Ma RCW, Ng NYH, Cheung LP, et al. - Authors sought to discuss on the long-term cardiovascular health of offspring born after assisted reproduction technology (ART), as several mechanisms have been hypothesized that may potentially contribute to impaired cardiovascular health, including inadequate culture conditions, ART-induced epigenetic alterations, as well as indirect effects through low birthweight, thereby contributing to altered cardiovascular phenotype.

• In support of a recent systematic review and meta-analysis, prior small studies have reported that offspring born after ART show increased adiposity, cardiometabolic risk, and blood pressure, which may be due to altered gene expression; however, for the included small studies, issues have been raised regarding potential selection bias.

• Findings from a large population-based study from the Committee of Nordic ART and Safety (CoNARTaS) cohort that was conducted by Norrman and colleagues suggested generally reassuring cardiometabolic outcomes in ART children; however, the study involved relatively few births from frozen embryos, and no comparison of these has been done with births by spontaneous conception (SC) for later risk of diabetes or cardiovascular disease (CVD).

• Discussion has been made concerning some of the challenges that are encountered in determining long-term effects of ART, or other early life exposures, for that matter.

• An important component for the way forward comprises the establishment of ART registries including the important exposure factors, especially given the requirement of long-term follow-up.

• Currently, there is limited information concerning the long-term outcome of some of these novel techniques.

• Also, new challenges have been posed by the globalization of healthcare delivery, with increasing cross-border reproductive care.

• As the data involved are highly sensitive, difficulties may be encountered in performing such analyses in some areas, and population-based analyses, wherever possible, will continue to contribute much-required data to this discussion.