ICSI Kids Show No Developmental Delays
Dec. 19, 2003 -- New research offers the most reassuring
evidence yet of the normal development of children conceived using an assisted
reproduction technique. The study found no developmental delays in
preschool-aged kids born to infertile parents who underwent intracytoplasmic
sperm injection (ICSI).
While there remain some concerns that ICSI babies could face
some long-term health issues, no significant problems have surfaced so far, an
assisted reproduction expert tells WebMD. The technique, used to overcome male
infertility, is just over a decade old.
"The oldest ICSI child is now only about 11, and most of
the studies have involved babies or very young children," Society for
Assisted Reproductive Technology president Owen Davis, MD, tells WebMD.
"These studies have been very reassuring, but I would be the first to say
that it is incumbent on us and others to continue to follow these
ICSI is commonly used in cases of severe male infertility.
Instead of relying on nature, conception is done outside the womb. The sperm is
simply injected into an egg manually during in vitro fertilization (IVF) and
then re-implanted into the partner's womb.
Early concerns about the procedure involved fears that the
sperm injection process might damage the embryo and cause birth defects and
other problems relating to poor quality sperm. A widely publicized study,
reported earlier this year, did find a slight increase in birth defects among
children conceived through assisted reproduction. But there was no evidence
that sperm injection, in particular, was associated with increased risk.
Another concern, which Davis says is probably better founded,
is that men who are infertile for genetic reasons could pass their infertility
on to their male offspring. He adds that most fertility clinics now offer
genetic counseling to infertile men to identify sex chromosome
"Because these children are still so young, it will
probably take awhile to figure out just how common this is," says Davis,
who is associate director of the IVF program at Cornell Medical College in New
No Increased Risk
In the new study, published in the December issue of the
journal Fertility and Sterility, developmental outcomes among 66
children conceived using ICSI and IVF were compared with those of 52 children
conceived through IVF alone and 59 naturally conceived children. All three
groups were matched as closely as possible in terms of age, sex, race, size at
birth, and socioeconomic status. Intellectual ability was assessed during four
separate home visits -- at ages 9 months, 18 months, 3 years, and 5 years.
The overall health of ICSI children was no different from that
of the other children. When differences in parental education were adjusted
for, the ICSI children were also found to be similar in terms of intellectual
"Our data tend to support the safety of the ICSI
procedure," researcher Isabelle Place, MSc, and colleagues of Brussels
Erasme Hospital wrote. "ICSI-conceived children do not seem at increased
risk of intellectual impairment or learning difficulties, and this appears to
be the case over the whole preschool period."
The researchers say they agree, however, that ICSI kids must
continue to be followed as they reach school age and beyond. They noted that
larger studies are also needed to determine if subtle developmental differences
exist between ICSI kids and other children.