The developmental outcomes in children born after IVF treatment in Kazakhstan

Abstract

The increasing utilization of assisted reproductive technologies (ART), including in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), has raised concerns regarding the treatment’s impact on child development. The evidence remains mixed with limited ART data coming from low- and middle-income countries (LMICs). The study aimed to assess the association between mode of conception and early developmental outcomes. A prospective cohort study was conducted at a fertility clinic in Astana, Kazakhstan. Child development was evaluated with the Ages and Stages Questionnaire, Third Edition (ASQ-3) across five domains, including communication, gross motor, fine motor, problem solving, and personal-social, at 6 and 12 months. The study outcome as a developmental delay was defined by a screening positive result in at least one of the ASQ-3 domains. 223 mother-child pairs, 131 participants in the IVF/ICSI group, and 92 participants in the natural conception (NC) group, were included in the study analysis. The prevalence of screen-positive cases was low across all domains at both screenings. There were no statistically significant differences in the observed rates of domain-specific deficits between the IVF/ICSI and NC groups at 6 and 12 months. Developmental delays identified at 6 months resolved by 12 months of the child’s age, indicating developmental variability in early infancy. Neonatal morbidity, neonatal intensive care unit (NICU) admission, male gender, and parental developmental concern were associated with higher odds of screen-positive outcomes. These findings were consistent with comparable early developmental screening outcomes between IVF/ICSI and spontaneously conceived children in infancy. Early developmental vulnerability was influenced by perinatal and neonatal factors and not by mode of conception in the study cohort. The study supported a universal routine developmental surveillance for all children. Further large longitudinal studies with extended follow-up and diagnostic developmental assessment are required to evaluate infertility and ART impact on long-term outcomes in the offspring. The development of a national ART registry linking infertility treatment to health record databases would be an important step toward establishing a sustainable source of ART evidence in the country.