While cardiovascular dysfunction is clearly associated with IVF, the underlying mechanisms remain unknown.  

Controlled laboratory studies have found cardiovascular abnormalities also exist in mouse models of IVF, which suggests cardiovascular dysfunction originates from the IVF process itself

Problems could occur at any stage of IVF:  ovarian hyperstimulation, oocyte extraction, in vitro fertilization, in vitro culture (typically for 5 days), and embryo transfer.  

While there is evidence that all of these factors influence offspring cardiovascular structure and function, in vitro culture per se is emerging as a crucial step.  

In particular, selection of the nutritional media for embryo culture in vitro is vital for embryonic viability and health, and the gradual optimisation of the media is one of the reasons IVF success rates have improved.  

However, similar to other in vitro environments, the conditions do not faithfully recapitulate the in vivo scenario, and importantly

Furthermore, there are dramatic differences in the nutrient composition and oxygen saturation of the culture media between different IVF clinics.  V

Variation in the culture environment can have major clinical implications due to the phenomenon of developmental programming, whereby environmental stress during development can alter the developmental trajectory of organisms, leading to disease susceptibility in adulthood.  T

These observations have recently led researchers to speculate that cardiovascular dysfunction in IVF offspring may originate from in vitro programming induced by the embryonic culture conditions.