{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T23:39:46Z","timestamp":1789342786344,"version":"build-2803163510"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T00:00:00Z","timestamp":1752192000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the impact of different assisted reproductive technology (ART) embryo transfer strategies on neonatal and early childhood health outcomes, focusing on fresh versus frozen transfers and cleavage versus blastocyst stages.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective cohort study analyzing data from Taiwan\u2019s national assisted reproduction database (2013\u20132017).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study included 10,803 ART-conceived singleton births and 894,615 naturally conceived singletons. ART groups were categorized by embryo transfer type: fresh cleavage stage, fresh blastocyst, frozen cleavage stage, and frozen blastocyst. Maternal, paternal, and perinatal outcomes were adjusted using inverse probability of treatment weighting (IPTW). Outcomes included major and minor diseases in offspring, such as ADHD, developmental delays, atopic dermatitis, and respiratory diseases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>ART-conceived children had higher rates of major and minor health conditions compared to naturally conceived peers, particularly preterm birth, ADHD, and developmental delay. No significant differences were observed in major disease incidence between frozen and fresh transfers or cleavage and blastocyst stages. The elevated risks in ART-conceived children may reflect the influence of underlying parental infertility rather than ART procedures alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>While ART is linked to increased risks of certain adverse health outcomes, the choice between embryo transfer strategies has minimal impact on neonatal or early childhood health. These findings underscore the need to optimize ART protocols and perinatal care while addressing the role of parental infertility in shaping offspring health.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1630293","type":"journal-article","created":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T04:11:38Z","timestamp":1752207098000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Impact of embryo transfer strategies on children health outcomes: a retrospective national cohort study in Taiwan"],"prefix":"10.3389","volume":"16","author":[{"given":"Chih-Ting","family":"Chang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih-Feng","family":"Weng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui-Yu","family":"Chuang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Yi","family":"Hsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eing-Mei","family":"Tsai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1017\/mdh.2019.6","article-title":"Looking into the test tube: the birth of IVF on British television","volume":"63","author":"Dow","year":"2019","journal-title":"Med Hist"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15585\/mmwr.ss7104a1","article-title":"Assisted reproductive technology surveillance - United States, 2018","volume":"71","author":"Sunderam","year":"2022","journal-title":"MMWR Surveill Summ"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1008095","article-title":"Reproductive technologies and the risk of birth defects","volume":"366","author":"Davies","year":"2012","journal-title":"N Engl J Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1093\/humrep\/deaa272","article-title":"The risk of birth defects with conception by ART","volume":"36","author":"Luke","year":"2021","journal-title":"Hum Reprod"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1004078","article-title":"Cancer in children born after frozen-thawed embryo transfer: A cohort study","volume":"19","author":"Sargisian","year":"2022","journal-title":"PloS Med"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.48141","article-title":"Neurodevelopmental Disorders in Offspring Conceived via In Vitro Fertilization vs Intracytoplasmic Sperm Injection","volume":"5","author":"Lo","year":"2022","journal-title":"JAMA Netw Open"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1093\/humupd\/dmy033","article-title":"Fresh versus elective frozen embryo transfer in IVF\/ICSI cycles: a systematic review and meta-analysis of reproductive outcomes","volume":"25","author":"Roque","year":"2019","journal-title":"Hum Reprod Update"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2022.10.021","article-title":"Fresh vs. frozen embryo transfer: new approach to minimize the limitations of using national surveillance data for clinical research","volume":"119","author":"Weiss","year":"2023","journal-title":"Fertil Steril"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deae010","article-title":"ESHRE guideline: number of embryos to transfer during IVF\/ICSI\u2020","volume":"39","author":"Alteri","year":"2024","journal-title":"Hum Reprod"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dev203","article-title":"Physical health of singleton children born after frozen embryo transfer using slow freezing: a 3-year follow-up study","volume":"30","author":"Pelkonen","year":"2015","journal-title":"Hum Reprod"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/det440","article-title":"Large baby syndrome in singletons born after frozen embryo transfer (FET): is it due to maternal factors or the cryotechnique","volume":"29","author":"Pinborg","year":"2014","journal-title":"Hum Reprod"},{"key":"B12","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1016\/j.fertnstert.2012.05.019","article-title":"Obstetric and perinatal outcomes in singleton pregnancies resulting from the transfer of frozen thawed versus fresh embryos generated through in vitro fertilization treatment: a systematic review and meta-analysis","volume":"98","author":"Maheshwari","year":"2012","journal-title":"Fertil Steril"},{"key":"B13","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1093\/humupd\/dmx031","article-title":"Is frozen embryo transfer better for mothers and babies? 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