title: Fertility treatment and childhood type 1 diabetes mellitus: a nationwide cohort study of 565,116 live births.
abstract: OBJECTIVE
  To investigate the association between specific types of fertility treatment and childhood type 1 diabetes mellitus.
  
  
  METHODS
  Nationwide birth cohort study.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  All pregnancies resulting in a live-born singleton child in Denmark from 1995 to 2003.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Childhood type 1 diabetes mellitus identified from redeemed prescriptions for insulin until 2013.
  
  
  RESULTS
  The study included 565,116 singleton pregnancies. A total of 14,985 children were conceived by ovulation induction or intrauterine insemination, and 8,490 children were conceived by in vitro fertilization or intracytoplasmic sperm injection. During the follow-up period, 2,011 (0.4%) children developed type 1 diabetes mellitus. The primary analyses showed no association between fertility treatment and childhood type 1 diabetes mellitus. In secondary analyses, ovulation induction or intrauterine insemination with follicle-stimulating hormone was associated with an increased risk of type 1 diabetes mellitus (hazard ratio 3.22; 95% confidence interval 1.20 to 8.64). No clear associations were seen with other types of fertility treatment or with specific treatment indications.
  
  
  CONCLUSIONS
  No association between fertility treatment and childhood type 1 diabetes mellitus was found. Ovulation induction or intrauterine insemination with follicle-stimulating hormone may be associated with an increased risk of childhood type 1 diabetes mellitus. However, this finding may be due to chance or to confounding by indication and thus requires further investigation.
authors: Perinatal Epidemiology Research Unit and Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark. Electronic address: laura@kettner.nu.
authors: Laura Ozer
authors: LO
authors: Kettner
authors: Perinatal Epidemiology Research Unit and Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark.
authors: Niels Bjerregaard
authors: NB
authors: Matthiesen
authors: Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark.
authors: Cecilia Høst
authors: CH
authors: Ramlau-Hansen
authors: Fertility Clinic, Department of Obstetrics and Gynecology, Herlev University Hospital, Herlev, Denmark.
authors: Ulrik Schiøler
authors: US
authors: Kesmodel
authors: Fertility Clinic, Department of Obstetrics and Gynecology, Aarhus University, Regional Hospital Horsens, Horsens, Denmark.
authors: Bjørn
authors: B
authors: Bay
authors: Perinatal Epidemiology Research Unit and Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark.
authors: Tine Brink
authors: TB
authors: Henriksen
mesh_terms: D000328:Adult; D017668:Age of Onset; D015331:Cohort Studies; D003718:Denmark; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D005298:Fertility; D005300:Fertility Agents, Female / Q000009:adverse effects; D005307:Fertilization in Vitro / Q000009:adverse effects; D005640:Follicle Stimulating Hormone / Q000009:adverse effects; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007246:Infertility / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D007315:Insemination, Artificial / Q000009:adverse effects; D007328:Insulin / Q000627:therapeutic use; D050498:Live Birth; D008297:Male; D010062:Ovulation Induction / Q000009:adverse effects; D011247:Pregnancy; D012042:Registries; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects*; D018570:Risk Assessment; D012307:Risk Factors; D020554:Sperm Injections, Intracytoplasmic / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005300:Fertility Agents, Female; D007004:Hypoglycemic Agents; D007328:Insulin; D005640:Follicle Stimulating Hormone
keywords: Assisted reproductive technology; intracytoplasmic sperm injection; intrauterine insemination; in vitro fertilization; ovulation induction; type 1 diabetes mellitus