This commentary focuses on assisted reproductive technologies and their impact on pregnancy outcomes, specifically multiple births, prematurity, and birth defects. Issues of informed consent and the ethical application of these technologies are also addressed. We call for a multidisciplinary review of assisted reproductive technologies given their increasing influence in the disciplines of maternal fetal medicine, neonatology, and medical genetics. We are concerned with increasing medical resource utilization given current health-care disparities. Despite professional recommendations suggesting limitations in multiple embryo transfer, there has not been substantial oversight in adherence to these guidelines. Without adequate stewardship, it is a concern that assisted reproductive technologies will contribute to increasing rates of prematurity, low birthweight infants, and birth defects. It will continue to divert a disproportionate share of medical resource utilization. We advance suggestions to reduce the health-care impact and disparities with greater focus on the well-being of infants born via assisted reproductive technologies.

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