Association between in vitro fertilization-embryo transfer and hearing loss: risk factors of hearing loss among twin infants in a cohort study

Purpose: Assisted reproductive technologies (ART), including in vitro fertilization-embryo transfer (IVF-ET), intracytoplasmic sperm injection (ICSI), are recognized contributing higher risk of birth defect, whereas rare studies evaluate the association of IVF-ET with diagnostic hearing loss (HL). This study aimed to evaluate the prevalence and risk factors of HL to clarify the association between IVF-ET and HL among twinborn infants. Methods: : We enrolled 1860 live-born twin neonates born in hospital of China from January, 2017 to December, 2020. After examined by two-step hearing screening, participants were finally diagnosed with HL by pediatric audiologists at age of 6 months. Prevalence of hearing loss and odds ratio (OR) for specific risk factors was estimated with generalized estimation equations (GEE) model in twin-born infants. Characteristics and prevalence of failure for hearing screening and HL was measured in IVF-ET twin infants. Results: : IVF-ET conception and preterm birth conferred higher risk for hearing loss, with increased adjusted odd ratios (AOR [95% confidence intervals (CI)] IVF-ET: 2.82 [1.17-6.80], P = 0.021; preterm birth: 6.14 [2.30-16.40], P < 0.001). Among 1860 twin infants, more IVF-ET twins failed in dual-step hearing screening (3.26%) and diagnosed with hearing loss (2.21%) compared with spontaneous pregnancy. Conclusions: : IVF-ET and premature birth conception were associated with higher risk of hearing impairment. Twin infants conceived by IVF-ET tend to fail in hearing screening and diagnosed with hearing loss. These observations provide a more comprehensive approach for prevention and management of deafness in twin-born children.