Behavioral, cognitive, and motor performance and physical development of five-year-old children who were born after intracytoplasmic sperm injection with the use of testicular sperm

Five-year-old children born after TESE- ICSI assessed significantly better on behavioral and cognitive performance and significantly worse on motor performance--though still in normal range--than the general population.

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Volume 106, Issue 7, Pages 1673-1682

Authors:

Aukje M. Meijerink, M.D., Liliana Ramos, Ph.D., Anjo J.W.M. Janssen, Ph.D., Nienke M. Maas–van Schaaijk, Ph.D., Andreas Meissner, M.D., Sjoerd Repping, M.D., Ph.D., Monique H. Mochtar, M.D., Ph.D., Didi D.M. Braat, M.D., Ph.D., Kathrin Fleischer, M.D., Ph.D.

Abstract:

Objective

To evaluate at the age of 5 years the behavioral, cognitive, and motor performance and physical development of children born after testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI).

Design

A prospective longitudinal cohort study.

Setting

Two university medical centers.

Patient(s)

A total of 103 5-year-olds who were born after TESE-ICSI.

Intervention(s)

The follow-up of the children was performed by questionnaires at birth and again at 1 year and at 4 years of age. Five-year-old children were invited for individual assessment. Behavioral performance was assessed with the use of the Child Behavior Checklist for parents and teachers. Cognitive performance was assessed with the use of the Dutch Wechsler Preschool and Primary Scale of Intelligence test, 3rd version. Motor performance was assessed with the use of the Dutch Movement Assessment Battery for Children, 2nd version. Physical development was assessed by means of physical examination and medical history.

Main Outcome Measure(s)

Behavioral, cognitive, and motor performance and physical development.

Result(s)

Eighty-nine children were completely assessed, and 14 were partially assessed at the age of 5 years. The 5-year-old cohort assessed significantly better on behavioral and cognitive performance and significantly worse on motor performance—but still in the normal range—compared with the theoretic distribution in the general population. Four children (3.8%) of the 5-year-old cohort had developmental problems/delays. Two of them were previously diagnosed with a form of autism (pervasive developmental disorder—not otherwise specified). Two children had developmental problems based on our behavioral, cognitive, and/or motor assessments.

Conclusion(s)

The long-term effects on development and health in children born after TESE-ICSI procedures seem to be reassuring.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

2 Comments

Go to the profile of Mary Samplaski
Mary Samplaski over 3 years ago

I wonder if the effect that is seen is due to advanced paternal age, and not the ICSI technology itself. I suspect that due to the small number of children included, this was not able to be assessed.

Go to the profile of T. Mike Hsieh
T. Mike Hsieh over 3 years ago

Interesting study but will require long term follow-up to assess the significance and safety of TESE-ICSI. However, with what's known about the potential adverse effects of fertility treatment on the offspring, more emphasis should be placed on treating male factor infertility to decrease the complexity of ART.