Conception by fertility treatment and cardiometabolic risk in middle childhood

The measurement of blood pressure, arterial stiffness, anthropometry, and related biomarkers at the age of 9 years did not indicate greater cardiometabolic risk in children conceived using fertility treatment compared with that in children conceived without treatment.

VOLUME 118, ISSUE 2, P349-359


Edwina H. Yeung, Ph.D., Pauline Mendola, Ph.D., Rajeshwari Sundaram, Ph.D., Tzu-Chun Lin, M.S., Miranda M. Broadney, M.D., M.P.H., Diane L. Putnick, Ph.D., Sonia L. Robinson, Ph.D., Kristen J. Polinski, Ph.D., Jean Wactawski-Wende, Ph.D., Akhgar Ghassabian, M.D., Ph.D., Thomas G. O’Connor, Ph.D., Robert E. Gore-Langton, Ph.D., Judy E. Stern, Ph.D., Erin Bell, Ph.D.



To evaluate whether children conceived using assisted reproductive technology (ART) or ovulation induction (OI) have greater cardiometabolic risk than children conceived without treatment.


Clinical assessments in 2018–2019 in the Upstate KIDS cohort.


Clinical sites in New York.


Three hundred thirty-three singletons and 226 twins from 448 families.


Mothers reported their use of fertility treatment and its specific type at baseline and approximately 4 months after delivery. High validity of the self-reported use of ART was previously confirmed. The children were followed up from infancy through 8–10 years of age. A subgroup was invited to participate in clinic visits.

Main Outcome Measure(s)

The measurements of blood pressure (BP), arterial stiffness using pulse wave velocity, anthropometric measures, and body fat using bioelectrical impedance analysis were performed (n = 559). The levels of plasma lipids, C-reactive protein, and hemoglobin A1c were measured using blood samples obtained from 263 children.


The average age of the children was 9.4 years at the time of the clinic visits Approximately 39% were conceived using fertility treatment (18% using ART and 21% using OI). Singletons conceived using fertility treatment (any type or using ART or OI specifically) did not statistically differ in systolic or diastolic BP, heart rate, or pulse wave velocity. Singletons conceived using OI were smaller than singletons conceived without treatment, but the average body mass index of the latter was higher (z-score: 0.41 [SD, 1.24]) than the national norms. Twins conceived using either treatment had lower BP than twins conceived without treatment. However, twins conceived using OI had significantly higher arterial stiffness (0.59; 95% CI, 0.03–1.15 m/s), which was attenuated after accounting for maternal BP (0.29; 95% CI, −0.03 to 0.46 m/s). Twins did not significantly differ in size or fat measures across the groups. The mode of conception was not associated with the levels of lipids, C-reactive protein, or glycosylated hemoglobin.


Clinical measures at the age of 9 years did not indicate greater cardiometabolic risk in children conceived using ART or OI compared with that in children conceived without treatment.

Clinical Trial Registration Number #NCT03106493.

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