Long term development of children born after ART

Research output: Contribution to journalEditorial


Assisted reproductive techniques (ART) have been used for nearly 30 years leading to approximately 1% of births in most developed countries. Numerous studies on neonatal outcome indicate an increased risk of low birth weight and prematurity among ART conceived children even after controlling for extensive maternal factors and multiple gestation. Controlled studies also indicate a possible higher malformation rate in IVF compared to the general population, mainly related to parental variables and genetic background.
Infertility treatments, multiple gestations and parental infertility are major players that determine the outcome of ART children. Questions about the long term development of children born after ART need to be addressed.

- Are there increased risks of adverse outcomes in childhood?
- Are childhood outcomes fully or partially mediated by LBW or prematurity?
- Do infertility treatments have a direct effect on adverse outcomes?

In the meanwhile, a number of controlled studies matching for plurality of gestation have been performed and different aspects of childhood development after IVF and ICSI have been studied. Although these studies show many shortcomings, we can formulate a number of observations:
General growth (height, weight, head circumference) and health (including hearing and vision) do not differ in IVF compared to NC children.
Some studies find more childhood illnesses and/or hospital admissions (in singletons), others not. A lower birth weight and lower gestational age compared to matched controls may contribute to these findings. An increased need for surgical intervention may be due to an increase in malformation rate.
An increased risk of neurological problems such as cerebral palsy was found in some large registry based studies in IVF children. This was partially due to the higher number of twins born, to LBW and to lower gestational age also found in singletons. However, a possible IVF effect, the parents' infertility or other factors that have not been adjusted for in the studies cannot be excluded. Other neurological complications have been detected such as febrile convulsions and epilepsy. There is no evidence for developmental or motor delay in children born after IVF or ICSI (born .32 weeks gestation).
In cancer registers there seems to be no increased risk for childhood cancer in IVF children. However, there are insufficient controlled studies to be conclusive.
Overall there is evidence that ART children have similar temperaments and behaviour up to school-age.
Conclusion: Further prospective monitoring of the health of children born after assisted conception needs to be pursued as they grow up. In these studies, appropriate controls are needed that deal with baseline confounders such as socio-demographic variables and the fertility status of the parents. Special attention to puberty and future fertility should be given, especially in the ICSI children who are now growing up. Other potential long-term consequences including the development of cardiovascular diseases, imprinting disorders and cancer should be further monitored for all ART children.
Original languageEnglish
Pages (from-to)83-84
Number of pages2
JournalHum Reprod
Publication statusPublished - 2010


  • Assisted reproductive techniques (ART)


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