Assisted Reproductive Technology Use Has Little Impact on Long-Term Cardiometabolic Health in Offspring

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An analysis of more than a dozen cohort studies containing data from more than 30,000 offspring provides clinicians with the most detailed overview yet of differences in cardiometabolic health outcomes in those conceived naturally compared to those conceived with use of assisted reproductive technologies.

A meta-analysis of more than 35,000 children provides a comprehensive overview of the long-term cardiometabolic health, including potential differences in cholesterol and blood pressure, of people conceived with use of assisted reproductive technology (ART).

Leveraging data from 14 longitudinal cohort studies conducted on 3 continents, results of the analysis, which included up to 27.4 years of follow-up data, indicate the observed differences in offspring cardiometabolic outcomes among those conceived natural and those conceived with ART over the follow-up period were small and statistically insignificant.

“Parents conceiving or hoping to conceive through assisted reproductive technology and their offspring should be reassured that cardiometabolic health appears to be comparable in ART-conceived and naturally conceived children. Studies with longer follow-up would now be beneficial to examine how results might change across adulthood,” said Ahmed Elhakeem, PhD, research fellow in Epidemiology at Bristol Medical School: Population Health Sciences at the University of Bristol.2

Citing flaws in previous research limiting the scope of understanding pertaining to long-term outcomes in those conceived with use of ART, Elhakeem and colleagues from Bristol Medical School designed the current study with the intent of developing more complete understanding of the offspring differences in cardiometabolic health outcomes with ART conception compared with natural conception among studies recruited from the Assisted Reproductive Technology and Future Health (ART-Health) Cohort Collaboration. From the ART-Health Cohort Collaboration, investigators identified 14 cohorts for inclusion in the current study.

Of these 14 cohorts, 2 cohorts each contained individuals from the United Kingdom, the Netherlands, Italy, and Australia, and 1 cohort each contained individuals from Ireland, France, Portugal, Greece, Norway, and Singapore. From these 14 cohorts, investigators obtain data related to 35,938 individuals, with mean follow-up ages ranging from 13 months to 27.4 years. Investigators pointed out the mean follow-up age for 11 of the 14 cohorts exceeded 10 years. The primary outcomes of interest for the study were differences in systolic (SBP) and diastolic blood pressure (DBP), heart rate, lipids, and markers of hyperglycemia and insulin resistance, which were assessed in multiple linear regression models and combined using meta-analysis.

Results of the meta-analysis indicated there were no statistically significant differences for those with conceived with ART for SBP (-0.53 mmHg [95% CI, -1.59 to 0.53]), DBP (-0.24 mmHg [-0.83 to 0.35]), or heart rate (0.02 beat/min [95% CI, -0.91 to 0.94]). However, results suggested 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]) were significantly higher for those conceived with ART compared to naturally conceived offspring. Further analysis demonstrated there were no statistical differences observed for triglycerides, glucose, insulin, and glycated hemoglobin.1

Investigators called attention to results of an age-change trajectory analysis of 17,244 individuals, including 244 conceived with ART. Results of this analysis provided evidence of statistically significant associations between ART and lower predicted SBP/DBP in childhood, and subtle trajectories to higher SBP and triglycerides in young adulthood, but investigators pointed out most differences were not statistically significant.1

“This important research is only possible through large scale international collaboration and longitudinal health studies, where participants contribute health data throughout their entire lives,” said Deborah Lawlor, MBChB, MPH, a professor of Epidemiology at the Bristol Medical School and chair of the British Heart Foundation.2


  1. Elhakeem A, Huang J, Inskip H, et al. Long-term cardiometabolic health in people born after assisted reproductive technology: a multi-cohort analysis. Published February 6, 2023. Accessed February 6, 2023.
  2. BristolUni. Fertility treatment does not adversely affect cardiovascular health of offspring, International Study suggests. EurekAlert! Published February 6, 2023. Accessed February 6, 2023.