The Journal of Medicine, Law & Public Health (Sep 2024)
Long-Term Neurodevelopmental, Mental, and Cardiometabolic Health in Individuals Conceived with Assisted Reproductive Technology: A Literature Review
Abstract
Background: Assisted reproductive technology (ART) has revolutionised fertility treatments since 1978 and, while its immediate perinatal outcomes have been extensively studied, its long-term health effects require exploration. Method: PubMed database was searched for studies spanning 2016 to 2023 to conduct this literature review of the long-term neurodevelopmental, mental, and cardiometabolic health of ART-conceived individuals. Results: A total of 49 studies were included in this review. ART-conceived individuals revealed mostly positive neurodevelopmental and mental health impacts. However, children conceived via intracytoplasmic sperm injection (ICSI) demonstrated an increased risk of neurodevelopmental disorders, including autism spectrum disorder, intellectual disability, and psychological and neurological development delays, while frozen embryo transfer was linked to an increased risk of language delay. Additionally, children born via ART as multiples or prematurely showed an elevated risk of cerebral palsy. While ART generally demonstrated a favourable impact on cardiometabolic health, there were concerns about increased risk of high blood pressure, altered lipid profiles, obesity, insulin resistance, premature vascular aging, and adverse metabolic changes. Specifically, ICSI-conceived individuals were more prone to adiposity and insulin resistance, while frozen embryo transfer was associated with type 1 diabetes. Conclusion: While ART-conceived individuals generally exhibit favourable health, specific subgroups may face elevated risks for certain neurodevelopmental disorders and long-term cardiometabolic issues, warranting further research. ART may be associated with metabolic alterations at a young age, potentially increasing the risk of chronic diseases such as metabolic syndrome, type 2 diabetes, and cardiovascular disease later in life. Continued long-term monitoring and targeted interventions are recommended to mitigate these risks.
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