Abstract
PURPOSE: Use of assisted reproductive technology (ART) could lead to abnormal pubertal development in children. We compared pubertal development in children conceived using ART to non-in vitro fertilization fertility treatment (NIFT) and unassisted (UA) conception. METHODS: Children from the Developmental Epidemiological Study of Children through Reproductive Technology (DESCRT) were assessed for pubertal development according to the standardized protocol. Tanner staging (breast, testes, and pubic hair development) was compared between ART, NIFT, and UA-conceived children. Differences were analyzed using Wilcoxon rank-sum test, Pearson's chi-squared test, and Fisher's exact test. Multivariable logistic regression was used to assess association between method of conception and pubertal development. RESULTS: The sample included 290 children (164 boys and 126 girls) at median age 6 years (range 4 to 18 years); 229 were conceived using ART compared to a combined reference group of 29 conceived via NIFT and 32 via UA. Statistical analyses adjusted for children's age, height, and weight showed statistically non-significant trends wherein boys conceived via ART tended to be in later Tanner stages for pubarche (OR = 2.33, 95% CI 0.44-12.21) and gonadarche (OR = 4.27, 95% CI 0.44-41.99), and girls tended to be in later stages for pubarche (OR = 4.29, 95% CI 0.40-45.62) and thelarche (OR = 2.23, 95% CI 0.35-14.03) compared to the reference group. CONCLUSION: As ART becomes more widespread, developmental concerns become increasingly prominent. While results were statistically non-significant, we observed a trend toward differences in pubertal development between ART-conceived children and those conceived without assistance or NIFT.