To What Extent Assisted Reproductive Technology Is Risky?

Background: The number of infants born after assisted reproductive technology (ART) is increasing worldwide. Concerns are rising regarding its safety with inconsistent results. Objective: to explore maternal and child health outcomes following ART. Method: The current case-control study was conducted in Alexandria from January to December 2018. Target population was all children that attended El-Shatby Pediatric University Hospital during the period of study. Interviewing questionnaire, clinical examination, and radiological investigation were the tools of data collection. Results: The present study involved 113 singleton children born after ART and a similar number of naturally conceived controls. It showed that among ART group; subfertility was primary in 90.3% and mostly due to male factor (64.6%). The study revealed that ART mothers were more likely to have hypertension in pregnancy (OR=4.8), preeclampsia (OR= 4.3), gestational diabetes (OR=3.4) placenta previa (OR=2.8), premature rupture of membrane (OR=2.7) and Caesarean section (OR= 2.3) versus naturally conceived (NC) women. ART children were more prone to low birth weight (OR=3.2), admission to neonatal intensive care unit (OR=4.9) or hospital (OR=2.4) with longer stay (p=0.001) versus naturally conceived children. Odds of Autism spectrum disorders (OR= 5.4) and global developmental delay (OR= 4.4) were higher among children born after ART than among controls. Major and multiple congenital anomalies were more likely to be observed among ART (OR=4.5 and OR= 2.1 respectively) versus NC children. Anomalies of the cardio vascular and central nervous systems (4.4% each) were the most frequent. Adversely affected ART children (100%) were well accepted within their families and all primary subfertile mothers (90.3%) were welling to have more. Conclusion and recommendations: Our study confirmed an increased risk of adverse maternal and child outcome after ART. Pre-implantation genetic screening, careful neonatal examination, long term follow up of ART children, and prospective studies to assess early and delayed ART outcomes and their determinants are recommended.