Assisted Reproductive Technologies and the Placenta: Clinical, Morphological, and Molecular Outcomes

As the biological bridge between mother and fetus, the placenta is not only important for the health of the mother and fetus during pregnancy but it also impacts the lifelong health of the fetus. Assisted reproductive technologies (ARTs) involve procedures and exposures that are not characteristic of in vivo reproduction. Moreover, ART procedures occur when the gametes and embryos are undergoing extensive epigenetic reprogramming. Thus, the oxidative, thermal, and mechanical stress that ART procedures introduce can impact the biological processes of placental growth, development, and function with potentially long-lasting health effects for the offspring. Here, we focus on the placenta and summarize the clinical, morphological, and molecular outcomes of ART. This review highlights that ART procedures have additive effects on placental morphology as well as epigenetic disturbances and provides a foundation for reconceptualizing ART outcomes.