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Published on: August 19, 2019
Mental development of children conceived using intracytoplasmic sperm injection. The current evidence
1Department of Obstetrics and Gynaecology, University of Sydney Northern Clinical School at Royal North Shore Hospital, Pacific Highway, St Leonards, NSW, Australia. gleslie@med.usyd.edu.au
Insights
Children conceived via intracytoplasmic sperm injection (ICSI) generally show normal mental development. Demographic factors, not ICSI itself, appear to be key determinants of developmental outcomes in these children.
Area of Science:
- Reproductive Medicine
- Developmental Psychology
- Pediatrics
Background:
- Intracytoplasmic sperm injection (ICSI) is an assisted reproductive technology.
- Concerns exist regarding potential developmental risks for children conceived via ICSI.
- Early studies suggested a possible increased risk for developmental delay in ICSI-conceived children.
Purpose of the Study:
- To review and synthesize evidence on the mental development of children conceived using ICSI.
- To clarify the association between ICSI and developmental outcomes.
- To identify factors influencing developmental trajectories in ICSI-conceived children.
Main Methods:
- Systematic review of published studies comparing ICSI children with control groups (IVF and naturally conceived).
- Inclusion of studies with standardized measures of infant or child development.
- Analysis of data from 9 publications involving 969 ICSI children and 828 controls.
Main Results:
- The majority of ICSI-conceived children demonstrate normal mental development.
- Most studies found no significant increased risk for developmental delay in ICSI children compared to controls.
- Demographic factors like maternal education and social class are more influential than ICSI itself.
Conclusions:
- ICSI per se does not appear to be an independent risk factor for delayed child development.
- Developmental outcomes for ICSI children are primarily influenced by socioeconomic and demographic factors.
- Current evidence suggests ICSI is a safe method regarding child mental development.
Abstract:
There are biologically plausible reasons why children conceived using intracytoplasmic sperm injection (ICSI) may be at increased risk for delayed mental development. The first controlled study of mental development in ICSI children which was published in 1998 found 1 year old ICSI children to be at significantly increased risk for developmental delay compared with both in vitro fertilization (IVF) and naturally conceived control children. These results encouraged several groups of investigators to further study developmental outcomes for ICSI children in order to clarify the level of risk, if any. This review considers the currently available evidence from published studies which included control groups and a standardized measure of infant or child development. The 9 publications included in the review include a total of 969 ICSI children and 828 controls (343 IVF, 485 naturally conceived). All studies indicate that the majority of children conceived using ICSI have normal mental development, and most have not found ICSI children to be at increased risk for developmental delay. The evidence to date suggests that ICSI per se is not an independent risk factor for delayed child development, but that demographic factors such as level of maternal education and social class are more important determinants of developmental outcome for ICSI children.
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