A controlled study of the psycho-social development of children conceived following insemination with donor semen.

Although donor insemination has been used to produce pregnancies for many years, there has been little information on how children conceived in this unusual manner develop psycho-socially. We have therefore carried out a controlled quantitative assessment comparing children who were conceived by donor insemination to adoptees and naturally conceived children who were matched for age and sex. We conclude that the psycho-social development of donor insemination children was no different from the two control groups.

The children of IVF pregnancies: a cohort study.

A number of concerns have been publicly expressed concerning children conceived by in vitro fertilization (IVF). For this reason the first 52 infants in the Monash University IVF Programme were seen for paediatric follow-up. Forty-nine children completed the Programme with one child dying at 4 months and one set of twins being withdrawn from the study. Assessment was by general paediatric interview and examination. A sub-group comprising 33 of the children and their parents received psychosocial assessment including developmental assessment. Results revealed no particular areas of concern related to the IVF conception itself. Problems found appeared to be related to the high incidence of preterm delivery (21%), twinning (21%), and Caesarean delivery (37%). The limitations of this preliminary study are noted and a longer term controlled study is planned.

In vitro fertilization children: early psychosocial development.

Following community concerns regarding the status of children conceived by in vitro fertilization (IVF), 33 children who had received pediatric follow-up were seen for a psychosocial evaluation. Parents were interviewed in a semistructured format by a child psychiatrist regarding their child's development, child-centered problems, parental problems, marital issues, parenting experience, and experience of the IVF program. The Bayley Scales of Infant Development were administered to the children by a clinical psychologist. Children's ages ranged from 12 to 37 months (the majority between 12 and 20 months). There was a high incidence of prematurity and twins in the population seen. Twenty-two children had no current problems and seven presented minor problems. Of the four with significant developmental problems, two had been very low-birth weight infants with significant neurological problems and one had severe congenital heart disease. Overall Bayley Scale scores were within the normal range and parents as a group were seen to function well. Problems presented were in accordance with those expected in a population of this age range, particularly considering the high incidence of prematurity.

Children of IVF.

This chapter has reviewed issues relevant to the consideration of children conceived by in vitro fertilization. The rationale and motivation for studying these children and the factors which might be relevant to their development have been discussed. Such factors involve the child, the parents, the family as a whole and the influences of the community at large. While as yet there is a paucity of research concerning these issues, questions can be generated by reference to possible related areas, such as adoption. The authors then discussed their study of a group comprising the first families (49 children) whose children were conceived by IVF in the Monash Hospital. All children received paediatric follow-up and 33 has psycho-social follow-up. The findings do not indicate any increased risk of pathology in IVF children or in their families. However, there was a significant increase in very low birth weight children and in twins. Those children with problems tended to fall into these two groups. It is recognized that this was an unmatched group seen at an early stage in development. The significance of these findings have been discussed and issues for management raised. There was also discussion of future directions for research in this area, particularly the need for a careful, long-term follow-up study of families in which children are conceived by in vitro fertilization.