Systemic and Pulmonary Vascular Dysfunction in Children Conceived by Assisted Reproductive Technologies

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Circulationcirc.ahajournals.org

1. CIRCULATIONAHA.111.071183 Published online before print March 20, 2012, doi: 10.1161/​CIRCULATIONAHA.111.071183

• Original Research Article

Systemic and Pulmonary Vascular Dysfunction in Children Conceived by Assisted Reproductive Technologies

1. Urs Scherrer1*;
2. Stefano F. Rimoldi2;
3. Emrush Rexhaj2;
4. Thomas Stuber2;
5. Hervé Duplain3;
6. Sophie Garcin3;
7. Stefano F. de Marchi2;
8. Pascal Nicod4;
9. Marc Germond5;
10. Yves Allemann2;
11. Claudio Sartori6

+ Author Affiliations

1. ¹ Univ Hospital, Bern & Hirslanden Grp, Lausanne, Switzerland & Univ de Tarapaca, Arica, Chile;
2. ² Swiss Cardiovascular Center Bern, University Hospital, Bern, Switzerland;
3. ³ Centre hospitalier universitaire vaudois - CHUV, Lausanne, Switzerland;
4. ⁴ Hirslanden Group, Lausanne, Switzerland;
5. ⁵ Centre de Procréation Médicalement Assistée, Lausanne, Switzerland;
6. ⁶ Swiss Cardiovascular Center Bern, University Hospital, Bern & CHUV, Lausanne, Switzerland, Switzerland

1. ↵* Corresponding author; email: urs.scherrer2@insel.ch

Abstract

Background—Assisted reproductive technology (ART) involves the manipulation of early embryos at a time when they may be particularly vulnerable to external disturbances. Environmental influences during the embryonic and fetal development influence the individual's susceptibility to cardiovascular disease raising concerns regarding the potential consequences of ART on the long-term health of the offspring.

Methods and Results—We assessed systemic (flow-mediated dilation of the brachial artery, pulse wave velocity and carotid intima-media thickness) and pulmonary (pulmonary-artery pressure at high altitude by Doppler echocardiography) vascular function in 65 healthy children born after ART and 57 control children. Flow-mediated dilation of the brachial artery was 25 percent smaller in ART than in control children (6.7±1.6 vs. 8.6±1.7%, P<0.0001) whereas endothelium-independent vasodilation was similar in the two groups. Carotid-femoral pulse wave velocity was significantly (P<0.001) faster and carotid intima-media thickness significantly (P<0.0001) greater in children conceived by ART than in controls. The systolic pulmonary-artery pressure at high altitude (3450m) was 30 percent higher (P<0.001) in ART than in control children. Vascular function was normal in children conceived naturally during hormonal stimulation of the ovulation and in siblings of ART children who were conceived naturally.

Conclusions—Healthy children conceived by ART display generalized vascular dysfunction. This problem does not appear to be related to parental factors, but to the ART procedure itself.

Clinical Trial Registration Information—clinicaltrials.gov; Unique identifier: NCT00837642

Key Words:

• endothelial dysfunction
• pulmonary hypertension
• assisted reproductive technologies

• Received September 30, 2011.
• Accepted February 10, 2012.

• Copyright © 2012, American Heart Association, Inc. All rights reserved. Unauthorized use prohibited