What We Know of the Health of Children Conceived by Assisted Reproductive Technology

ART  have been used for more than 30 years leading to the birth of several millions of children worldwide. 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 gestations. Controlled studies also indicate a higher malformation rate in IVF compared to the general population mainly related to parental variables and genetic background.
Major determinants in the outcome of ART children are recognized to be parental infertility, infertility treatments and multiple births. Questions related to the longer term developments need to be addressed. These questions include
-          Is there a higher risk for adverse outcomes in childhood?
-          Are these childhood outcomes fully or partially mediated by low birth weight or prematurity?
-          Is there a direct effect of the infertility treatment on adverse outcomes?
General growth (height, weight, head circumference) and health (including hearing and vision) do not differ in IVF compared to naturally conceived children.
Some studies report more childhood illnesses 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 interventions 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 low birth weight and to lower gestational age also found in singleton children. Other developmental outcomes 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 when born after 32 weeks of gestation.
In cancer registries there seems to be no increased risk for childhood cancer in IVF children. However, there are insufficient controlled studies to be conclusive.
Sofar the outcome of children after PGD is similar to the outcome of IVF-ICSI but this finding requires confirmation on a larger cohort of children.