Maternal, perinatal and long-term outcomes after assisted reproductive techniques (ART): implications for clinical practice

The use of assisted reproductive techniques (ART) is on the rise throughout the world and the number of babies born as a result of ART has reached an estimated total of 5 million since the world's first, Louise Brown, was born in 1978. Data from many prospective and retrospective studies have suggested increased risks of adverse maternal, perinatal and long-term outcomes after ART compared to natural conception. Recent research suggests that underlying maternal factors rather than ART methods themselves play a significant role in causing such outcomes. Couples attempting ART need to be provided with accurate and reliable information on risks of adverse reproductive outcomes and reassured that absolute risks appear small. Clinicians need to remain vigilant about increased risk of pregnancy complications and formulate a plan of care for the woman, from periconception to the puerperium, which aims to prevent or minimise maternal and perinatal morbidity. This review attempts to summarise the available data on reproductive outcomes after ART and provide guidance to the obstetricians and primary care physicians about management of ART pregnancies.