A multi-centre cohort study of the physical health of 5-year-old children conceived after intracytoplasmic sperm injection, in vitro fertilization and natural conception
A multi-centre cohort study of the physical health of 5-year-old children conceived after intracytoplasmic sperm injection, in vitro fertilization and natural conception
复制标题
DOI：
10.1093/humrep/deh592
复制
发表时间：
2005-02-01
影响因子：
6.1
通讯作者：
Sutcliffe, AG
中科院分区：
文献类型：
--
作者：
Bonduelle, M;Wennerholm, UB;Sutcliffe, AG
背景：全世界有超过100万儿童通过辅助受孕出生。新技术的引入似乎越来越不“自然”，如卵胞浆内单精子注射（ICSI），但几乎没有关于这些儿童超过新生儿期的信息。研究方法：对来自五个欧洲国家的540名ICSI受孕的5岁儿童进行了全面评估，其中沿着有538名匹配的自然受孕儿童和437名标准IVF受孕儿童。结果：在540例接受ICSI检查的儿童中，有63例（4.2%）患有严重的先天性畸形。与自然受孕的儿童相比，ICSI儿童和IVF儿童的主要畸形几率分别为2.77（95%CI 1.41-5.46）和1.80（95%CI 0.85-3.81）;这些估计值几乎不受社会人口因素调整的影响。在ICSI组中观察到的较高发生率部分是由于（男孩）泌尿生殖系统畸形过多。此外，与自然受孕的儿童相比，ICSI和IVF儿童更有可能患有严重的儿童疾病，接受外科手术，需要药物治疗和住院。然而，详细的体格检查显示，两组之间没有进一步的实质性差异。结论：单胎ICSI和IVF 5岁儿童比自然受孕的儿童更可能需要医疗保健资源。对5岁时单胎ICSI和IVF儿童的评估通常令人放心，然而，我们发现ICSI儿童存在更多的重大先天性畸形，ICSI和IVF儿童比自然受孕的儿童更可能需要医疗保健资源。因此，需要对这些儿童进行持续监测。
Background: Over a million children have been born from assisted conception worldwide. Newer techniques being introduced appear less and less 'natural', such as intracytoplasmic sperm injection (ICSI), but there is little information on these children beyond the neonatal period. Methods: 540 ICSI conceived 5-year-old children from five European countries were comprehensively assessed, along with 538 matched naturally conceived children and 437 children conceived with standard IVF. Results: Of the 540 ICSI children examined, 63 (4.2%) had experienced a major congenital malformation. Compared with naturally conceived children, the odds of a major malformation were 2.77 (95% CI 1.41-5.46) for ICSI children and 1.80 (95% CI 0.85-3.81) for IVF children; these estimates were little affected by adjustment for socio-demographic factors. The higher rate observed in the ICSI group was due partially to an excess of malformations in the (boys') urogenital system. In addition, ICSI and IVF children were more likely than naturally conceived children to have had a significant childhood illness, to have had a surgical operation, to require medical therapy and to be admitted to hospital. A detailed physical examination revealed no further substantial differences between the groups, however. Conclusions: Singleton ICSI and IVF 5-year-olds are more likely to need health care resources than naturally conceived children. Assessment of singleton ICSI and IVF children at 5 years of age was generally reassuring, however, we found that ICSI children presented with more major congenital malformations and both ICSI and IVF children were more likely to need health care resources than naturally conceived children. Ongoing monitoring of these children is therefore required.