No physical health problems for ICSI children

Dr Kirsty Horsey

Progress Educational Trust

20 June 2006

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[BioNews, London]

Researchers from Belgium have presented evidence at the annual conference of the European Society of Human Reproduction and Embryology (ESHRE) in Prague, Czech Republic, today, to show that children born from intracytoplasmic sperm injection (ICSI) are still developing well 8 years after birth. Some previous studies have reported slight developmental delays - in both cognitive and motor functions - in children born after ICSI. This study, however, looked at physical characteristics of the children, rather than their social and cognitive development.

The scientists undertook detailed physical and neurological examinations of '150 of the world's oldest ICSI children' (76 boys and 74 girls), and compared their findings to a control group of 147 children (76 boys and 71 girls) who were born without their parents having used any form of assisted conception. They found that there was no difference in the children's weight, height, head circumference or Body Mass Index between the two groups. Other results showed little or no difference - physically or neurologically - between the two groups of children in terms of medications taken, chronic diseases or requirements for therapy.

The scientists did find that 10 per cent of the ICSI children had a 'major congenital malformation' (according to the group's own definitions) compared with only 3.3 per cent of the control group. There were 24.1 per cent of ICSI children with a 'minor congenital malformation', compared with 17.2 per cent of the controls. However, when the results were reassessed by an Australian team - using a different set of definitions - the percentages of major and minor malformations decreased dramatically in both groups, showing that it was perhaps the case that the Belgian groups had a wider definition of what constituted a malformation than other groups would use. And, even though major malformations were found more frequently in the ICSI children, most of these were able to be easily corrected by minor surgery.

Dr Florence Belva, a paediatrician and research assistant at the Centre for Medical Genetics at the Vrije University of Brussels, pointed out that 'malformations' similar to those seen in the ICSI children studied also occur in the 'normal' population and can be caused by many factors, including inheritance, environmental factors or disease, for example. She also said that the researchers did not think that the ICSI technique itself was the cause, although suggested that the genetic background and infertility history of the parents (i.e. the factor that may make them need to use ICSI in the first place) may be related.

Overall, she said, the general health of the children studied was 'satisfactory', but added that it was a small study and that there is a need for a larger, multi-centre follow-up study. 'The children represent the first wave born after the introduction of the ICSI technique in 1991', she said, adding that the children were currently being assessed again at the age of 10. 'We need to check them again later at puberty and afterwards at reproductive age', she said, as 'from a reproductive and genetic point of view there are some concerns for the future, mainly because of fertility problems'.

Reproduced with permission from BioNews, an email and online sources of news, information and comment on assisted reproduction and genetics.