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Hum. Reprod. Advance Access published online on March 15, 2007
Human Reproduction, doi:10.1093/humrep/dem040
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© The Author 2007. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Matched follow-up study of 5–8 year old ICSI-singletons: comparison of their neuromotor development to IVF and naturally conceived singletons

Marjolein Knoester1,3, Jan P. Vandenbroucke2, Frans M. Helmerhorst2,3, Lucette A.J. van der Westerlaken3, Frans J. Walther1, Sylvia Veen On behalf of the Leiden Artificial Reproductive Techniques Follow-up Project (L-art-FUP)1,4

1 Department of Paediatrics, Neonatal Center, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands 2 Department of Clinical Epidemiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands 3 Department of Gynaecology, Division of Reproductive Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands

4 Correspondence address: Department of Paediatrics (J6-S), Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands. Tel: +31 (0) 71 526 2909; Fax: +31 (0) 71 524 8199; E-mail: s.veen{at}lumc.nl

BACKGROUND: Intracytoplasmic sperm injection (ICSI) is an invasive technique of artificial reproduction. We investigated the effect of ICSI on neuromotor development in 5–8 year old singletons.

METHODS: We did a follow-up of ICSI-singletons born between 1996 and 1999 after treatment in the Leiden University Medical Center and compared them with matched controls born after in vitro fertilization (IVF) and natural conception (NC). Children underwent a thorough neurological examination that focused on minor neurological dysfunction (MND).

RESULTS: There were no differences in outcome between ICSI (n = 81) and IVF-children (n = 81), all born at term: MND prevalence 66.3% versus 61.3%, prevalence ratio (PR) 1.08 [0.83; 1.29]. MND prevalence among all ICSI-children (n = 87) was higher than among NC-controls (n = 85) (66.3% versus 50.6%, PR 1.31 [1.02; 1.55]). After adjustment for maternal age and parity, the PR remained elevated but was no longer statistically significant (adjusted PR 1.22 [0.86; 1.52]). When comparing only term ICSI and NC-children (n = 81; n = 85), the PR adjusted for maternal age and parity was 1.20 [0.83; 1.51].

CONCLUSIONS: Neuromotor outcome of 5–8 year old singletons born at term after ICSI or IVF was similar; ICSI-children (both the total group and term children only) deviated slightly from NC-controls. Part of this effect was explained by a difference in parity, but not prematurity.

Key words: child/development/ICSI/IVF/neurological examination

Submitted on September 22, 2006; resubmitted on January 19, 2007; accepted on January 26, 2007.


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