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Bosch E, Espinós JJ, Fabregues F, Fontes J, García-Velasco J, Llácer J, Requena A, Checa MA, Bellver J. ALWAYS ICSI? A SWOT analysis. J Assist Reprod Genet 2020; 37:2081-2092. [PMID: 32578032 PMCID: PMC7492350 DOI: 10.1007/s10815-020-01836-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 05/17/2020] [Indexed: 12/21/2022] Open
Abstract
PURPOSE Intracytroplasmatic sperm injection (ICSI) is a common procedure used to improve reproductive results, even among couples without male factor infertility. However, the evidence available is still uncertain on the possible advantages and deficiencies that this procedure may have in patients with no formal indication for ICSI. METHODS A SWOT (strengths, weaknesses, opportunities, threats) analysis examines the possible advantages and deficiencies of performing ICSI in these patients with no formal indication. RESULTS The evidence suggests that ICSI is not justified for non-male factor infertile couples requiring in vitro conception. One of the major strengths associated to the procedure is the virtual elimination of cases further complicated by total fertilization failure and a combination between IVF and ICSI on sibling oocytes has been advised in the literature. Greater technical difficulties, higher costs and performing an unnecessary invasive technique in some cases represent some of the weaknesses of the procedure, and questions regarding safety issues should not be ruled out. CONCLUSION Despite the widespread use of ICSI in patients without a formal diagnosis of male factor infertility, evidence demonstrating its effectiveness in this population is still lacking. Additional large and well-designed randomized controlled trials are needed to clarify definitive indications for ICSI in non-male factor infertility.
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Affiliation(s)
- E Bosch
- IVI RMA Valencia, Plaza de la Policía Local, 3, 46015, Valencia, Spain.
| | - J J Espinós
- Fertty, Ausiàs March 25, 08010, Barcelona, Spain
- Universidad Autónoma de Barcelona, Campus de la UAB, Plaza Cívica, s/n, 08193, Bellaterra (Barcelona), Spain
| | - F Fabregues
- Institut Clinic Gynecology, Obstetrics and Neonatology (ICGON), Hospital Clinic, C/Villarroel 160, 08036, Barcelona, Spain
| | - J Fontes
- Hospital Universitario Virgen de las Nieves, Avd Fuerzas Armadas s/n, 18014, Granada, Spain
| | | | - J Llácer
- Instituto Bernabeu Alicante, Av. Albufereta, 31, 03540, Alacant (Alicante), Spain
| | - A Requena
- IVI RMA Madrid, Avda. del Talgo 68, 28023, Madrid, Spain
| | - M A Checa
- Hospital del Mar-Parc de Salut Mar, Paseo Maritimo 25-29, 08005, Barcelona, Spain
| | - J Bellver
- IVI RMA Valencia, Plaza de la Policía Local, 3, 46015, Valencia, Spain
- Departamento de Pediatría, Obstetricia y Ginecología. Facultad de Medicina, Universidad de Valencia, Valencia, Spain
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Catford SR, McLachlan RI, O'Bryan MK, Halliday JL. Long-term follow-up of ICSI-conceived offspring compared with spontaneously conceived offspring: a systematic review of health outcomes beyond the neonatal period. Andrology 2018; 6:635-653. [DOI: 10.1111/andr.12526] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Revised: 06/13/2018] [Accepted: 06/19/2018] [Indexed: 12/17/2022]
Affiliation(s)
- S. R. Catford
- Hudson Institute of Medical Research; Clayton VIC Australia
- Department of Obstetrics and Gynecology; Monash University; Clayton VIC Australia
- Public Health Genetics; Murdoch Childrens Research Institute; Parkville VIC Australia
| | - R. I. McLachlan
- Hudson Institute of Medical Research; Clayton VIC Australia
- Department of Obstetrics and Gynecology; Monash University; Clayton VIC Australia
| | - M. K. O'Bryan
- The School of Biological Sciences; Monash University; Clayton VIC Australia
| | - J. L. Halliday
- Public Health Genetics; Murdoch Childrens Research Institute; Parkville VIC Australia
- Department of Paediatrics; University of Melbourne; Parkville VIC Australia
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Catford SR, McLachlan RI, O'Bryan MK, Halliday JL. Long-term follow-up of intra-cytoplasmic sperm injection-conceived offspring compared with in vitro fertilization-conceived offspring: a systematic review of health outcomes beyond the neonatal period. Andrology 2017. [DOI: 10.1111/andr.12369] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- S. R. Catford
- Hudson Institute of Medical Research; Clayton Vic. Australia
- Department of Obstetrics and Gynecology; Monash University; Clayton Vic. Australia
- Public Health Genetics; Murdoch Childrens Research Institute; Parkville Vic. Australia
| | - R. I. McLachlan
- Hudson Institute of Medical Research; Clayton Vic. Australia
- Department of Obstetrics and Gynecology; Monash University; Clayton Vic. Australia
- Monash IVF Group Pty Ltd; Richmond Vic. Australia
| | - M. K. O'Bryan
- Department of Anatomy and Developmental Biology; Development and Stem Cell Program of Monash Biomedicine Discovery Institute; Monash University; Clayton Vic. Australia
| | - J. L. Halliday
- Public Health Genetics; Murdoch Childrens Research Institute; Parkville Vic. Australia
- Department of Paediatrics; University of Melbourne; Parkville Vic. Australia
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Jin R, Bao J, Tang D, Liu F, Wang G, Zhao Y, Bai G, Liu Y, Wang Y, Liu L, Zhao J. Outcomes of intracytoplasmic sperm injection using the zona pellucida-bound sperm or manually selected sperm. J Assist Reprod Genet 2016; 33:597-601. [PMID: 26941098 DOI: 10.1007/s10815-016-0676-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 02/08/2016] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Zona pellucida (ZP)-bound sperm used for intracytoplasmic sperm injection (ICSI) enhances embryo quality, implantation, and clinical pregnancy rates. This study aimed to assess the pregnancy outcomes and clinical significance of ICSI with ZP-bound sperm. METHOD A total of 84 infertile couples who underwent cycles of ICSI following failed in vitro fertilization between June 2012 and February 2014 were enrolled and randomized (1:1): in the treatment group, ICSI was performed using ZP-bound sperm; in the control group, ICSI was performed in a standard manner. Rates of fertilization, cleavage, high-quality embryos, and clinical pregnancy were compared between the two groups. RESULTS There were no significant differences in age, infertile period, gonadotrophin dose, number of metaphase II oocytes, and number of embryo transfers between the two groups (P > 0.05). The clinical pregnancy rate was higher in the treatment group than in the control group, but without statistical significance (60.5 vs. 47.6 %, P > 0.05). No significant differences in the rates of fertilization and cleavage were observed (83.0 vs. 81.6 %, and 96.3 vs. 96.5 %, both P > 0.05), but higher rates of high-quality embryos and useable embryos were observed with ZP-bound sperm compared with controls (66.1 vs. 50.8 % and 76.0 vs. 66.3 %, both P < 0.05). CONCLUSIONS ICSI using ZP-bound sperm might increase the embryo quality and number of useable embryos, possibly improving the clinical pregnancy outcome of ICSI.
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Affiliation(s)
- Rui Jin
- Centre of Assisted Reproduction, Maternal and Children Health Care Hospital of Yinchuan, Yinchuan, 750000, Ningxia, China.
| | - Junhua Bao
- Centre of Assisted Reproduction, Maternal and Children Health Care Hospital of Yinchuan, Yinchuan, 750000, Ningxia, China.
| | - Dawei Tang
- Centre of Assisted Reproduction, Maternal and Children Health Care Hospital of Yinchuan, Yinchuan, 750000, Ningxia, China
| | - Fang Liu
- Centre of Assisted Reproduction, Maternal and Children Health Care Hospital of Yinchuan, Yinchuan, 750000, Ningxia, China
| | - Guoping Wang
- Centre of Assisted Reproduction, Maternal and Children Health Care Hospital of Yinchuan, Yinchuan, 750000, Ningxia, China
| | - Yaqiong Zhao
- Centre of Assisted Reproduction, Maternal and Children Health Care Hospital of Yinchuan, Yinchuan, 750000, Ningxia, China
| | - Gang Bai
- Centre of Assisted Reproduction, Maternal and Children Health Care Hospital of Yinchuan, Yinchuan, 750000, Ningxia, China
| | - Yongjie Liu
- Centre of Assisted Reproduction, Maternal and Children Health Care Hospital of Yinchuan, Yinchuan, 750000, Ningxia, China
| | - Ying Wang
- Centre of Assisted Reproduction, Maternal and Children Health Care Hospital of Yinchuan, Yinchuan, 750000, Ningxia, China
| | - Lili Liu
- Centre of Assisted Reproduction, Maternal and Children Health Care Hospital of Yinchuan, Yinchuan, 750000, Ningxia, China
| | - Jing Zhao
- Centre of Assisted Reproduction, Maternal and Children Health Care Hospital of Yinchuan, Yinchuan, 750000, Ningxia, China
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Zhan QT, Pan PP, Xu XR, Lou HY, Lou YY, Jin F. An overview of studies on psychological well-being in children born following assisted reproductive technologies. J Zhejiang Univ Sci B 2014; 14:947-60. [PMID: 24190441 DOI: 10.1631/jzus.b1300101] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Over the course of the past 35 years, assisted reproductive technologies (ARTs) have been increasingly used worldwide, while debates on their safety have been generated. Birth defects and imprinting disorders were reported in previous research. Thus, the psychological development of children born following ARTs has become a major concern nowadays. This review gives a systematic view of psychological well-being of children conceived by different types of ART, including in vitro fertilization, intracytoplasmic sperm injection (ICSI), preimplantation genetic diagnosis/screening, and in vitro maturation. The previous studies are analyzed in three sections: (1) cognitive, motor, and language developments, (2) behavior problems and socio-emotional development, and (3) parent-child relationship. We conclude that although the majority of the studies on cognitive, motor, and language developments reported comparable achievements in the ART group vs. the naturally conceived group, lower intelligence quotient (IQ) scores, worse visual-motor ability or locomotor development, and delayed receptive language competence were found in the ART group. The results on the socio-emotional development were reassuring. As for the behavior problems, a higher prevalence of behavior problems existed in ART children; moreover, ICSI children were found to be at a higher risk of autism than the general population. Meanwhile, ART parents tended to have positive parental attitudes and be more protective of their children. Some suggestions for further research are also given in this review.
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Affiliation(s)
- Qi-tao Zhan
- Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
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No increase in autism-associated genetic events in children conceived by assisted reproduction. Fertil Steril 2014; 102:388-93. [PMID: 24842673 DOI: 10.1016/j.fertnstert.2014.04.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Revised: 04/13/2014] [Accepted: 04/14/2014] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To understand the rate of genetic events in patients with autism spectrum disorder (ASD) who were exposed to assisted reproduction. DESIGN Case control study using genetics data. SETTING Twelve collaborating data collection sites across North America as part of the Simons Simplex Collection. PATIENT(S) 2,760 children with ASD, for whom 1,994 had published copy number variation data and 424 had published gene mutation status available. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Rates of autism-associated genetic events in children with ASD conceived with assisted reproduction versus those conceived naturally. RESULT(S) No statistically significant differences in copy number variations or autism-associated gene-disrupting events were found when comparing ASD patients exposed to assisted reproduction with those not exposed to assisted reproduction. CONCLUSION(S) This is the first large genetic association to concurrently examine the genotype of individuals with ASD in relation to their exposure to ART versus natural conception, and it adds reassuring evidence to the argument that ART does not increase the risk of ASD.
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Bay B, Mortensen EL, Kesmodel US. Assisted reproduction and child neurodevelopmental outcomes: a systematic review. Fertil Steril 2013; 100:844-53. [PMID: 23810272 DOI: 10.1016/j.fertnstert.2013.05.034] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 05/13/2013] [Accepted: 05/22/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To systematically review the existing literature on neurodevelopmental outcomes in children born after medically assisted reproduction compared with those of children born after spontaneous conception. DESIGN Systematic review. SETTING Not applicable. PATIENT(S) Children born after medically assisted reproduction vs. reference groups of spontaneously conceived children. INTERVENTION(S) Data were reviewed from worldwide published articles, without restrictions as to publication year or language. A total of 80 studies included between 31 and 2,446,044 children. MAIN OUTCOME MEASURE(S) Child neurodevelopmental outcomes categorized as cognitive, behavioral, emotional or psychomotor development, or diagnoses of mental disorders. RESULT(S) For infants, studies on psychomotor development showed no deficits, but few investigated cognitive or behavioral development. Studies on toddlers generally reported normal cognitive, behavioral, socio-emotional, and psychomotor development. For children in middle childhood, development seems comparable in children born after assisted reproduction and controls, although fewer studies have been conducted with follow-up to this age. Very few studies have assessed neurodevelopmental outcomes among teens, and the results are inconclusive. Studies investigating the risk of diagnoses of mental disorders are generally large, with long follow-up, but the results are inconsistent. CONCLUSION(S) It may tentatively be concluded that the neurodevelopment of children born after fertility treatment is overall comparable to that in children born after spontaneous conception.
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Affiliation(s)
- Bjørn Bay
- Section of Epidemiology, School of Public Health, Aarhus University, Aarhus, Denmark.
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Szell AZ, Bierbaum RC, Hazelrigg WB, Chetkowski RJ. Live births from frozen human semen stored for 40 years. J Assist Reprod Genet 2013; 30:743-4. [PMID: 23615727 PMCID: PMC3696447 DOI: 10.1007/s10815-013-9998-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 04/09/2013] [Indexed: 11/25/2022] Open
Affiliation(s)
- Andras Z. Szell
- />Alta Bates IVF Program, 2999 Regent St, Suite 101-A, Berkeley, CA 94611 USA
- />Alta Bates Medical Center, 2450 Ashby Ave, Rm 2711, Berkeley, CA 94611 USA
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9
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Hammarberg K, Wynter K, Fisher J, McBain J, Gibson F, Boivin J, McMahon C. The experience of pregnancy: does age or mode of conception matter? J Reprod Infant Psychol 2013. [DOI: 10.1080/02646838.2013.782606] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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10
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Leze E, Thomaidis L, Kitsiou-Tzeli S, Kanavakis E. Author reply: To PMID 23151857. World J Pediatr 2013; 9:90-1. [PMID: 23389336 DOI: 10.1007/s12519-013-0409-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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11
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Thomaidis L, Kitsiou-Tzeli S, Critselis E, Drandakis H, Touliatou V, Mantoudis S, Leze E, Destouni A, Traeger-Synodinos J, Kafetzis D, Kanavakis E. Psychomotor development of children born after preimplantation genetic diagnosis and parental stress evaluation. World J Pediatr 2012; 8:309-16. [PMID: 23151857 DOI: 10.1007/s12519-012-0374-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2010] [Accepted: 08/08/2011] [Indexed: 12/19/2022]
Abstract
BACKGROUND The increasing number of children conceived following preimplantation genetic diagnosis (PGD) necessitates the evaluation of their motor and cognitive development. The primary study objective was to evaluate the physical, developmental, and neurological outcome of children born after PGD in Greece. In addition, the secondary study objective was to compare the stress levels regarding parental roles between parents of PGD children and those of naturally conceived children. METHODS A cross-sectional study design was applied. The study population consisted of 31 children (aged 2 months to 7.5 years) born after PGD analysis and their parents. The developmental evaluation of children included a detailed physical evaluation and cognitive assessment with the Bayley Scales of Infant Development. The parent stress index was applied to evaluate comparative parental stress levels between those parents of PGD children and those of naturally conceived healthy children. RESULTS High rates of caesarean deliveries, increased incidence of prematurity, multiples and low-birth weight were observed among the 31 PGD children. Overall, 24 of the 31 PGD children had cognitive skills within normal range [general developmental quotient (GDQ): 86-115], while 6 children had lower levels of cognitive skills (GDQ<85). With regard to parental stress, PGD parents reported lower levels of parenting stress as compared to parents of naturally conceived children (P<0.01). CONCLUSIONS The enhanced frequency of poor cognitive and motor skills as well as low parental stress necessitates early detection and intervention for developmental delays among PGD children.
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Affiliation(s)
- Loretta Thomaidis
- Developmental Assessment Unit, Second Department of Pediatrics, P. & A. Kyriakou Children's Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
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Koutra K, Chatzi L, Roumeliotaki T, Vassilaki M, Giannakopoulou E, Batsos C, Koutis A, Kogevinas M. Socio-demographic determinants of infant neurodevelopment at 18 months of age: Mother–Child Cohort (Rhea Study) in Crete, Greece. Infant Behav Dev 2012; 35:48-59. [DOI: 10.1016/j.infbeh.2011.09.005] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2010] [Revised: 09/26/2011] [Accepted: 09/27/2011] [Indexed: 10/16/2022]
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Abstract
Since the birth of the first baby through in vitro fertilisation over 30 years ago, there has been a rapid increase in the number of women using assisted reproductive technologies. New techniques are constantly being introduced and are evolving rapidly. Understanding the long-term impact of these treatments, which have been linked with several potential complications affecting the mother and the child, poses a constant challenge for the scientific community. The main complications discussed in this review include the rare but serious risk of thromboembolic disease particularly in the upper half of the body and a higher risk of pregnancy complications including abnormal placentation, miscarriage, gestational diabetes and hypertensive disorders. A link between assisted conception and a number of genital cancers particularly of the breast, ovary and endometrium has also been suggested, but the evidence is currently inconclusive. A number of foetal and neonatal complications including imprinting disorders, low birth weight, congenital malformations and growth disorders are also discussed.
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Affiliation(s)
- Mostafa Metwally
- The Assisted Conception Unit, Ninewells Hospital, Dundee, Scotland.
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Silva IMD, Lopes RDCS. Reprodução assistida e relação conjugal durante a gravidez e após o nascimento do bebê: uma revisão da literatura. ESTUDOS DE PSICOLOGIA (NATAL) 2009. [DOI: 10.1590/s1413-294x2009000300006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A chegada de um bebê inicia um período de desafios e mudanças para o casal. Quando a gravidez é alcançada a partir da reprodução assistida, soma-se aos desafios já característicos desse período o impacto das experiências próprias a esse contexto. Neste trabalho, são revisadas e discutidas pesquisas que investigaram a relação de casais que recorreram à reprodução assistida, durante a gravidez e os dois primeiros anos do bebê. A revisão da literatura indica semelhanças entre esses casais e aqueles que conceberam naturalmente. No entanto, essas pesquisas tendem a basear-se na avaliação de variáveis específicas, como as relacionadas à satisfação conjugal e a características sociodemográficas, bem como pela ausência de um enfoque desenvolvimental que investigue a história prévia desse casal e suas famílias de origem. Esse enfoque, aliado a uma abordagem que privilegie a descrição das experiências desses casais, poderia contribuir para a compreensão desse contexto.
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Palermo GD, Neri QV, Takeuchi T, Squires J, Moy F, Rosenwaks Z. Genetic and epigenetic characteristics of ICSI children. Reprod Biomed Online 2009; 17:820-33. [PMID: 19079967 DOI: 10.1016/s1472-6483(10)60411-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The outcome of pregnancy and the developmental wellbeing of children conceived from 12,866 consecutive intracytoplasmic sperm injection (ICSI) cycles was assessed. A total of 3277 couples delivered 5891 neonates. There was a higher than normal incidence of de-novo chromosomal abnormalities in a small sample of ICSI offspring. Controlling for maternal age showed that the incidence of low birth weight and gestational length were comparable with the naturally conceived counterpart. Rates of malformation in ICSI offspring ranged from 3.5 to 6.2%. At 3 years of age (n = 811), the proportion of children at risk for developmental delays was 10.4% in ICSI and 10.7% in IVF singletons. However, high order gestations were characterized by 19.4% of the children having compromised development. Epigenetic analysis of assisted reproductive technique conceptuses found minor imprinted gene expression imbalances. ICSI offspring presented with genetic defects that were inherited or arose de novo. Obstetric and neonatal outcomes of singleton pregnancies appeared to be dependent upon maternal age. ICSI and IVF appeared to exert a negative effect on the wellbeing of offspring mainly because of the association with multiple gestations. All assisted reproduction procedures should be monitored for the eventual effect of environmental aggressors on offspring epigenesis.
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Affiliation(s)
- Gianpiero D Palermo
- The Centre for Reproductive Medicine and Infertility, Weill Medical College of Cornell University, New York, NY, USA.
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Goldbeck L, Gagsteiger F, Mindermann I, Ströbele S, Izat Y. Cognitive development of singletons conceived by intracytoplasmic sperm injection or in vitro fertilization at age 5 and 10 years. J Pediatr Psychol 2008; 34:774-81. [PMID: 19036784 DOI: 10.1093/jpepsy/jsn120] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To investigate the cognitive functioning of low-risk singletons born after intracytoplasmic sperm injection (ICSI) or in vitro fertilization (IVF) at the age of 5 or 10 years. METHODS Sixty-nine children (35 ICSI, 34 IVF) participated voluntarily in the study that had been approved by the local IRB. Their intellectual functioning was examined by the Kaufmann Assessment Battery for Children. RESULTS The IQ of the study group fell in the normal range (mean = 98.2; SD = 12.2). ICSI children (IQ = 94.1, SD = 13.8) had statistically lower intellectual abilities compared to IVF children (IQ = 102.0, SD = 9.1; t = -2.81, p = .005), especially in simultaneous mental processing. 23.5% ICSI children, but only 2.9% IVF children (p = .011) had at least borderline delayed cognitive development. CONCLUSIONS Most artificially conceived singletons show a normal cognitive development, however the method of fertilization seems to have an impact on their IQ. ICSI might be associated with the risk for a slightly delayed cognitive development compared to IVF.
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Affiliation(s)
- Lutz Goldbeck
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany.
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Hammarberg K, Fisher J, Wynter K. Psychological and social aspects of pregnancy, childbirth and early parenting after assisted conception: a systematic review. Hum Reprod Update 2008; 14:395-414. [DOI: 10.1093/humupd/dmn030] [Citation(s) in RCA: 165] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Paxson H. Reproduction as spiritual kin work: orthodoxy, IVF, and the moral economy of motherhood in Greece. Cult Med Psychiatry 2006; 30:481-505. [PMID: 17051429 DOI: 10.1007/s11013-006-9028-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Bringing gender and kinship studies together with an anthropology of religion, in this article I demonstrate how urban Greek couples and clinical practitioners in the middle 1990s proceeded with in vitro fertilization (IVF) in the absence of government regulations, and did so with reference to cultural beliefs and social relations consistent with Greek Orthodox religious practice. Drawing on ethnographic observations at an Athens IVF clinic as well as on interviews with former patients, I argue that Athenian women, in particular, engage IVF as a kind of spiritual kin work, normalizing the use of medical techniques with reference to ideologies of motherhood that treat it as a woman's moral achievement and as a source of womanly suffering. Since the period of ethnographic research described here, and despite disapproval of the Greek Orthodox Church, legislation regulating the use of IVF and other methods of medically assisted reproduction has become law. This article reconciles how the Church can officially reject medically assisted means of reproduction that Athenian users have normalized with reference to spiritual beliefs and practices.
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Affiliation(s)
- Heather Paxson
- Anthropology Program, Massachusetts Institute of Technology, Room 66-257, 77 Massachusetts Avenue, Cambridge, MA 02139-4307, USA.
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Abstract
Perinatal outcomes, such as preterm delivery, low birth weight and some obstetric complications, are increased significantly after in-vitro fertilization (IVF) compared with spontaneously conceived pregnancies. The degree of difference is greater for singletons than for twins, especially with regard to preterm delivery which is increased two fold in IVF singletons and by 40% in twins. It is difficult to obtain accurate outcome information because of unmeasured confounders such as smoking status and fetal reduction. It is also unknown whether IVF technologies or patient infertility is the major contributor to adverse outcomes. Birth defects are increased, shown in a number of systematic reviews, and there has been a particular interest in imprinting syndromes. Epigenetic modifications may play a larger role in IVF outcomes, as yet unidentified. There is no apparent increase in adverse outcomes in children up to adolescence, although further studies are needed to examine longer-term risks, including those for cancer.
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Affiliation(s)
- Jane Halliday
- Public Health Genetics, Murdoch Childrens Research Institute, Parkville, 3052 Victoria, Australia.
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Leunens L, Celestin-Westreich S, Bonduelle M, Liebaers I, Ponjaert-Kristoffersen I. Cognitive and motor development of 8-year-old children born after ICSI compared to spontaneously conceived children. Hum Reprod 2006; 21:2922-9. [PMID: 16885388 DOI: 10.1093/humrep/del266] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND As a continuation of two large-scale, multicentre studies on the development of 5-year-old ICSI children, we present results of the follow-up study undertaken on the cognitive and motor development of 8-year-old ICSI children. METHODS Developmental outcomes of 151 8-year-old singletons born through ICSI after 32 weeks of gestation were compared with those of 153 singletons of the same age born after spontaneous conception (SC). Part of this population was seen in a cohort at the age 5 years. Outcome measures include Wechsler Intelligence Scale for Children-Revised (WISC-R) and Movement Assessment Battery for Children (ABC). RESULTS Regarding intellectual functioning, ICSI children tend to obtain significantly higher total (P < 0.01), verbal (P < 0.01) and performance (P < 0.05) intelligence scores than SC children, nevertheless remaining in similar ranges. These effects are small (Cohen's d < 0.50). High maternal educational level stayed in the regression as a factor accounting for some of the variance in total IQ between the groups. In terms of motor development, no significant differences were found between ICSI and SC children regarding overall motor skills, manual, balance and ball skills. CONCLUSION In this follow-up study, ICSI and SC children show a comparable cognitive and motor development until the age of 8 years.
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Affiliation(s)
- L Leunens
- Developmental and Lifespan Psychology, Centre for Medical Genetics, Vrije Universiteit Brussel, Brussels, Belgium.
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Ludwig AK, Sutcliffe AG, Diedrich K, Ludwig M. Post-neonatal health and development of children born after assisted reproduction: A systematic review of controlled studies. Eur J Obstet Gynecol Reprod Biol 2006; 127:3-25. [PMID: 16621225 DOI: 10.1016/j.ejogrb.2006.02.009] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2006] [Accepted: 02/13/2006] [Indexed: 11/21/2022]
Abstract
Long-term follow-up studies on the health and the development of children conceived by assisted reproduction (ART) are mandatory to assess the safety of ART. Meanwhile, different aspects of health of these children have been studied. To put these results together, we performed a systematic review of these publications. A Pubmed search and a hand-search of the abstract books from the annual meeting of the European Society of Human Reproduction and Embryology and the American Society of Reproductive Medicine were performed for controlled studies on the developmental outcome of children after ART, which include a matching for plurality of gestation. Regarding general health, growth, mental and psychomotor development IVF children do not differ from spontaneously conceived (SC) children. An increased need for surgical interventions may be due to an increase in the malformation rate. However, a lower birth weight and lower gestational age compared to matched controls may contribute to some health problems observed. The increased risk of neurological problems found in some large registry-based studies can partly be explained by the higher frequency of twins born, by low birth weight, and by low gestational age also found in singletons. But an effect of IVF, the parents' infertility or other factors not adjusted for in the studies cannot be excluded. In addition to this reporting bias caused by concerned parents cannot be excluded, either. To conclude, children born after assisted reproductive techniques are generally healthy and are developmentally similar to children born after SC. However, low birth weight and prematurity contributes to health care problems. An increase of neurological problems by IVF cannot be excluded. Further prospective studies on the neurological outcome are needed.
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Affiliation(s)
- A K Ludwig
- Department of Gynaecology and Obstetrics, University of Schleswig-Holstein, Campus Lübeck, Germany.
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Lazaratou H, Golse B. Du désir à l'acte : les enfants de la procréation médicalement assistée (PMA). PSYCHIATRIE DE L ENFANT 2006. [DOI: 10.3917/psye.492.0573] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Current World Literature. Curr Opin Obstet Gynecol 2005. [DOI: 10.1097/01.gco.0000169110.00376.bd] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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