Fertility treatment and childhood type 1 diabetes mellitus: a nationwide cohort study of 565,116 live births

Fertility treatment was not associated with childhood type 1 diabetes mellitus. Ovulation induction or intrauterine insemination with follicle-stimulating hormone may be associated with childhood type 1 diabetes mellitus.

Volume 106, Issue 7, Pages 1751-1756

Authors:

Laura Ozer Kettner, M.D., Niels Bjerregaard Matthiesen, Ph.D., Cecilia Høst Ramlau-Hansen, Ph.D., Ulrik Schiøler Kesmodel, Ph.D., Bjørn Bay, Ph.D., Tine Brink Henriksen, Ph.D.

Abstract:

Objective

To investigate the association between specific types of fertility treatment and childhood type 1 diabetes mellitus.

Design

Nationwide birth cohort study.

Setting

Not applicable.

Patient(s)

All pregnancies resulting in a live-born singleton child in Denmark from 1995 to 2003.

Intervention(s)

Not applicable.

Main Outcome Measure(s)

Childhood type 1 diabetes mellitus identified from redeemed prescriptions for insulin until 2013.

Result(s)

The study included 565,116 singleton pregnancies. A total of 14,985 children were conceived by ovulation induction or intrauterine insemination, and 8,490 children were conceived by in vitro fertilization or intracytoplasmic sperm injection. During the follow-up period, 2,011 (0.4%) children developed type 1 diabetes mellitus. The primary analyses showed no association between fertility treatment and childhood type 1 diabetes mellitus. In secondary analyses, ovulation induction or intrauterine insemination with follicle-stimulating hormone was associated with an increased risk of type 1 diabetes mellitus (hazard ratio 3.22; 95% confidence interval 1.20 to 8.64). No clear associations were seen with other types of fertility treatment or with specific treatment indications.

Conclusion(s)

No association between fertility treatment and childhood type 1 diabetes mellitus was found. Ovulation induction or intrauterine insemination with follicle-stimulating hormone may be associated with an increased risk of childhood type 1 diabetes mellitus. However, this finding may be due to chance or to confounding by indication and thus requires further investigation.


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