Cardiovascular and metabolic profiles of offspring conceived by assisted reproductive technologies: a systematic review and meta-analysis

Fertil Steril. 2017 Mar;107(3):622-631.e5. doi: 10.1016/j.fertnstert.2016.12.007. Epub 2017 Jan 16.

Abstract

Objective: To evaluate cardiovascular and metabolic features of offspring conceived by in vitro fertilization/intracytoplasmic sperm injection (IVF-ICSI).

Design: Literature review and meta-analysis.

Setting: Not applicable.

Patient(s): Offspring from IVF-ICSI versus natural conception.

Intervention(s): None.

Main outcome measure(s): Systolic and diastolic blood pressure (SBP and DBP), cardiovascular function, body mass index (BMI), and lipid and glucose profiles.

Result(s): We included 19 studies that had recruited 2,112 IVF-ICSI and 4,096 naturally conceived offspring, ranging from childhood to early adulthood. The blood pressure levels of IVF-ICSI offspring were statistically significantly higher than those of naturally conceived offspring (weighted mean differences and confidence intervals: 1.88 mm Hg [95% CI, 0.27, 3.49] for SBP and 1.51 mm Hg [95% CI, 0.33, 2.70] for DBP). In addition, cardiac diastolic function was suboptimal and vessel thickness was higher among IVF-ICSI offspring. Compared with the metabolism of naturally conceived offspring, IVF-ICSI offspring displayed comparable BMI, lower low-density lipoprotein cholesterol levels, and higher fasting insulin levels.

Conclusion(s): Children conceived by IVF-ICSI manifested a minor yet statistically significant increase in blood pressure without the clustering of increased BMI or impaired lipid metabolism by early adulthood. Our findings indicate a risk of cardiovascular disease among IVF-ICSI offspring, which calls for longer-term follow-ups and further investigation.

Keywords: BMI; ICSI; IVF; blood pressure; metabolism.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adiposity
  • Adolescent
  • Age Factors
  • Biomarkers / blood
  • Blood Glucose / metabolism
  • Blood Pressure
  • Body Mass Index
  • Child
  • Child, Preschool
  • Dyslipidemias / blood
  • Dyslipidemias / etiology
  • Female
  • Humans
  • Hypertension / diagnosis
  • Hypertension / etiology*
  • Hypertension / physiopathology
  • Infant
  • Infertility / diagnosis
  • Infertility / physiopathology
  • Infertility / therapy*
  • Insulin / blood
  • Insulin Resistance
  • Lipids / blood
  • Live Birth
  • Obesity / etiology
  • Obesity / physiopathology
  • Pregnancy
  • Prenatal Exposure Delayed Effects*
  • Reproductive Techniques, Assisted / adverse effects*
  • Risk Assessment
  • Risk Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Biomarkers
  • Blood Glucose
  • Insulin
  • Lipids