title: Matched follow-up study of 5-8 year old ICSI-singletons: comparison of their neuromotor development to IVF and naturally conceived singletons.
abstract: BACKGROUND
  Intracytoplasmic sperm injection (ICSI) is an invasive technique of artificial reproduction. We investigated the effect of ICSI on neuromotor development in 5-8 year old singletons.
  
  
  METHODS
  We did a follow-up of ICSI-singletons born between 1996 and 1999 after treatment in the Leiden University Medical Center and compared them with matched controls born after in vitro fertilization (IVF) and natural conception (NC). Children underwent a thorough neurological examination that focused on minor neurological dysfunction (MND).
  
  
  RESULTS
  There were no differences in outcome between ICSI (n = 81) and IVF-children (n = 81), all born at term: MND prevalence 66.3% versus 61.3%, prevalence ratio (PR) 1.08 [0.83; 1.29]. MND prevalence among all ICSI-children (n = 87) was higher than among NC-controls (n = 85) (66.3% versus 50.6%, PR 1.31 [1.02; 1.55]). After adjustment for maternal age and parity, the PR remained elevated but was no longer statistically significant (adjusted PR 1.22 [0.86; 1.52]). When comparing only term ICSI and NC-children (n = 81; n = 85), the PR adjusted for maternal age and parity was 1.20 [0.83; 1.51].
  
  
  CONCLUSIONS
  Neuromotor outcome of 5-8 year old singletons born at term after ICSI or IVF was similar; ICSI-children (both the total group and term children only) deviated slightly from NC-controls. Part of this effect was explained by a difference in parity, but not prematurity.
authors.affiliation: Department of Paediatrics, Neonatal Center, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
authors.forename: Marjolein
authors.initials: M
authors.lastname: Knoester
authors.forename: Jan P
authors.initials: JP
authors.lastname: Vandenbroucke
authors.forename: Frans M
authors.initials: FM
authors.lastname: Helmerhorst
authors.forename: Lucette A J
authors.initials: LA
authors.lastname: van der Westerlaken
authors.forename: Frans J
authors.initials: FJ
authors.lastname: Walther
authors.forename: Sylvia
authors.initials: S
authors.lastname: Veen
mesh_terms: D002648:Child; D002657:Child Development; D005260:Female; D005306:Fertilization; D005307:Fertilization in Vitro; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016472:Motor Neuron Disease / Q000453:epidemiology*; D009048:Motor Skills; D009426:Netherlands / Q000453:epidemiology; D011247:Pregnancy; D015995:Prevalence; D020554:Sperm Injections, Intracytoplasmic