Tags

Type your tag names separated by a space and hit enter

Parental time to pregnancy, medically assisted reproduction and pubertal development in boys and girls.
Hum Reprod. 2019 04 01; 34(4):724-732.HR

Abstract

STUDY QUESTION

Does parental fertility, measured by time to pregnancy (TTP), or use of medically assisted reproduction (MAR) affect pubertal development in the offspring?

SUMMARY ANSWER

Neither TTP nor type of MAR treatment had clinically relevant implications for mean age at achieving individual pubertal milestones or overall timing of puberty in boys and girls.

WHAT IS KNOWN ALREADY

Parental TTP and MAR have been associated with impaired semen quality in adult sons. Timing of puberty reflects earlier signals of reproductive health, but it remains unclear whether parental fertility or MAR affects pubertal development, especially in the growing generation of children conceived by IVF or ICSI.

STUDY DESIGN, SIZE, DURATION

In this study, 15 819 children born by mothers in the Danish National Birth Cohort from 2000 to 2003 participated in a nationwide puberty cohort (participation rate = 70%). Parental TTP and use of MAR were reported by mothers in early pregnancy and children's pubertal development data was self-recorded in web-based questionnaires from 11 years of age and 6 monthly throughout puberty (2012-2018).

PARTICIPANTS/MATERIALS, SETTING, METHODS

Pubertal development in children (of planned pregnancies, n = 13 285) born by untreated subfecund (TTP: 6-12 months) (n =2038), untreated severely subfeund (TTP: >12 months) (n = 1242), treated subfecund (n = 230) and treated severely subfecund (n = 1234) parents were compared to children born to more fertile parents (TTP: ≤5 months). We estimated mean monthly differences in mean age at achieving individual pubertal milestones (i.e. age at menarche, voice break, first ejaculation and Tanner stages 2, 3, 4 and 5 for breast or genital development and pubic hair growth) and a combined indicator of timing of puberty. Further, we compared mean age at achieving the individual pubertal milestones in children born by use of IVF or ICSI (n = 480) with children born by controlled ovarian stimulation or ovulation induction with or without intrauterine insemination (n = 902).

MAIN RESULTS AND THE ROLE OF CHANCE

We found tendencies towards slightly later mean age at male pubertal timing and slightly earlier mean age at female pubertal timing among children born by untreated subfecund, treated subfecund, untreated severely subfecund and treated severely subfecund parents. There were no specific patterns with increasing TTP, use of MAR nor type of MAR treatment, and the magnitude of the mean differences for individual milestones and overall timing of puberty were small, i.e. 0.9 months (95% CI: -1.0; 2.8) for first ejaculation and -0.5 months (95% CI: -2.0; 1.0) months for age at menarche in boys and girls, respectively, born by treated severely subfecund parents when compared with children born by more fertile parents.

LIMITATIONS, REASONS FOR CAUTION

Non-differential misclassification of the self-reported information on parental TTP and pubertal development in the offspring may serve as an alternative explanation of the findings, possibly biasing the estimates towards the null. The information on pubertal development was collected from around 11 years of age and onwards.

WIDER IMPLICATIONS OF THE FINDINGS

This study adds to the growing body of literature suggesting only limited harmful effects of parental subfecundity and MAR on offspring's long-term growth and development.

STUDY FUNDING/COMPETING INTEREST(S)

This work was supported by the Danish Council for Independent Research [DFF 4183-00152]; and the Faculty of Health at Aarhus University. The authors have no financial relationships or competing interests to disclose.

Authors+Show Affiliations

Department of Public Health, Section for Epidemiology, Aarhus University, Bartholins Allé 2, Aarhus C, Denmark. Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles (UCLA), 650 Charles E. Young Drive South, Los Angeles, CA, USA.Department of Public Health, Section for Epidemiology, Aarhus University, Bartholins Allé 2, Aarhus C, Denmark.Department of Public Health, Section for Epidemiology, Aarhus University, Bartholins Allé 2, Aarhus C, Denmark. Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles (UCLA), 650 Charles E. Young Drive South, Los Angeles, CA, USA.Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles (UCLA), 650 Charles E. Young Drive South, Los Angeles, CA, USA. California Center for Population Research, UCLA, 337 Charles E. Young Drive East, Los Angeles, CA, USA. Center for Health Policy Research, UCLA, 337 Charles E. Young Drive East, Los Angeles, CA, USA.Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles (UCLA), 650 Charles E. Young Drive South, Los Angeles, CA, USA. Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43, Aarhus N, Denmark.Department of Urology, Section for Paediatric Urology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 35, Aarhus N, Denmark.Department of Public Health, Section for Epidemiology, Aarhus University, Bartholins Allé 2, Aarhus C, Denmark.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30753468

Citation

Ernst, A, et al. "Parental Time to Pregnancy, Medically Assisted Reproduction and Pubertal Development in Boys and Girls." Human Reproduction (Oxford, England), vol. 34, no. 4, 2019, pp. 724-732.
Ernst A, Lauridsen LLB, Brix N, et al. Parental time to pregnancy, medically assisted reproduction and pubertal development in boys and girls. Hum Reprod. 2019;34(4):724-732.
Ernst, A., Lauridsen, L. L. B., Brix, N., Arah, O. A., Olsen, J., Olsen, L. H., & Ramlau-Hansen, C. H. (2019). Parental time to pregnancy, medically assisted reproduction and pubertal development in boys and girls. Human Reproduction (Oxford, England), 34(4), 724-732. https://doi.org/10.1093/humrep/dez008
Ernst A, et al. Parental Time to Pregnancy, Medically Assisted Reproduction and Pubertal Development in Boys and Girls. Hum Reprod. 2019 04 1;34(4):724-732. PubMed PMID: 30753468.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Parental time to pregnancy, medically assisted reproduction and pubertal development in boys and girls. AU - Ernst,A, AU - Lauridsen,L L B, AU - Brix,N, AU - Arah,O A, AU - Olsen,J, AU - Olsen,L H, AU - Ramlau-Hansen,C H, PY - 2018/06/01/received PY - 2019/01/02/revised PY - 2019/01/22/accepted PY - 2019/2/13/pubmed PY - 2020/7/22/medline PY - 2019/2/13/entrez KW - cohort study KW - medically assisted reproduction KW - prenatal exposure delayed effects KW - puberty KW - sex characteristics KW - tanner stages KW - time to pregnancy SP - 724 EP - 732 JF - Human reproduction (Oxford, England) JO - Hum Reprod VL - 34 IS - 4 N2 - STUDY QUESTION: Does parental fertility, measured by time to pregnancy (TTP), or use of medically assisted reproduction (MAR) affect pubertal development in the offspring? SUMMARY ANSWER: Neither TTP nor type of MAR treatment had clinically relevant implications for mean age at achieving individual pubertal milestones or overall timing of puberty in boys and girls. WHAT IS KNOWN ALREADY: Parental TTP and MAR have been associated with impaired semen quality in adult sons. Timing of puberty reflects earlier signals of reproductive health, but it remains unclear whether parental fertility or MAR affects pubertal development, especially in the growing generation of children conceived by IVF or ICSI. STUDY DESIGN, SIZE, DURATION: In this study, 15 819 children born by mothers in the Danish National Birth Cohort from 2000 to 2003 participated in a nationwide puberty cohort (participation rate = 70%). Parental TTP and use of MAR were reported by mothers in early pregnancy and children's pubertal development data was self-recorded in web-based questionnaires from 11 years of age and 6 monthly throughout puberty (2012-2018). PARTICIPANTS/MATERIALS, SETTING, METHODS: Pubertal development in children (of planned pregnancies, n = 13 285) born by untreated subfecund (TTP: 6-12 months) (n =2038), untreated severely subfeund (TTP: >12 months) (n = 1242), treated subfecund (n = 230) and treated severely subfecund (n = 1234) parents were compared to children born to more fertile parents (TTP: ≤5 months). We estimated mean monthly differences in mean age at achieving individual pubertal milestones (i.e. age at menarche, voice break, first ejaculation and Tanner stages 2, 3, 4 and 5 for breast or genital development and pubic hair growth) and a combined indicator of timing of puberty. Further, we compared mean age at achieving the individual pubertal milestones in children born by use of IVF or ICSI (n = 480) with children born by controlled ovarian stimulation or ovulation induction with or without intrauterine insemination (n = 902). MAIN RESULTS AND THE ROLE OF CHANCE: We found tendencies towards slightly later mean age at male pubertal timing and slightly earlier mean age at female pubertal timing among children born by untreated subfecund, treated subfecund, untreated severely subfecund and treated severely subfecund parents. There were no specific patterns with increasing TTP, use of MAR nor type of MAR treatment, and the magnitude of the mean differences for individual milestones and overall timing of puberty were small, i.e. 0.9 months (95% CI: -1.0; 2.8) for first ejaculation and -0.5 months (95% CI: -2.0; 1.0) months for age at menarche in boys and girls, respectively, born by treated severely subfecund parents when compared with children born by more fertile parents. LIMITATIONS, REASONS FOR CAUTION: Non-differential misclassification of the self-reported information on parental TTP and pubertal development in the offspring may serve as an alternative explanation of the findings, possibly biasing the estimates towards the null. The information on pubertal development was collected from around 11 years of age and onwards. WIDER IMPLICATIONS OF THE FINDINGS: This study adds to the growing body of literature suggesting only limited harmful effects of parental subfecundity and MAR on offspring's long-term growth and development. STUDY FUNDING/COMPETING INTEREST(S): This work was supported by the Danish Council for Independent Research [DFF 4183-00152]; and the Faculty of Health at Aarhus University. The authors have no financial relationships or competing interests to disclose. SN - 1460-2350 UR - https://www.unboundmedicine.com/medline/citation/30753468/Parental_time_to_pregnancy_medically_assisted_reproduction_and_pubertal_development_in_boys_and_girls_ L2 - https://academic.oup.com/humrep/article-lookup/doi/10.1093/humrep/dez008 DB - PRIME DP - Unbound Medicine ER -