In vitro fertilisation and stage 3 retinopathy of prematurity

Purpose To re-examine the risk of children born by assisted conception deve loping stage 3 retinopathy of prematurity (ROP) and to define whether the r isk of ROP varies with the method of assisted conception. Methods This tvas a retrospective study carried out between December 1995 a nd December 1998 of infants in a single neonatal unit serving the Brent and Harrow area of North West Thames requiring screening and treatment of ROP. The infants screened were identified from the ROP screening database. Thos e conceived by in vitro fertilisation (IVF) and other forms of assisted con ception were identified by reviewing the neonatal notes and the maternal ob stetric records. Birth weight, gestational age and the type of assisted con ception were recorded. The presence or absence of any stage of ROP, its loc ation and severity and the cases requiring treatment were recorded. Results One hundred and seventy-nine infants fulfilled the screening criter ia during this period. Acute ROP was detected in 32.4% (58 infants) and sta ge 3 ROP developed in 15.6% (28 infants). Twenty-one infants (11.7%) were b orn after assisted conception, with 12 (6.7%) being conceived by IVF. The o thers were conceived on clomiphene (8) or after intrauterine insemination ( 1). Assisted conception accounted for 21.4% of all those reaching stage 3 d isease and 28.6% of those infants requiring treatment. Of the 12 infants co nceived by IVF, 41.6% (5 infants) developed acute ROP which progressed to t hreshold ROP in ail infants (100%). Of the assisted conception babies requi ring treatment for ROP, 83.3% were conceived by NF. The other child had bee n conceived on clomiphene. The gestational age and birth weight of the IVF infants reaching stage 3 ROP were 26.6 +/- 0.89 weeks and 937 +/- 170.2 g. The gestational age and birth weight in the rest of the infants reaching st age 3 ROP were lower than in those conceived by assisted conception (25.739 +/- 1.13 weeks and 735.29 +/- 117.70 g); however, this did not approach st atistical significance (p = 0.35 and p = 0.13, respectively). Conclusions In this study 11.7% of the group requiring screening were conce ived by assisted conception. Of all babies requiring treatment for ROP, 28. 6% were born after assisted conception. Of the assisted conception group, 8 3.3% were conceived by IVF. Assisted conception using IVF rather than other techniques appears to be the major risk factor for the development of thre shold ROP. We would advise increased vigilance when screening babies concei ved by the IVF methods of assisted conception.