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ICSI Kids Show No Developmental Delays

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WebMD Health News

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 kids."

Concerns

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 abnormalities.

"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 York.

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 development.

"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.

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