Medium and long-term health of children conceived through in vitro fertilization (IVF)

Among the medical, scientific and ethical questions raised by medically assisted procreation and in particular in vitro fertilization (IVF), those concerning the medium and long-term health of children and young adults are essential. Many studies have been conduc-ted focusing on the occurrence of various health alterations, including growth and metabolic disorders, cardiovascular disorders, pathologies linked to imprinted genes, pediatric cancers, neurodevelopmental disorders and fertility. The published results are not all consistent. Ove-rall, it emerges that children conceived by IVF can sometimes be affected by health problems without a particular type predominating, that their incidence is relatively moderate and that, in the event of a significant increase in incidence, it is not much greater than in naturally conceived children. However, comparative studies conducted on better characterized populations must be carried on, particularly at later ages of life. The alterations observed in children are not necessarily attributable to IVF insofar as infertile couples may be more at risk of transmitting to their children factors responsible for health disturbances. For example, some boys, born as a result of an IVF with intra cytoplasmic sperm injection (ICSI) performed to compensate for male infertility of genetic origin, risk being sterile like their father. Among the procedures used to perform IVF, hormonal ovarian stimulation treatments, embryo culture conditions and embryo freezing are most often suspected of being the cause of the observed disorders. It would there-fore be necessary for these procedures to be precisely documented in the published studies and in the databases developed to analyze the activity. The mechanisms involved in the occurrence of the observed alterations are poorly understood. If disturbances of epigenetic regulations are most often mentioned, research on animal models, but also in the human species, is neces-sary to clarify them. The fact that many uncertainties remain should not prevent to give clear, objective and precise information to people having recourse to IVF so that the most appropriate measures could be taken in the event of the appearance of health problems in their children. & COPY; 2023 l'Academie nationale de medecine. Published by Elsevier Masson SAS. All rights reserved.