Long-term outcomes in children conceived with assisted reproductive technologies.

Over five million children have been born worldwide through assisted reproductive technology (ART) and access to ART treatment is increasing yearly. Investigations of the health, disease, cognitive, developmental and behavioral outcomes in the children conceived with ART are often confounded by parental and other social, environmental and medical factors, including multiplicity, prematurity and low birth weight. Reports of the long-term health and psychosocial adjustment of children conceived with ART show generally good outcomes. Many of the major long-term conditions observed in the children may be associated with multiple gestations, preterm delivery and low birth weight, or with subfertility of the parents. Evidence in the male infants conceived with the aid of intracytoplasmic injection (ICSI) suggests an increased risk of reproductive tract anomalies such as hypospadias. Health-related outcomes of children born after cryopreservation of cleavage stage embryos are reassuring. Currently, our knowledge and understanding of the long-term health risks and/or benefits to the children conceived is incomplete. Measuring long-term outcomes is the first step to improving and optimizing health in the offspring conceived with medical and technological assistance.