精蟲來源與胎兒畸形率並無明顯關聯

大規模統計顯示，IVF 或 ICSI懷孕生產之胎兒其畸形率並無統計差異(3.8 vs 3.4%)
精蟲來源(精液，睪丸，副睪)與胎兒畸形率並無明顯關聯

http://humrep.oxfordjournals.org/content/17/3/671.full

Neonatal data on a cohort of 2889 infants born after ICSI (1991–1999) and of 2995 infants born after IVF (1983–1999)

1. Maryse Bonduelle1,4, 
2. Inge Liebaers1, 
3. Veerle Deketelaere1,
4. Marie-Paule Derde2, 
5. M. Camus3, 
6. Paul Devroey3 and
7. André Van Steirteghem3

+Author Affiliations

1. ¹Centre for Medical Genetics,
2. ²Centre for Biostatistics and
3. ³Centre for Reproductive Medicine, Dutch-speaking Brussels Free University (VUB), Brussels, Belgium

• Accepted November 1, 2001.

 

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Abstract

BACKGROUND: To evaluate the safety of ICSI, this study compared data of IVF and ICSI children by collecting data on neonatal outcome and congenital malformations during pregnancy and at birth. METHODS: The follow-up study included agreement to genetic counselling and eventual prenatal diagnosis, followed by a physical examination of the children after 2 months, after 1 year and after 2 years. 2840 ICSI children (1991–1999) and 2955 IVF children (1983–1999) were liveborn after replacement of fresh embryos. ICSI was carried out using ejaculated, epididymal or testicular sperm. RESULTS: In the two cohorts, similar rates of multiple pregnancies were observed. ICSI and IVF maternal characteristics were comparable for medication taken during pregnancy, pregnancy duration and maternal educational level, whereas maternal age was higher in ICSI and a higher percentage of first pregnancies and first children born was observed in the ICSI mothers. Birthweight, number of neonatal complications, low birthweight, stillbirth rate and perinatal death rate were compared between the ICSI and the IVF groups and were similar for ICSI and IVF. Prematurity was slightly higher in the ICSI children (31.8%) than in the IVF children (29.3%). Very low birthweight was higher in the IVF pregnancies (5.7%) compared with ICSI pregnancies (4.4%). Major malformations (defined as those causing functional impairment or requiring surgical correction), were observed at birth in 3.4% of the ICSI liveborn children and in 3.8% of the IVF children (P = 0.538). Malformation rate in ICSI was not related to sperm origin or sperm quality. The number of stillbirths (born │20 weeks of pregnancy) was 1.69% in the ICSI group and 1.31% in the IVF group. Total malformation rate taking into account major malformations in stillborns, in terminations and in liveborns was 4.2% in ICSI and 4.6% in IVF (P = 0.482). CONCLUSIONS: The comparison of ICSI and IVF children taking part in an identical follow-up study did not show any increased risk of major malformations and neonatal complications in the ICSI group.