A prospective comparative study of 5 year old children (and their families) born after intracytoplasmic sperm injection, conventional in vitro fertilisation or natural conception, and other studies of child/family outcome after in-vitro fertilisation techniques
Objectives: To assess the extent to which exposure to Intracytoplasmic Sperm Injection (ICSI) is associated with significant health, developmental and psychosocial adjustment outcomes. To investigate the incidence of assisted conception in children with Beckwith-Wiedemann syndrome.;Methods: A population case-control study of 510 school age children (and their families) born after ICSI (n=189), conventional in-vitro fertilisation (IVF) (n=158) or natural conception (n=163). Outcome measures included: A full physical examination of the child which included enumeration of physical abnormalities and an assessment of general health. An assessment of childhood IQ using the Weschler Preschool and Primary Scale of Intelligence (WPPSI). An assessment of gross and fine motor skills using the WPPSI and McCarthy Motor Skills tests. Questionnaires to assess of parent-child relationships. A survey of parental attitudes towards disclosing the method of conception to their IVF children. A survey of 160 members of the Beckwith-Wiedemann Syndrome (BWS) support group enquiring about conception.;Results: There was no difference between conception groups for overall physical health or fine/gross motor difficulties. There was evidence of an increase in congenital abnormalities in the assisted reproduction groups. Parent-child relationships were similar between groups. The majority of ICSI / IVF parents wish to disclose the method of conception to their child. There is an increased likelihood of children with BWS being conceived after IVF compared to the general population.;Conclusion: The studies in this thesis are reassuring, in terms of physical and neurodevelopmental health of ICSI children aged 4-5 years and their family relationships. The increase in congenital abnormalities after IVF/ICSI requires further study. Families of assisted conception children wish to disclose conception method to their child but require more support. There is evidence of an increased risk of BWS in children conceived after assisted reproduction.