Santé des enfants conçus après assistance médicale à la procréation

Abstract

In 2015, the proportion of children born after assisted reproductive therapy (ART) reached 3.1 % of births in France. Monitoring the health of these children represents a major public health issue since the first studies of children born as a result of IVF treatment, published in the early 2 000’s, reported increased perinatal complications (prematurity, hypotrophy and neonatal mortality) and increased risk of congenital abnormalities (cardiovascular, metabolic or urogenital) compared to naturally conceived children. This study presents a review of the literature concerning the follow-up of 1st generations born after ART. The interpretation of literature data requires the greatest vigilance due to many confounding factors, first of all regarding multiple pregnancies outcomes. An increased in birth weight after frozen embryo transfer compared to fresh transfer, an increase incidence in epigenetic diseases and some solid tumors are reported among newborns conceived by ART, regardless of the technique. However, the absolute risks remain moderate and the prevalence of these pathologies is low. After adjusting for the confounding factors, the data are reassuring with a cognitive and psychomotor development equivalent to those of children conceived naturally. It seems that the occurrence of chronic diseases in adulthood can be attributed to an embryo-fetal origin. Hence the need for further long-term follow-up studies of these children, still too few, as well as the investigation of the causes of these observations (context of parental infertility, clinical or biological procedures). In this configuration counseling of couples prior to embarking on an IVF treatment cycle regarding the risks for the unborn child must be a major concern.