Association Between Human Embryo Culture Conditions, Cryopreservation, and the Potential Risk of Birth Defects in Children Conceived Through Assisted Reproduction Technology

Assisted reproduction technology (ART) has advanced significantly over the past four decades, leading to improved pregnancy outcomes and a reduction in complications, particularly those associated with multiple pregnancies. These improvements largely stem from advances in understanding embryonic phy...

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Main Authors: Romualdo Sciorio, Luca Tramontano, Giuseppe Gullo, Steven Fleming
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/7/1194
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author Romualdo Sciorio
Luca Tramontano
Giuseppe Gullo
Steven Fleming
author_facet Romualdo Sciorio
Luca Tramontano
Giuseppe Gullo
Steven Fleming
author_sort Romualdo Sciorio
collection DOAJ
description Assisted reproduction technology (ART) has advanced significantly over the past four decades, leading to improved pregnancy outcomes and a reduction in complications, particularly those associated with multiple pregnancies. These improvements largely stem from advances in understanding embryonic physiology, which has enabled better culture conditions. As a result, embryologists can now efficiently culture embryos to the blastocyst stage and successfully cryopreserve them for future use. However, while incubators aim to replicate the maternal environment of the oviduct and uterus, embryos in vitro are cultured in static conditions, unlike the dynamic, constantly changing environment they experience in vivo. Key factors such as pH, temperature, osmolality, and gas concentrations are crucial for establishing optimal embryo development and implantation potential. Moreover, the vitrification procedure for gametes or embryos can introduce oxidative stress, as well as osmotic shock and cryoprotectant toxicity, which may affect embryo viability and increase the risk of birth defects. Since the first successful ART birth in 1978, over 10 million babies have been conceived through these techniques. Although most of these children are healthy, concerns exist about potential birth defects or changes linked to the handling of gametes and embryos. The preimplantation period is marked by significant epigenetic reprogramming, which can be influenced by ART procedures such as ovarian stimulation, in vitro fertilization, embryo culture, and cryopreservation. However, the long-term health implications for offspring remain uncertain. Epigenetic reprogramming during early embryogenesis is essential for proper embryo development and can be changed by ART-related conditions. These concerns have raised questions about the possible connection between ART and a higher risk of birth defects or other changes in children born through these methods. Therefore, we conducted a scoping review following PRISMA-ScR guidelines to map evidence on ART-related risks, including epigenetic and birth defect outcomes.
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spelling doaj-art-12602ff5cd0f405fb7a5874f1197eb452025-08-20T03:08:09ZengMDPI AGMedicina1010-660X1648-91442025-06-01617119410.3390/medicina61071194Association Between Human Embryo Culture Conditions, Cryopreservation, and the Potential Risk of Birth Defects in Children Conceived Through Assisted Reproduction TechnologyRomualdo Sciorio0Luca Tramontano1Giuseppe Gullo2Steven Fleming3Fertility Medicine and Gynaecological Endocrinology Unit, Department Woman Mother Child, Lausanne University Hospital, 1011 Lausanne, SwitzerlandDépartement de Gynécologie-Obstétrique, Réseau Hospitalier Neuchâtelois, 2000 Neuchâtel, SwitzerlandAzienda Ospedaliera Ospedali Riuniti (AOOR) Villa Sofia Cervello, IVF Public Center, Department of Medicine, University of Palermo, 90133 Palermo, ItalyDiscipline of Anatomy & Histology, School of Medical Sciences, University of Sydney, Sydney, NSW 2006, AustraliaAssisted reproduction technology (ART) has advanced significantly over the past four decades, leading to improved pregnancy outcomes and a reduction in complications, particularly those associated with multiple pregnancies. These improvements largely stem from advances in understanding embryonic physiology, which has enabled better culture conditions. As a result, embryologists can now efficiently culture embryos to the blastocyst stage and successfully cryopreserve them for future use. However, while incubators aim to replicate the maternal environment of the oviduct and uterus, embryos in vitro are cultured in static conditions, unlike the dynamic, constantly changing environment they experience in vivo. Key factors such as pH, temperature, osmolality, and gas concentrations are crucial for establishing optimal embryo development and implantation potential. Moreover, the vitrification procedure for gametes or embryos can introduce oxidative stress, as well as osmotic shock and cryoprotectant toxicity, which may affect embryo viability and increase the risk of birth defects. Since the first successful ART birth in 1978, over 10 million babies have been conceived through these techniques. Although most of these children are healthy, concerns exist about potential birth defects or changes linked to the handling of gametes and embryos. The preimplantation period is marked by significant epigenetic reprogramming, which can be influenced by ART procedures such as ovarian stimulation, in vitro fertilization, embryo culture, and cryopreservation. However, the long-term health implications for offspring remain uncertain. Epigenetic reprogramming during early embryogenesis is essential for proper embryo development and can be changed by ART-related conditions. These concerns have raised questions about the possible connection between ART and a higher risk of birth defects or other changes in children born through these methods. Therefore, we conducted a scoping review following PRISMA-ScR guidelines to map evidence on ART-related risks, including epigenetic and birth defect outcomes.https://www.mdpi.com/1648-9144/61/7/1194culture mediapH and osmolalitytemperatureoxygen tensioncryopreservation and vitrificationbirth defects
spellingShingle Romualdo Sciorio
Luca Tramontano
Giuseppe Gullo
Steven Fleming
Association Between Human Embryo Culture Conditions, Cryopreservation, and the Potential Risk of Birth Defects in Children Conceived Through Assisted Reproduction Technology
Medicina
culture media
pH and osmolality
temperature
oxygen tension
cryopreservation and vitrification
birth defects
title Association Between Human Embryo Culture Conditions, Cryopreservation, and the Potential Risk of Birth Defects in Children Conceived Through Assisted Reproduction Technology
title_full Association Between Human Embryo Culture Conditions, Cryopreservation, and the Potential Risk of Birth Defects in Children Conceived Through Assisted Reproduction Technology
title_fullStr Association Between Human Embryo Culture Conditions, Cryopreservation, and the Potential Risk of Birth Defects in Children Conceived Through Assisted Reproduction Technology
title_full_unstemmed Association Between Human Embryo Culture Conditions, Cryopreservation, and the Potential Risk of Birth Defects in Children Conceived Through Assisted Reproduction Technology
title_short Association Between Human Embryo Culture Conditions, Cryopreservation, and the Potential Risk of Birth Defects in Children Conceived Through Assisted Reproduction Technology
title_sort association between human embryo culture conditions cryopreservation and the potential risk of birth defects in children conceived through assisted reproduction technology
topic culture media
pH and osmolality
temperature
oxygen tension
cryopreservation and vitrification
birth defects
url https://www.mdpi.com/1648-9144/61/7/1194
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