32 Assisted Reproductive Technologies and adverse perinatal outcomes: the what, why and how?

Abstract Greater than 200,000 children in the United States are born yearly with the aid of assisted reproductive technologies (ART). Recent epidemiological studies have suggested that these treatments are associated with an increased risk of adverse perinatal outcomes, including fetal growth restriction, low birth weight, preterm labor, preeclampsia and some rare genetic and epigenetic diseases. Given that many ART treatments including in vitro fertilization (IVF) utilize multiple clinical and laboratory interventions to generate a cohort of embryos capable of implantation and development, it is critical to examine each intervention individually in order to assess its relationship, if any, to the described adverse perinatal outcomes. Both human and animal studies can provide us with significant insights into the clinical procedures as well as the molecular mechanisms that may be playing in role in the adverse outcomes associated with IVF. By analyzing these data, we can not only can we modify current protocols to minimize the maternal and neonatal risk, but we can gain understanding of the critical cells and processes that play a role in pregnancy establishment and maintenance.