Children Born After Intracytoplasmic Sperm Injection Compared with Spontaneously Conceived Children a Prospective Study

Objective: To study the outcome of ICSI conceived children in our IVF center; their growth, their psychomotor development and to find out possible birth defects and genetic anomalies. Material and Methods: This is a prospective survey about ICSI conceived children and naturally conceived children in our IVF center over the period between 2007 and 2012. One hundred ICSI children aged between 2 and 6 years were invited in order to get a thorough physical examination and to undergo ultrasound imaging and genetic explorations for birth defects. One hundred naturally conceived children paired by age and sexduring the same period were taken as a control population. Results: The comparison of both ICSI and natural conception groups showed that the rate of prematurity was higher in the ICSI group with 50% vs 6% in the natural conception group, p<0.05.The rate of low birth weight was also higher in the ICSI group 35% vs 4% in the natural conception group, p<0,05. In the ICSI group, no child had slow growth or slow psychomotor development. 4% of the major birth defects were found in the ICSI group and 2% in the control group, the difference was not significant (p=0.52). These defects were essentially urogenital, orthopedic and facial. In both groups, the affected children were boys. The rate of minor birth defects found in the ICSI children is significantly higher than that in control group (23% vs 4%; p<0.05). These malformations were mainly facial, cardiac, gastrointestinal, orthopedic, neurological, urogenital and inguinal hernia type. In the ICSI group, there was a male predominance (sex ratio=1.3) without any significant difference, while in the control group there was no sex predominance. As for genetic anomalies, 3% of balanced genetic defects were detected in the ICSI children, 1% of which were in the sexual chromosomes and 2% in the autosomes. These anomalies were found in 2 boys and one girl without any significant difference. Conclusion: This work is greatly reassuring about the future of ICSI children. Larger series with long term follow-up are needed as an only guarantee in assessing the safety of ICSI technique.