Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China.
J Zhejiang Univ Sci B. 2013 Nov;14(11):947-60. doi: 10.1631/jzus.B1300101.
Over the course of the past 35 years, assisted reproductive technologies (ARTs) have been increasingly used worldwide, while debates on their safety have been generated. Birth defects and imprinting disorders were reported in previous research. Thus, the psychological development of children born following ARTs has become a major concern nowadays. This review gives a systematic view of psychological well-being of children conceived by different types of ART, including in vitro fertilization, intracytoplasmic sperm injection (ICSI), preimplantation genetic diagnosis/screening, and in vitro maturation. The previous studies are analyzed in three sections: (1) cognitive, motor, and language developments, (2) behavior problems and socio-emotional development, and (3) parent-child relationship. We conclude that although the majority of the studies on cognitive, motor, and language developments reported comparable achievements in the ART group vs. the naturally conceived group, lower intelligence quotient (IQ) scores, worse visual-motor ability or locomotor development, and delayed receptive language competence were found in the ART group. The results on the socio-emotional development were reassuring. As for the behavior problems, a higher prevalence of behavior problems existed in ART children; moreover, ICSI children were found to be at a higher risk of autism than the general population. Meanwhile, ART parents tended to have positive parental attitudes and be more protective of their children. Some suggestions for further research are also given in this review.
在过去的 35 年中,辅助生殖技术(ART)在全球范围内得到了越来越多的应用,同时也引发了对其安全性的争论。以前的研究报告了出生缺陷和印迹障碍。因此,如今ART 所生儿童的心理发展成为一个主要关注点。这篇综述从认知、运动和语言发展、行为问题和社会情感发展以及亲子关系三个方面系统地阐述了不同类型的 ART(包括体外受精、胞浆内精子注射(ICSI)、胚胎植入前遗传学诊断/筛查和体外成熟)所孕育的儿童的心理健康状况。对以前的研究进行了分析:(1)认知、运动和语言发展;(2)行为问题和社会情感发展;(3)亲子关系。我们的结论是,虽然大多数关于认知、运动和语言发展的研究报告表明,ART 组与自然受孕组在这方面的表现相当,但在 ART 组中发现了较低的智商(IQ)得分、较差的视觉运动能力或运动发育迟缓以及接受性语言能力延迟。社会情感发展的结果令人欣慰。至于行为问题,ART 儿童中存在更高的行为问题发生率;此外,与一般人群相比,ICSI 儿童患自闭症的风险更高。同时,ART 父母往往对孩子持积极的态度,更保护孩子。在这篇综述中,还提出了一些进一步研究的建议。