Assisted reproductive technology and the impact on children

The miraculous birth of Louise Brown, the first baby conceived through in vitro fertilization (IVF), raised the hopes of infertile couples everywhere. Since her birth in 1978, more than 100,000 babies worldwide have been conceived through IVF and other assisted reproductive technologies (ARTs).[1] Women infertile as a result of tubal problems were the first patients, but in a very short time IVF became the treatment of choice for a host of reproductive disorders in men and women alike. ART innovations such as oocyte donation, embryo cryopreservation, gestational surrogacy, and intra-cytoplasmic sperm injection (ICSI) have made parenthood possible to an entirely new cohort of patients, such as women without ovarian function, women without a uterus, and men who are quadriplegic or otherwise unable to ejaculate. These innovations have, in turn, introduced and redefined the family in a new way. Infertility treatment centers throughout the world initially focused on the infertile couple with little regard to the possible long-term impact of treatment on the children they were helping to create. Historically, the goal of treatment was pregnancy and the focus was on the medical and psychological aspects of the treatment itself. Mental health practitioners working in the field focused on the ‘roller coaster’ of euphoria and dysphoria associated with infertility and its treatment, particularly on the emotional impact of treatment failure.