Long-term effects on women of assisted reproduction

The long-term health sequelae for women from assisted reproductive technolo gy (ART) have not been studied extensively. There are a number of reasons t hat women's health may be compromised after ART procedures, including the c onsequences of the increased incidence of multiple births, operative delive ries, and preterm infants, the possible adverse effects of the drug regimen s used for ovarian stimulation, and the instrumentation involved in ART pro cedures. In this paper we review the existing literature in these areas. It emphasizes the effects of the drugs used for ovarian stimulation, and in p articular the incidence of cancer among women who have undergone ART. The r eview indicates that there is cause for concern about the long-term effects on women from ART treatments. It highlights the lack of research undertake n in almost all areas related to women's long-term health after ART. In the area of ART and cancer, it draws attention to the lack of conclusive evide nce in relation to the posited association between fertility treatments and cancer, resulting from the limited number of very large studies and the ne ed for longer follow-up periods. We make a number of recommendations regard ing further research that is needed to address the current shortcomings in the published literature.