Human Reproduction, Vol. 18, No. 10, 2067-2072,
October 2003
© 2003 European Society of Human Reproduction and Embryology
Children conceived using ICSI do not have an increased risk of delayed mental development at 5 years of age*
Departments of 1 Obstetrics and Gynaecology and 2 Psychological Medicine, University of Sydney Northern Clinical School, and 3 Department of Neonatology, Royal North Shore Hospital, St Leonards, NSW, Australia
4 To whom correspondence should be addressed at: P.O. Box 537, Crows Nest, NSW, 1585, Australia. e-mail: gleslie{at}med.usyd.edu.au
BACKGROUND: Concerns about possible adverse outcomes for children conceived using ICSI were highlighted in 1998 when 1-year-old ICSI children were found to be at increased risk (relative risk = 9.2) of delayed mental development compared with children conceived naturally or using IVF. As the findings were biologically plausible, it was considered important to reassess child development when a more accurate measure of long-term cognitive ability could be obtained. METHODS: The mental development of 97 ICSI, 80 IVF and 110 naturally conceived (NC) children at 5 years of age was assessed using intelligence quotients (IQ) obtained from the Wechsler Preschool and Primary Scales of Intelligence. RESULTS: The mean full-scale IQ was 110 ± 18 for ICSI, 111 ± 13 for IVF and 114 ± 13 for NC children (P = 0.21, non-significant). ICSI children were not at increased risk for delayed (full-scale IQ <85) cognitive development (ICSI 5.2%, IVF 2.5%, NC 0.9%; P = 0.18, non-significant). The only significant independent predictor of below-average full-scale IQ on multivariate analysis was lower maternal education level. CONCLUSIONS: These findings suggest that the genetic influence of parental cognitive ability is more important than the mode of conception in determining the long-term intellectual ability of children conceived using ICSI.
Key words: child development/conception mode/ICSI/intelligence quotient/IVF
* The results of this study were presented in part at the18th Annual Meeting of the European Society for Human Reproduction and Embryology in July 2002 (presentation received award for the best presentation by an established clinician) and the 21st Annual Meeting of the Fertility Society of Australia in October 2002 (presentation received award for the best clinical presentation).
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