Health and development of children conceived using assisted reproductive technology: a meta-analysis of real-world...

Understanding the long-term health and developmental outcomes of children conceived through conventional IVF (cIVF) and intracytoplasmic sperm injection (ICSI) is essential for informed decision-making regarding fertilization techniques and for planning appropriate follow-up strategies. A comprehensive search of PubMed, Embase and the Cochrane Library was undertaken to evaluate outcomes including congenital anomalies, pubertal disorders, obesity, hypertension, asthma, diabetes, cerebral palsy, autism, attention-deficit/hyperactivity disorder, cancer, and mean full-scale intelligence quotient scores, ultimately including 94 studies. The prevalence of specific congenital anomalies was generally low in both the cIVF and ICSI groups; however, chromosomal abnormalities were more frequent in the ICSI group than in the cIVF group (0.91% versus 0.06%; P = 0.0064). Other long-term health and developmental outcomes showed low prevalence, and were broadly similar between the cIVF and ICSI groups. These outcomes were also generally consistent with those observed in naturally conceived children, with the exception of elevated risk of certain conditions in the ICSI group, including cerebral palsy, cleft lip or palate, and systemic abnormalities (circulatory, digestive or urogenital). Overall, these findings suggest that long-term outcomes for ICSI and cIVF are largely comparable, and provide essential data for patient counselling in fertility treatments.