Daily Dose: Fertility Treatment & Cardiometabolic Health in Offspring

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On February 6, 2023, we reported on a study published in European Heart Journal that examined associations of assisted reproductive technology (ART) conception (vs natural conception [NC]) with offspring cardiometabolic health outcomes and whether these differ with age.

The study

Researchers recruited cohort studies from the Assisted Reproductive Technology and Future Health (ART-Health) Cohort Collaboration, a multinational collaboration of 26 cohort studies. From ART-Health, the team identified 14 cohorts that met inclusion criteria for the analysis. From these 14 cohorts, data were obtained on 35 938 individuals (654 conceived via ART). Mean follow-up age ranged from 13 months to 27.4 years, however participants in 11 of the 14 cohorts were younger than age 10 years. The primary outcomes of interest for the study were differences between ART-and naturally-conceived children in systolic blood pressure (SBP) and diastolic blood pressure (DBP), heart rate (HR), lipids, and markers of hyperglycemia and insulin resistance.

There were no statistically signficant pooled differences based on the meta-analysis for offspring conceived with ART vs natural conception for SBP (-0.53 mm Hg [95% CI, -1.59 to 0.53]), DBP (-0.24 mm Hg [-0.83 to 0.35]), or HR (0.02 beat/min [95% CI, -0.91 to 0.94]). The researchers did, however, report just slightly significantly higher measures among offspring conceived with ART for total cholesterol (2.59% [95% CI, 0.10 to 5.07]), HDL cholesterol (4.16% [95% CI, 2.52 to 5.81]), and LDL cholesterol (4.95% [95% CI, 0.47-9.43]) compared to naturally conceived offspring. Further analysis demonstrated no statistical differences for triglycerides, glucose, insulin, and glycated hemoglobin.

Note from authors

"Overall, our findings should be deemed largely reassuring to people conceived by ART. Studies with longer follow-up are needed to examine associations of ART with cardiometabolic health across adulthood, and investigate mechanisms that might link ART to subsequent outcomes, if evidence does emerge in later adulthood. Future research on epigenetics, metabolomics, and cardiovascular and arterial phenotypes may provide insight into possible underlying mechanisms."

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