Abstract
When a couple cannot conceive, it is commonly assumed that an underlying medical problem can be identified. However, emotional and psychological issues may play an important role in the development of infertility. In addition, assisted reproductive techniques (ARTs) themselves may add to this stress in susceptible individuals. Infertile couples may have an increased susceptibility to these adverse effects. This in turn may result in increased risks for long-term psychological and medical problems in both the parents and the newborn. Among mechanisms mediating these effects altered DNA methylation affecting epigenetic regulation, preterm delivery, vanishing twin syndrome and the persistence of cell-free fetal DNA might be particularly important. Since emotional and psychological problems are highly prevalent in this population and ARTs can adversely influence these, we suggest that a thorough psychological evaluation should be an integral part of both the evaluation process for infertility and the follow-up after assisted reproduction. Furthermore, regarding the mentioned studies here, we propose that ARTs may induce stress-related epigenetic and neurodevelopmental risk.
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