BACCH and child development and disability
Archives of Disease in Childhood
Aims: To investigate the physical and neurodevelopmental wellbeing of ICSI, conventional IVF and naturally conceived controls five year olds. Methods: IVF and ICSI children were recruited through fertility clinics, naturally conceived children were recruited through schools/ nurseries. Children were singleton, first born and caucasian. A paediatrician ascertained a sociodemographic, medical and developmental history and performed a physical examination including visual testing, pure tone
... try, measurement of growth and ascertainment of congenital abnormalities. A psychologist (who was blinded to conception type) assessed the child using WPPSI-R, McCarthy, and Bene-Anthony family relations test. Results: 188 ICSI, 159 IVF and 163 controls were assessed. A range of sociodemograhic factors, including social class, parental level of education, maternal smoking, and parental drinking were comparable between groups. Mean maternal age of study children, 34.4 years, was comparable to IVF group, 35.2 years, but both were significantly older than naturally conceived controls, 32.0 years (p=0.0001). There was no sex bias, but study children, 5.06 years, and control children, 5.02 years, were slightly older than IVF children, 4.96 years (p=0.01). Study children were born slightly less mature at 38.6 vs 39.2 weeks for IVF and controls. Height, weight and head circumference were not statistically different at examination. There was no increase in hospital admissions in either group and the causes of childhood illnesses and surgery were no different. Combined major and minor congenital abnormality rates were also comparable (ICSI 13/45, IVF 5/47, control 9/32). WPPSI-R, McCarthy and Bene-Anthony scores were comparable and around the mean for age. IVF children were less likely to be left handed: 5.5% ICSI, 4.8% controls, 3.8% IVF (p=0.05). Conclusions: Evidence to date in this ongoing UK project suggests that when a study is designed to exclude confounding variables (eg prematurity, higher order births), ICSI per se appears safe. However, a much larger cohort is required to definitively address the risk of congenital abnormalities.