Investigation of cardiac remodeling and cardiac function on fetuses conceived via artificial reproductive technologies: a review

Abstract

The prevalence of artificial reproductive technologies (ART), such as intra-uterine insemination (IUI), in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI), has surged in response to the global increase in infertility rates, now impacting 17.5% of couples. With over nine million babies born through ART, the safety and efficacy of these methods are largely recognized; however, emerging concerns regarding their association with prenatal and long-term health risks, especially cardiovascular disease (CVD), necessitate a thorough examination. This review synthesizes recent findings on the cardiac remodeling observed in ART-conceived fetuses, highlighting the potential for sub-clinical dysfunction and subsequent cardiovascular anomalies that may extend into adolescence. It delves into the perinatal complications linked to ART and examines the contribution of the renin-angiotensin system, epigenetic modifications, and altered microRNA expressions to fetal cardiovascular development. The analysis further differentiates the cardiac effects of fresh vs. frozen ART cycles and investigates the enduring nature of these changes beyond birth. Addressing the elevated CVD risk among ART individuals, the review suggests proactive measures, including lifestyle adjustments initiated early in life, to mitigate potential adverse outcomes. It emphasizes the critical need for ongoing research and intervention strategies to safeguard the cardiovascular health of the increasing number of ART-conceived individuals.