Third grade academic achievement among children conceived with the use of in vitro fertilization: a population-based study in Texas

Third grade academic achievement in reading and math is comparable among IVF and naturally- conceived children.

Volume 113, Issue 6, Pages 1242–1250.e4


Barbara Luke, Sc.D., M.P.H., Morton B. Brown, Ph.D., Mary K. Ethen, M.P.H., Mark A. Canfield, Ph.D., Stephanie Watkins, Ph.D., M.S.P.H., M.S.P.T., Ethan Wantman, M.B.A., Kevin J. Doody, M.D.



To evaluate if there are differences in standardized testing results at the end of third grade between children conceived with the use of in vitro fertilization (IVF) and those conceived spontaneously.


Retrospective population-based cohort.


Texas public school system.


Singleton and twin children 8–9 years of age who took the third-grade public school standardized testing in Texas from 2012 to 2018.



Main Outcome Measure(s)

Standardized testing in reading and mathematics.


After exclusions, there were 6,970 IVF and 12,690 non-IVF children with reading scores and 6,973 IVF and 12,729 non-IVF children with mathematics scores. IVF children scored significantly higher in reading (singletons: 1,543 ± 2 vs. 1,525 ± 1; twins: 1,534 ± 2 vs. 1,504 ± 5 [mean ± SE]), and mathematics (singletons: 1,566 ± 2 vs. 1,550 ± 1; twins: 1,557 ± 2 vs. 1,529 ± 5). Children of mothers ≥30 years of age scored consistently higher than children of mothers 18–29 years of age. The differences were of similar magnitude between IVF and control children for older ages, but not significant for IVF. Within the IVF group, there were no significant differences between children born from fresh versus froze-thawed embryos.


Children of ages 8–9 years who were conceived with the use of IVF performed as well on third-grade reading and math assessments as their counterparts who were conceived spontaneously. We also found consistent racial and ethnic differences, gender differences, and beneficial effects of older maternal age. Because we were not able to adjust adequately for socioeconomic status and other confounding factors, which may explain some of the observed differences, we conclude that there is no negative effect of IVF conception on academic achievement in third grade.

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