Abstract

PurposeHigher serum estradiol levels occur in women undergoing assisted reproductive technology (ART) owing to ovarian stimulation. Here, we investigated the association between maternal serum estradiol levels and the intellectual development of offspring conceived with ART.MethodsA total of 204 singletons born after fresh embryo transfer were recruited for this cohort study. Among them, 102 children were born from mothers with high serum estradiol levels (> 12,000 pmol/L) on the day that human chorionic gonadotropin was administered. Another 102 children, matched by gestational age and age of the children, were recruited as controls from mothers with low serum estradiol (≤ 12,000 pmol/L). The Wechsler Preschool and Primary Scale of Intelligence was used to evaluate the intellectual development of the children.ResultsChildren from mothers with higher serum estradiol levels scored lower in the verbal intelligence quotient (IQ) tests and verbal comprehension than children whose mothers had lower estradiol levels. The main difference between the two groups was in verbal subtests including information, vocabulary, and sorting. Partial correlation analysis revealed that the logarithm of maternal serum estradiol level negatively correlated with verbal IQ, performance IQ, and full scale IQ.ConclusionOur data demonstrate that a high maternal serum estradiol level may negatively associate the verbal ability of children conceived via ART.

Highlights

  • Accumulating research suggests that exposure of a fetus to an abnormal environment in the uterus can cause chronic disease in later life [1,2,3,4], as has been observed in both human populations and animal models [4,5,6,7,8,9].Assisted reproductive technology (ART) was pioneered in 1978 and is widely used; its short- and longterm effects on offspring are not fully understood

  • Offspring of mothers who suffered from ovarian hyper-stimulation syndrome (OHSS) have reduced intelligence, which has been associated with supraphysiological levels of maternal serum estradiol [16]

  • We explored the association between high maternal serum estradiol and the intellectual development of children conceived via ART

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Summary

Introduction

Assisted reproductive technology (ART) was pioneered in 1978 and is widely used; its short- and longterm effects on offspring are not fully understood. Superovulation has been the conventional strategy for ART, but multi-follicle development generates excessively high hormone levels in maternal serum [10]. Studies have shown that exposure of a fetus to high maternal serum estradiol is associated with low birth weight, dyslipidemia, and dysfunction of the thyroid and cardiovascular system in offspring [12,13,14,15]. Offspring of mothers who suffered from ovarian hyper-stimulation syndrome (OHSS) have reduced intelligence, which has been associated with supraphysiological levels of maternal serum estradiol [16]

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