Health Outcomes of Offspring Conceived by Assisted Reproductive Technologies

Assisted reproductive technologies (ART), including in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI), have resulted in millions of births worldwide. Research into the health trajectories of ART‐conceived children spans perinatal outcomes, growth patterns, cardiometabolic risk factors and longer‐term organ function. In the neonatal period, ART is consistently associated with modestly higher rates of preterm birth and low birth weight, particularly following fresh embryo transfer, while frozen‐thawed transfers may yield higher birth weights. Growth studies to age three indicate comparable weight and height trajectories for singletons, with subtle catch‐up growth observed among multiples.

In childhood and adolescence, cardiometabolic assessments reveal largely reassuring findings: blood pressure and heart‐rate differences are small and often not statistically significant, although trajectories hint at slightly higher lipid levels and insulin resistance markers in early adulthood. Detailed cardiac imaging has shown mild alterations in left ventricular structure and function among ART‐conceived children, suggesting the need for ongoing surveillance. Emerging mechanistic work emphasises the vulnerability of epigenetic reprogramming during gamete maturation and preimplantation culture, implicating DNA methylation changes in metabolic, vascular and endocrine pathways.

Globally, these insights inform counselling of prospective parents and guide optimisation of laboratory and embryo transfer protocols. The field is moving towards longer‐term, life-course studies that integrate mechanistic biomarker discovery with clinical end-points, aiming to refine ART practice and mitigate any subtle risks while preserving its transformative benefits.

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Health Outcomes of Offspring Conceived by Assisted Reproductive Technologies publication trend

The graph below shows the total number of articles in health outcomes of offspring conceived by assisted reproductive technologies across all publications each year (not limited to Nature Index journals).

Technical terms

Assisted reproductive technologies (ART): Medical procedures that aid human conception, most commonly including IVF and ICSI.

In vitro fertilisation (IVF): Laboratory fertilisation of an oocyte by sperm, with subsequent embryo culture and transfer to the uterus.

Intracytoplasmic sperm injection (ICSI): Injection of a single sperm directly into an oocyte to facilitate fertilisation.

Fresh versus frozen-thawed embryo transfer: Transfer of embryos either immediately after culture (fresh) or following cryopreservation and later thawing (frozen-thawed).

Cardiometabolic health: Integrated assessment of cardiovascular and metabolic risk factors, including blood pressure, lipid profiles and measures of glucose regulation.

References

1. Long-term cardiometabolic health in people born after assisted reproductive technology: a multi-cohort analysis. European Heart Journal (2023).
2. Overweight or obesity in children born after assisted reproductive technologies in Denmark: A population-based cohort study. PLOS Medicine (2023).
3. Assessment of Cardiovascular Health of Children Ages 6 to 10 Years Conceived by Assisted Reproductive Technology. JAMA Network Open (2021).
4. Infertility treatment and children's longitudinal growth between birth and 3 years of age. Human Reproduction (2016).
5. In vitro fertilization (IVF) in mammals: epigenetic and developmental alterations. Scientific and bioethical implications for IVF in humans. Biological Research (2015).