FETAL AND MATERNAL CONSEQUENCES OF PREGNANCIES CONCEIVED USING ART

Abstract

Artificial reproductive technology (ART) was first introduced to clinical practice in the late 1970s1 and has subsequently resulted in approximately 5 million births worldwide2. Globally, the rates of assisted conceptions continue to rise3. In 2011, approximately 1.5% of all pregnancies in the US were conceived using ART4. Since its introduction, much interest has been generated regarding the effects of ART on the developing fetus and potential adverse impacts on the health of the mother. In particular, early studies suggested an increase in fetal genetic and structural anomalies, and a high risk of perinatal complications. As experience with pregnancies conceived using ART has increased worldwide and more data regarding the outcomes of ART-conceived pregnancies have been reported, many of the initial worries have been shown to be unfounded. However, concern still exists regarding whether any adverse fetal and maternal outcomes result from the use of this technology. Many studies have reported higher risks of fetal complications following the use of ART including an increase in perinatal mortality, even in singleton pregnancies5,6. However, interpretation of these data are far from simple and it is important to consider that observations of higher rates of complications do not equate to a causal relationship between adverse pregnancy outcomes and the use of ART7. There are multiple confounding factors that may account for these associations, many of which are difficult to control for in large-scale studies.