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Article History

Received: 10 February 2026

Accepted: 28 May 2026

First Online: 4 June 2026

Declarations

:

: The study was approved by the Institutional Review Boards (IRB) of Debre Berhan University, Asrat Woldeyes Health Science College (Protocol number: IRB-296), and consent was also waived by the ethical review board. The study was conducted in compliance with the Ethical Guidelines for Medical and Health Research Involving Human Subjects and the moral principles of the Declaration of Helsinki. A permission letter was obtained from each hospital’s paediatric ART clinics for use of the patient data. The study was conducted without individual informed consent as the study relied on retrospective data collected as part of routine patient care. In this retrospective cohort study, no patient identifiers were used, and data were anonymized. To keep confidentiality, names and other personal identifiers were not included in the data collection tool.

: Patients and/or the public were not involved in the design, conduct, reporting, or dissemination plans of this research.

: Not required.

: The authors declare no competing interests.