Table 1.

Key Methodological Considerations in Studying Children Conceived by Infertility Treatment

Challenges with studies on ART	Primary concerns
Selection of appropriate populations	Using children conceived spontaneously as a comparison poses challenges in discerning whether differences are due to the treatment procedures or the underlying infertility Socio-economic differences in couples who undergo infertility treatment and the general population may limit comparability, and future studies should seek to evaluate differences in socio-economically and racially diverse populations
Confounding	Studies may be confounded by a number of factors, and perhaps most importantly underlying infertility Other factors to consider include: thyroid function, BMI, age, race, SES, nutrition, environment, mental health, health of both parents
Study design	Lack of RCTs Lack of long follow-up in cohort studies
Representativeness	Comparison between studies is often challenging due to protocol heterogeneity in treating infertility (ovarian stimulation, ICSI, ART) and evolving technologies and techniques Technological advances in techniques make any findings today not necessarily relevant for future children conceived by more advanced techniques