Prospective follow-up study of 423 children born after intracytoplasmic sperm injection

In order to evaluate the safety of the intracytoplasmic sperminjection (ICSI) procedure, a prospective follow-up study of423 children born after ICSI was carried out. The aim of thisstudy was to compile data on karyotypes, congenital malformations,growth parameters and developmental milestones. Before startingthe infertility treatment, couples were asked to participatein a follow-up study including genetic counselling and prenataldiagnosis. The follow-up study of the child was based on a visitto the paediatrician-geneticist at birth or at 2 months of age,at 1 year and at 2 years of age when a physical examinationfor major and minor malformations and a psychomotoric evaluationwere done. Between April 1991 and September 1994, 320 pregnanciesobtained after ICSI led to the birth of 423 children (222 singletons,186 twins and 15 triplets). Prenatal diagnosis determined atotal of 293 karyotypes, one of which was abnormal (0.3%), andfour were benign familial structural aberrations, all inheritedfrom the paternal side. A total of 14 (3.3%) major malformationswere observed, defined as those causing functional impairmentor requiring surgical correction. Neurological or developmentalproblems at the age of 2 months were found in 14 children, fourof whom were multiples. Compared to most registers of childrenborn after assisted reproduction and to registers of malformationsin the general population, the figure of 3.3% major malformationsis within the expected range. Before drawing any firm conclusion,further careful evaluations of the available data are necessary.