Richard S Legro1, Michael P Diamond2, Christos Coutifaris3, William D Schlaff4, Ruben Alvero4, Peter Casson5, Gregory M Christman6, R Mitchell Rosen7, Marcelle I Cedars7, Karl R Hansen8, Randal Robinson9, Valerie Baker10, Rebecca Usadi11, William C Dodson12, Stephanie J Estes12, Allen Kunselman13, Christina Stetter13, Kurt T Barnhart4, R Matthew Coward14, J C Trussell15, Stephen A Krawetz16, Nanette Santoro4, Hao Huang17, Heping Zhang17, Esther Eisenberg18. 1. Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, Pennsylvania. Electronic address: RSL1@PSU.EDU. 2. Department of Obstetrics and Gynecology, Augusta University, Augusta, Georgia. 3. Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania. 4. Department of Obstetrics and Gynecology, University of Colorado, Denver, Colorado. 5. Department of Obstetrics and Gynecology, University of Vermont, Burlington, Vermont. 6. Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan. 7. Department of Obstetrics and Gynecology, University of California at San Francisco, San Francisco, California. 8. Department of Obstetrics and Gynecology University of Oklahoma, Oklahoma City, Oklahoma. 9. Department of Obstetrics and Gynecology, University of Texas at San Antonio, San Antonio, Texas. 10. Department of Obstetrics and Gynecology, Stanford University, Palo Alto, California. 11. Department of Obstetrics and Gynecology, Carolinas Medical Center, Charlotte, North Carolina. 12. Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, Pennsylvania. 13. Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania. 14. Department of Urology, University of North Carolina, Raleigh, North Carolina; UNC Fertility LLC, Raleigh, North Carolina. 15. Department of Urology, SUNY Upstate University Hospital, Syracuse, New York. 16. Department of Obstetrics and Gynecology and Center for Molecular Medicine and Genetics, Wayne State University, Detroit, Michigan. 17. Department of Biostatistics, Yale University, New Haven, Connecticut. 18. Fertility and Infertility Branch, National Institute of Child Health and Human Development, Rockville, Maryland.
Abstract
OBJECTIVE: To study the development of children conceived from non-IVF infertility treatments consisting of gonadotropins, clomiphene, or letrozole. DESIGN: Prospective cohort study. SETTING: U.S. academic health centers. PATIENT(S): Children of women with polycystic ovary syndrome who conceived with letrozole (LTZ) or clomiphene (CC) in the PPCOS II study or women with unexplained infertility (AMIGOS study) who conceived with LTZ, CC, or gonadotropin (GN). INTERVENTION(S): Longitudinal annual follow-up from birth to age 3. MAIN OUTCOME MEASURE(S): Scores from Ages and Stages Developmental Questionnaire (ASQ), MacArthur-Bates Communicative Development Inventory (MCDI), and annual growth. RESULT(S): One hundred eighty-five children from 160 families participated in at least one follow-up evaluation from the two infertility trials. Most multiple gestations in the follow-up study resulted from GN treatment (n = 14) followed by CC (n = 6) and LTZ (n = 3). There were no significant differences among the three groups at any time point with respect to abnormal scores on the ASQ. On the MCDI Words and Gestures, the LTZ group scored significantly higher than the GN group for most items (phrases, early gestures, later gestures, and total gestures). Children in the CC group scored significantly higher than the GN group for the later gestures and total gestures items. CONCLUSION(S): Differences in growth and cognitive developmental rates among children conceived with first-line infertility therapies, including LTZ, are relatively minor and likely due to differences in multiple pregnancy rates.
OBJECTIVE: To study the development of children conceived from non-IVF infertility treatments consisting of gonadotropins, clomiphene, or letrozole. DESIGN: Prospective cohort study. SETTING: U.S. academic health centers. PATIENT(S): Children of women with polycystic ovary syndrome who conceived with letrozole (LTZ) or clomiphene (CC) in the PPCOS II study or women with unexplained infertility (AMIGOS study) who conceived with LTZ, CC, or gonadotropin (GN). INTERVENTION(S): Longitudinal annual follow-up from birth to age 3. MAIN OUTCOME MEASURE(S): Scores from Ages and Stages Developmental Questionnaire (ASQ), MacArthur-Bates Communicative Development Inventory (MCDI), and annual growth. RESULT(S): One hundred eighty-five children from 160 families participated in at least one follow-up evaluation from the two infertility trials. Most multiple gestations in the follow-up study resulted from GN treatment (n = 14) followed by CC (n = 6) and LTZ (n = 3). There were no significant differences among the three groups at any time point with respect to abnormal scores on the ASQ. On the MCDI Words and Gestures, the LTZ group scored significantly higher than the GN group for most items (phrases, early gestures, later gestures, and total gestures). Children in the CC group scored significantly higher than the GN group for the later gestures and total gestures items. CONCLUSION(S): Differences in growth and cognitive developmental rates among children conceived with first-line infertility therapies, including LTZ, are relatively minor and likely due to differences in multiple pregnancy rates.
Authors: Michael P Diamond; Richard S Legro; Christos Coutifaris; Ruben Alvero; Randal D Robinson; Peter Casson; Gregory M Christman; Joel Ager; Hao Huang; Karl R Hansen; Valerie Baker; Rebecca Usadi; Aimee Seungdamrong; G Wright Bates; R Mitchell Rosen; Daniel Haisonleder; Stephen A Krawetz; Kurt Barnhart; J C Trussell; Yufeng Jin; Nanette Santoro; Esther Eisenberg; Heping Zhang Journal: Fertil Steril Date: 2015-02-20 Impact factor: 7.329
Authors: Michael P Diamond; Mohamed Mitwally; Robert Casper; Joel Ager; Richard S Legro; Robert Brzyski; Peter Casson; Esther Eisenberg; Heping Zhang Journal: Contemp Clin Trials Date: 2011-07-20 Impact factor: 2.226
Authors: Richard S Legro; Xiaoke Wu; Kurt T Barnhart; Cynthia Farquhar; Bart C J M Fauser; Ben Mol Journal: Hum Reprod Date: 2014-09-12 Impact factor: 6.918