaviors?

Pregnancy and parenting may be psychologically more complex after assisted conception than after spontaneous conception. On the other hand, the literature demonstrates that mothers who conceived with ART comply with transition to parenting easily although they experience more problems in pregnancy and postpartum. This study aimed to compare postpartum parenting behaviors of women who conceived spontaneously or with ART. This descriptive, cross-sectional and comparative study was conducted between October 2017 and June 2018 in Dokuz Eylul University postpartum clinic with 50 spontaneous mother and 50 ART mothers. After a brief explanation of the study, the personal information form was applied to women and the parenting behaviours were observed by using Postpartum Parenting Behavior Scale. The total PPBS average score in the ART group was 5.40 ± 1.41 compared with 3.62 ± 2.24 in the comparison group. The ART mother displayed significantly a more positive attitude toward their infant than spontaneous mother (p = 0.00). Also, in six components of PPBS separately it was determined higher score in ART group, respectively (p = 0.04, p = 0.00, p = 0.00, p = 0.00, p = 0.00, p = 0.00). Mothers who were conceived with ART exhibit more positive parenting behaviors.

Fathers of children conceived using ART have higher cognitive ability scores than fathers of naturally conceived children

STUDY QUESTION

Does paternal cognitive ability differ for children conceived with and without assisted reproductive technology (ART)?

SUMMARY ANSWER

Young fathers of ART conceived children tend to score cognitively below their same-age natural conception (NC) counterparts and older (above 35) fathers of ART conceived children tend to score above.

WHAT IS KNOWN ALREADY

Cognitive ability is a genetically and socially transmitted trait, and If ART and NC children have parents with different levels of this trait, then this would in itself predict systematic differences in child cognitive outcomes. Research comparing cognitive outcomes of children with different modes of conception finds conflicting results, and studies may be influenced by selection and confounding.

STUDY DESIGN, SIZE, DURATION

This is a population-based study based on Norwegian data, combining information from the Medical Birth Registry (births through 2012), military conscription tests (birth cohorts 1955–1977) and the population registry. These data allow us to compare the cognitive ability scores of men registered as the father of an ART-conceived child to the cognitive abilities of other fathers and to average scores in the paternal birth cohorts.

PARTICIPANTS/MATERIALS, SETTINGS, METHODS

The population level study included 18 566 births after ART (5810 after ICSI, 12 756 after IVF), and 1 048 138 NC births. It included all Norwegian men who received a cognitive ability score after attending military conscription between 1973 and 1995. This constituted 614 827 men (89.4% of the male birth cohorts involved). An additional 77 650 unscored males were included in sensitivity analyses.

MAIN RESULTS AND THE ROLE OF CHANCE

Paternal cognitive level was assessed using intelligence quotients (IQ) converted from stanine scores on a three-part cognitive ability test with items measuring numeracy, vocabulary and abstract thought (Raven-like matrices). ART fathers averaged 1.95 IQ points above the average of their own birth cohort (P-value < 0.0005) and 1.83 IQ points above NC fathers in their own birth cohort (P < 0.0005). Comparisons of the IQ of ART fathers to those of NC fathers of similar age and whose children were born in the same year, however, found average scores to be more similar (point estimate 0.24, P = 0.023). These low average differences were found to differ substantially by age of fatherhood, with young ART fathers scoring below their NC counterparts and older ART fathers scoring above their NC counterparts.

LIMITATIONS, REASONS FOR CAUTION

We do not have information on maternal cognition. We also lack information on unsuccessful infertility treatments that did not result in a live birth.

WIDER IMPLICATIONS OF THE FINDINGS

Paternal cognitive ability of ART children differs from that of NC children, and this difference varies systematically with paternal age at child birth. Selection effects into ART may help explain differences between ART and NC children and need to be adequately controlled for when assessing causal effects of ART treatment on child outcomes.

STUDY FUNDING/COMPETING INTEREST(S)

This research has also been supported by the Research Council of Norway through its Centres of Excellence funding scheme, project number 262700 (Centre for Fertility and Health). It has also been supported by the Research Council of Norway’s Project 236992 (Egalitarianism under pressure? New perspectives on inequality and social cohesion). There are no competing interests.

TRIAL REGISTRATION NUMBER

N/A