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Prospective follow-up study of 423 children born after intracytoplasmic sperm injection
M Bonduelle1, J Legein, A Buysse
1Centre for Medical Genetics, Medical Campus, Dutch-speaking Brussels Free University, (Vrije Universiteit Brussel), Belgium.
Insights
This study followed 423 children born via intracytoplasmic sperm injection (ICSI). Major malformation rates were 3.3%, comparable to general population data, suggesting ICSI safety.
Area of Science:
- Reproductive Medicine
- Pediatric Genetics
- Developmental Pediatrics
Background:
- Intracytoplasmic sperm injection (ICSI) is an assisted reproductive technology.
- Evaluating the long-term safety and developmental outcomes of children born after ICSI is crucial.
Purpose of the Study:
- To assess the safety of ICSI by evaluating karyotypes, congenital malformations, growth, and development in children.
- To compare outcomes in ICSI-conceived children with general population data.
Main Methods:
- Prospective follow-up study of 423 children born after ICSI (1991-1994).
- Data collected via pediatric-geneticist visits at birth/2 months, 1 year, and 2 years.
- Included physical examinations for malformations and psychomotor evaluations.
- Prenatal diagnosis for karyotyping was performed.
Main Results:
- 293 karyotypes analyzed; 0.3% abnormal, 4 benign familial structural aberrations (paternally inherited).
- 14 major malformations (3.3%) observed, within the expected range.
- 14 children (4 multiples) showed neurological/developmental issues at 2 months.
Conclusions:
- The rate of major malformations in children born after ICSI appears comparable to general population data.
- Further evaluation is needed to draw definitive conclusions on ICSI safety.
- ICSI outcomes require ongoing monitoring and comparison with assisted reproduction registers.
Abstract:
In order to evaluate the safety of the intracytoplasmic sperm injection (ICSI) procedure, a prospective follow-up study of 423 children born after ICSI was carried out. The aim of this study was to compile data on karyotypes, congenital malformations, growth parameters and developmental milestones. Before starting the infertility treatment, couples were asked to participate in a follow-up study including genetic counselling and prenatal diagnosis. The follow-up study of the child was based on a visit to the paediatrician-geneticist at birth or at 2 months of age, at 1 year and at 2 years of age when a physical examination for major and minor malformations and a psychomotoric evaluation were done. Between April 1991 and September 1994, 320 pregnancies obtained after ICSI led to the birth of 423 children (222 singletons, 186 twins and 15 triplets). Prenatal diagnosis determined a total of 293 karyotypes, one of which was abnormal (0.3%), and four were benign familial structural aberrations, all inherited from the paternal side. A total of 14 (3.3%) major malformations were observed, defined as those causing functional impairment or requiring surgical correlation. Neurological or developmental problems at the age of 2 months were found in 14 children, four of whom were multiples. Compared to most registers of children born after assisted reproduction and to registers of malformations in the general population, the figure of 3.3% major malformations is within the expected range. Before drawing any firm conclusion, further careful evaluations of the available data are necessary.