Human Reproduction, Vol. 14, No. 9, 2404-2410,
September 1999
© 1999 European Society of Human Reproduction and Embryology
Pregnancies, growth and development of children conceived by subzonal injection of spermatozoa
1 Laboratoire de Biologie de la Reproduction, Université Paris V–Hôpital Cochin, 123, bd du Port-Royal, 75014 Paris, 2 Laboratoire de Biologie de la Reproduction, Université Paris XIII, 74, rue Marcel Cachin, 93017 Bobigny, Service d'Histologie Embryologie Cytogénétique, Hôpital Jean Verdier, 93140 Bondy, 3 Service de Gynécologie–Obstétrique, Hôpital Saint-Vincent de Paul, 82, avenue Denfert Rochereau, 75674 Paris Cédex 14, 4 Service de Médecine de la Reproduction, Hôpital Jean Verdier: avenue du 14 Juillet, 93140 Bondy, 5 Service de Gynécologie–Obstétrique, Hôpital Antoine Béclère, 157, rue de la Porte de Trivaux, 92141 Clamart Cédex, 6 Laboratoire de Biologie de la Reproduction, Institut Mutualiste Montsouris, 42 bd Jourdan, 75014 Paris Cédex and 7 Service de Gynécologie–Obstétrique, Hôpital Cochin–Port-Royal, 123, bd du Port-Royal, 75014 Paris, France
Subzonal injection of spermatozoa (SUZI) was one of the first micromanipulation techniques efficient in treating male factor infertility and unexplained in-vitro fertilization failures. The aim of this retrospective study was to evaluate the in-vitro development of embryos conceived by SUZI, the obstetric outcome, the rate of congenital malformations and subsequent follow-up in children. Fifty-five pregnancies were obtained between 1991 and 1994 (54 after fresh embryos were transferred and one after cryopreserved embryos were transferred). Among the 50 clinical pregnancies, there were seven miscarriages (14%) and two ectopic pregnancies (4%). Among the 41 resulting evolutive pregnancies, the discovery of one anencephaly led to a medical abortion. Forty deliveries including six twin pregnancies occurred, leading to the births of 45 live neonates and one stillbirth. The gender distribution of the offspring included 17 males and 29 females (ratio 0.59:1). Birth weight, length and head circumference were within the expected ranges. Two children presented a malformation: the first one had one thumb with congenital shelf and the second a polymalformative neurological syndrome. Growth curves were normal for all these children except one (weight above the 2 SD curve). Medical follow-up detected no pathological features in these children apart from a physical disability in one girl. In this small series a 4.2% rate of malformation was observed, particularly affecting the neural tube, in SUZI offspring. However, no firm conclusions can be drawn since the study was carried out on a small cohort. SUZI is no longer performed but these observations suggest that it is necessary to collect extensive data about children conceived by microfertilization.
Key words: assisted reproductive techniques/children/congenital malformation/pregnancies/subzonal injection