Assisted reproductive technology: Short- and long-term outcomes

被引:79
作者
Graham, Mary Elaine [1 ]
Jelin, Angie [2 ,3 ]
Hoon, Alexander H., Jr. [4 ,5 ]
Floet, Anna Maria Wilms [4 ,6 ,7 ]
Levey, Eric [8 ]
Graham, Ernest M. [3 ,9 ]
机构
[1] Washington & Lee Univ, Coll Arts & Sci, Lexington, VA 24450 USA
[2] Johns Hopkins Univ, Sch Med, Dept Genet Med, Baltimore, MD USA
[3] Johns Hopkins Univ, Sch Med, Dept Gynecol & Obstet, Div Maternal Fetal Med, Baltimore, MD 21205 USA
[4] Johns Hopkins Sch Med, Dept Pediat, Div Dev Med, Baltimore, MD USA
[5] Kennedy Krieger Inst, Phelps Ctr Cerebral Palsy & Neurodev Med, Baltimore, MD USA
[6] Kennedy Krieger Inst, Ctr Autism & Related Disorders, Baltimore, MD USA
[7] Kennedy Krieger Inst, Ctr Dev & Learning, Baltimore, MD USA
[8] Hlth Serv Children Special Needs, Washington, DC USA
[9] Johns Hopkins Univ, Neurosci Intens Care Nursery Program, Sch Med, Baltimore, MD USA
关键词
DEVELOPMENTAL ORIGINS; OVARIAN STIMULATION; EMBRYO-TRANSFER; INFERTILITY; HEALTH; ASSOCIATION; BIRTH; CHILDREN; HISTORY; ART;
D O I
10.1111/dmcn.15332
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Assisted reproductive technology (ART) includes fertility treatment in which either eggs or embryos are handled outside a female's body to promote successful pregnancies and healthy offspring. Current ART procedures encompass in vitro fertilization with or without intracytoplasmic sperm injection. The most common complication of ART is related to the consequences of multiple pregnancy, which can be prevented or minimized by reducing the number of embryos transferred to the uterus, commonly single embryo transfer. ART has been shown to be variably associated with adverse short- and long-term perinatal outcomes, including cerebral palsy, autism, neurodevelopmental imprinting disorders, and cancer. However, there is uncertainty as to whether reported problems are related to the ART procedure itself, to factors related to infertility, to other medical and environmental factors, or a combination thereof. From a pathophysiological perspective, whether ART alters epigenetic mechanisms of gene expression, leading to later developmental, medical, and behavioral disorders, is an area of active investigation. With the meticulously conducted short- and long-term outcome studies completed so far, overall, and after controlling for multiple gestations and preterm delivery, the results suggest that ART is a safe procedure, offering hope to many parent(s) wishing for a healthy child. This paper highlights ART methods and the risk factors and confounders in the interpretation of short- and long-term outcome data, providing the reader with a means to evaluate findings and conclusions of outcome studies.
引用
收藏
页码:38 / 49
页数:12
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