Well-being of children born after medically assisted reproduction

Abstract

Background: The increasing number and proportion of children born after medically assisted reproduction (MAR) has raised concerns and motivated research about the impact of MAR on the well-being and development of children. Objective: We summarize existing studies on the well-being and development of children conceived through MAR. Materials and methods: Review of existing studies. Results: Children conceived through MAR are at increased risk of adverse birth outcomes such as low birthweight and preterm delivery compared to naturally conceived children. The higher rates of multiple births amongst MAR-conceived children continue to represent an important driving factor behind these disparities. Reassuringly, elective single embryo transfer (eSET)—which is associated with more favourable pregnancy outcomes among MAR-conceived children—is becoming more common. Despite the early life health disadvantages, the evidence on later life outcomes such as physical, cognitive and psychosocial development is generally reassuring. On average, MAR-conceived children show similar or better outcomes than naturally conceived children. The selected and advantaged socioeconomic characteristics of parents who conceive through MAR are likely to play an important role in explaining why, on average, MAR-conceived children perform better than naturally conceived children—particularly in terms of cognitive outcomes. In contrast, there is some evidence pointing to potentially increased risks of mental health problems among MAR-conceived children. Conclusion: There is need for continued monitoring and longer follow-up studies on the well-being of these children in order to better understand whether their outcomes are similar to or different from those of naturally conceived children, and, if so, why.