Fertility Therapies & Diabetes Risk in Offspring

Children born to women who have had fertility treatment are not at increased risk for type 1 diabetes (T1DM), according to a Danish study published online in Acta Obstetricia et Gynecologica Scandinavica.¹

“In this first large population-based cohort study on the risk of type 1 diabetes in children born to women with fertility problems, our results indicate that maternal fertility status is unrelated to type 1 diabetes in children irrespective of birth date, age at diagnosis, sex, parental age at birth, birth order or history of parental type 1 diabetes,” wrote lead author Allan Jensen, PhD, of the Danish Cancer Society Research Center (Copenhagen, Denmark), and colleagues.

The study is the first to evaluate whether children born to women who have had fertility treatment have increased risk of T1DM. Results from past studies have been inconsistent on related issues, although some have suggested that children born following fertility treatment may have elevated blood glucose levels and an increased risk of insulin resistance.^2,3

Researchers have postulated that hormonal stimulation, semen preparation, embryo and gamete freezing, and factors related to the culture media could affect the offspring. Underlying fertility problems like polycystic ovarian syndrome and genetic factors may also have an impact on the health status of offspring.

In the study, researchers linked several national registries and the Danish Infertility Cohort to obtain data on women with infertility problems between 1963 and 2011, and T1DM diabetes in their offspring. The analysis included data on all children born in Denmark between 1987 and 2010 (n=1,550,519), of which 7% (n=110,393) were born following maternal fertility treatment.

Key Results:

• T1DM diagnoses occurred at a mean age of 9.9 years and among:

♦ 0.36% (n=313) of these children were born to women with fertility problems

♦ 0.28% (n=5176) of these children were born to women without fertility problems

• Results adjusted for birth year, sex, history of parental diabetes, parental age, and age at diagnosis, maternal fertility status was unrelated to risk of T1DM (HR 1.01, 95% CI 0.90–1.13)

The authors noted that some women may have had undiagnosed fertility problems, or may have been referred from private gynecologists and would not have been in the Danish Infertility Cohort. If so, the results would have underestimated the risk of T1DM in children born following fertility treatment. Additionally, because the study could not evaluate specific information on fertility treatments, it could not differentiate the effects of treatment from underlying fertility problems.

They concluded: “[S]tudies are needed to confirm these first findings. Furthermore, studies which include information on both maternal fertility problems and fertility treatment information are needed to explore further the effects of the treatment of infertility on the risk of type 1 diabetes in children while taking into account the possible effect of the underlying infertility.”

Take-home Points

• Research has been inconsistent about whether maternal fertility treatment increases the risk of insulin sensitivity and elevated blood glucose levels in offspring.

• The first population-based cohort study to evaluate the risk of T1DM in children born following fertility treatment suggested no increased risk of T1DM in these children.

• Further research is needed to evaluate the role of fertility treatment vs underlying fertility problems on the health status of offspring.

References:

1. Hargreave M, et al. Type 1 diabetes risk in children born to women with fertility problems: a cohort study in 1.5 million Danish children. Acta Obstet Gynecol Scand. 2016 Sep 28.

2. Gkourogianni A, et al. Plasma metabolomic profiling suggests early indications for predisposition to latent insulin resistance in children conceived by ICSI. PLoS ONE. 2014;9:e94001.

3. Ceelen M, et al. Cardiometabolic differences in children born after in vitro fertilization: follow-up study. J Clin Endocrinol Metab. 2008;93:1682-1688.