Abstract
Over 5 million children have been born through in vitro fertilization (IVF) across the world. IVF is only one of the many methods of assisted reproduction, which can be used to achieve pregnancy in the context of infertility or subfertility. Since the birth of the first IVF child, Louise Brown, in 1978, a number of researchers have started to study the various impacts of the conception through these methods, on both mothers and children. A growing body of evidence suggests that conception through medically assisted reproduction (MAR) is not without risk. Given that MAR is relatively new and that our look back period is short, there is limited evidence on the risks associated to these procedures, both for the mother and the child. In this chapter, we aim to explore the association between MARs and adverse perinatal outcomes specifically. We will first provide you with an overview of the prevalence and trends of use of these methods around the world, and then delve into the associations between MARs and the risk of perinatal outcomes, namely prematurity, being born with low birth weight and/or small for gestational age, and lastly the impact of MARs on cognitive functions including cerebral palsy, behavioral problems, and autism, which are identified later in the child’s life.
Highlights
1.1 Infertility and subfertilityInfertility is defined as failure to conceive within 12 months of the first pregnancy attempt [1], while subfertility describes any form or grade of reduced fertility [2, 3].The National Survey of Family Growth interviewed over 12,000 women of childbearing age (15–44 years old) to estimate the prevalence of infertility in the United States (US) [4]
Between 1982–1985, the World Health Organization (WHO) performed a multicenter study where they attributed 20% of infertility cases to male factors, 38% to female factors, 27% to causal factors identified in both partners, and 15% could not be attributed to either partner [10]
Environmental factors that come into play in the early stages of embryonic development can interact with the genotype and alter the capacity of the organism to cope with this environment later in life, modulating a child’s susceptibility to disease [114, 115]
Summary
Infertility is defined as failure to conceive within 12 months of the first pregnancy attempt [1], while subfertility describes any form or grade of reduced fertility [2, 3]. From 1982 to 2006–2010, the percentage of infertile women based on this definition fell from 8.5 to 6.0% [4]. These estimates are lower than the 12–18% incidence of infertility in the US [5]. Infertility and subfertility may be due to conditions originating from the male and/or female reproductive systems [6]. Between 1982–1985, the World Health Organization (WHO) performed a multicenter study where they attributed 20% of infertility cases to male factors, 38% to female factors, 27% to causal factors identified in both partners, and 15% could not be attributed to either partner [10]. We will provide you with an overview of the main causes of infertility
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