Long-term outcomes in children born after assisted conception.

Millions of children have been born worldwide through assisted reproductive technology (ART), and access is increasing yearly. Our current knowledge and understanding of the long-term risks and/or benefits to the children conceived is incomplete. Investigations of the health, disease, cognitive, developmental, and behavioral outcomes are often confounded by other factors, including multiple gestations, prematurity, and low birthweight. Reports of the long-term health and psychosocial adjustment of children conceived with ART show generally good outcomes. Many of the major long-term problems observed in the children may be associated with multiple gestations, preterm delivery, and low birthweight or with subfertility of the parents. Evidence in the male infants conceived with the aid of intracytoplasmic sperm injection suggests an increased risk of reproductive tract anomalies such as hypospadias. Outcome data on health of children born after cryopreservation of cleavage stage embryos are reassuring. Measuring long-term outcomes is the first step to improving and optimizing health in the offspring conceived with medical and technological assistance.