The proportion of babies born through medically assisted procreation (MAP) techniques is considerable: 8 million children at the World level since 1978. In France, 2.7% of babies born in 2020 were from ART – a figure down from 2019, but which had been increasing until then (from 2.6% in 2009 to 3.6% in 2019). In the vast majority of cases (80%), these were fertilizations in vitro (FIV)with or without intracytoplasmic sperm injection (ICSI), with immediate embryo transfer (35.5%) or frozen embryos (44.1%). This last technique has been constantly increasing for several years (37.4% in 2019 versus 16% in 2013).
Moreover, globally, approximately 1 in 6 people are currently facing fertility problems (absence of pregnancy following 1 year of regular sexual intercourse without contraception), according to a report which has just been published by the WHO. Moreover, the lifetime prevalence of infertility is comparable between high-income and low-income countries (respectively 17.8% and 16.5%); it is therefore likely that ART techniques will become more widespread in the years to come.
The medium and long-term health of children and young adults born thanks to these techniques is therefore a fundamental subject. Indeed, beyond the neonatal risks associated with these procedures – which are themselves well documented – certain medium and long-term risks have been mentioned (pediatric cancers, cardiovascular diseases, growth and metabolism disorders, neurodevelopment and fertility, etc.), because the periconceptional period, corresponding to the intervention phases of ART techniques, is particularly sensitive to environmental influences and is thus marked by an epigenetic reprogramming that plays a decisive role throughout life. It is however difficult to identify these risks and especially to establish a causal link with ART procedures.
The National Academy of Medicine has just published a report* to take stock of this topic. It is limited to children born by ART with an IVF techniquestandard or with ICSI, and their complements (culture and embryo freezing), excluding on the one hand intrauterine inseminations and on the other hand ART with gamete donations.
