Assisted reproductive technology: Short- and long-term outcomes.
Mary Elaine Graham, Angie Jelin, Alexander H Hoon and 3 others
PMID 35851656WHAT IT FOUND
Multiple embryo transfer and preterm birth carry the clearest neurodevelopmental risk in ART-conceived children, not ART alone.
Neurodevelopmental outcomes are mostly reassuring.
Key findings
01Transfer of multiple embryos is tied to increased risk for multiple birth and preterm delivery, while single embryo transfer has been associated with decreased risk for later neurodevelopmental disorders including cerebral palsy.
02In singleton pregnancies, ART is associated with increased maternal and neonatal risks, including hypertensive disorders of pregnancy, placental complications, preterm birth, low birthweight, small for gestational age, stillbirth, and perinatal mortality.
03The review reports that cerebral palsy risk in ART studies is largely due to increased rates of multiple births and preterm birth.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The article is a narrative review, not a systematic review, so the authors do not describe how studies were found, selected, or judged. Most outcome information comes from observational studies, and infertility itself, maternal age, multiple births, and preterm birth can confound results. Long-term adult outcomes cannot be fully known yet because the oldest ART-conceived people are still relatively young. Animal studies suggest possible epigenetic and metabolic effects, but the review states that species differences mean conclusions cannot necessarily be extrapolated to humans.
Declared interests
The supplied article text does not include a conflicts of interest or funding declaration. The metadata indicates NIH extramural research support.
The easy way to misread this
Do not conclude that ART alone causes cerebral palsy or autism. The review says the clearest neurodevelopmental risk is multiple embryo transfer, and cerebral palsy risk is largely due to multiple births and preterm birth.