title: Systemic and pulmonary vascular dysfunction in children conceived by assisted reproductive technologies.
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 about the potential consequences of ART on the long-term health of the offspring.
  
  
  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% smaller in ART than in control children (6.7 ± 1.6% versus 8.6 ± 1.7%; P<0.0001), whereas endothelium-independent vasodilation was similar in the 2 groups. Carotid-femoral pulse-wave velocity was significantly (P<0.001) faster and carotid intima-media thickness was significantly (P<0.0001) greater in children conceived by ART than in control children. The systolic pulmonary artery pressure at high altitude (3450 m) was 30% higher (P<0.001) in ART than in control children. Vascular function was normal in children conceived naturally during hormonal stimulation of 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.
  
  
  BACKGROUND
  URL: www.clinicaltrials.gov. Unique identifier: NCT00837642.
authors.affiliation: Swiss Cardiovascular Center Bern, University Hospital, Bern, Freiburgstrasse, BHH A 143, Bern, 3010, Switzerland. urs.scherrer2@insel.ch
authors.forename: Urs
authors.initials: U
authors.lastname: Scherrer
authors.forename: Stefano F
authors.initials: SF
authors.lastname: Rimoldi
authors.forename: Emrush
authors.initials: E
authors.lastname: Rexhaj
authors.forename: Thomas
authors.initials: T
authors.lastname: Stuber
authors.forename: Hervé
authors.initials: H
authors.lastname: Duplain
authors.forename: Sophie
authors.initials: S
authors.lastname: Garcin
authors.forename: Stefano F
authors.initials: SF
authors.lastname: de Marchi
authors.forename: Pascal
authors.initials: P
authors.lastname: Nicod
authors.forename: Marc
authors.initials: M
authors.lastname: Germond
authors.forename: Yves
authors.initials: Y
authors.lastname: Allemann
authors.forename: Claudio
authors.initials: C
authors.lastname: Sartori
mesh_terms: D000293:Adolescent; D000328:Adult; D001916:Brachial Artery / Q000502:physiology; D059168:Carotid Intima-Media Thickness; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011652:Pulmonary Circulation; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects*; D014652:Vascular Diseases / Q000209:etiology*; D014664:Vasodilation