Pregnancy registry: three-year follow-up of children conceived from letrozole, clomiphene, or gonadotropins

Fertil Steril. 2020 May;113(5):1005-1013. doi: 10.1016/j.fertnstert.2019.12.023.

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.

Keywords: Infertility; children; cognitive development; infant growth; ovulation induction.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Age Factors
  • Child Behavior*
  • Child Development*
  • Child, Preschool
  • Clomiphene / adverse effects
  • Clomiphene / therapeutic use*
  • Cognition
  • Female
  • Fertility
  • Fertility Agents / adverse effects
  • Fertility Agents / therapeutic use*
  • Follow-Up Studies
  • Gestures
  • Gonadotropins / adverse effects
  • Gonadotropins / therapeutic use*
  • Humans
  • Infant
  • Infertility, Female / drug therapy*
  • Infertility, Female / epidemiology
  • Infertility, Female / physiopathology
  • Letrozole / adverse effects
  • Letrozole / therapeutic use*
  • Live Birth
  • Male
  • Ovulation Induction* / adverse effects
  • Polycystic Ovary Syndrome / epidemiology
  • Pregnancy
  • Prospective Studies
  • Randomized Controlled Trials as Topic
  • Registries
  • Treatment Outcome
  • United States / epidemiology
  • Weight Gain

Substances

  • Fertility Agents
  • Gonadotropins
  • Clomiphene
  • Letrozole