Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, the Netherlands.
Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, the Netherlands.
Fertil Steril. 2016 Dec;106(7):1673-1682.e5. doi: 10.1016/j.fertnstert.2016.09.011. Epub 2016 Oct 25.
To evaluate at the age of 5 years the behavioral, cognitive, and motor performance and physical development of children born after testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI).
A prospective longitudinal cohort study.
Two university medical centers.
PATIENT(S): A total of 103 5-year-olds who were born after TESE-ICSI.
INTERVENTION(S): The follow-up of the children was performed by questionnaires at birth and again at 1 year and at 4 years of age. Five-year-old children were invited for individual assessment. Behavioral performance was assessed with the use of the Child Behavior Checklist for parents and teachers. Cognitive performance was assessed with the use of the Dutch Wechsler Preschool and Primary Scale of Intelligence test, 3rd version. Motor performance was assessed with the use of the Dutch Movement Assessment Battery for Children, 2nd version. Physical development was assessed by means of physical examination and medical history.
MAIN OUTCOME MEASURE(S): Behavioral, cognitive, and motor performance and physical development.
RESULT(S): Eighty-nine children were completely assessed, and 14 were partially assessed at the age of 5 years. The 5-year-old cohort assessed significantly better on behavioral and cognitive performance and significantly worse on motor performance-but still in the normal range-compared with the theoretic distribution in the general population. Four children (3.8%) of the 5-year-old cohort had developmental problems/delays. Two of them were previously diagnosed with a form of autism (pervasive developmental disorder-not otherwise specified). Two children had developmental problems based on our behavioral, cognitive, and/or motor assessments.
CONCLUSION(S): The long-term effects on development and health in children born after TESE-ICSI procedures seem to be reassuring.
在 5 岁时评估经睾丸精子提取（TESE）和胞浆内单精子注射（ICSI）后出生的儿童的行为、认知和运动表现以及身体发育情况。
前瞻性纵向队列研究。
两所大学医学中心。
共 103 名 5 岁时接受 TESE-ICSI 的儿童。
在出生时、1 岁时和 4 岁时通过问卷调查对儿童进行随访。邀请 5 岁的儿童进行个体评估。使用儿童行为检查表（父母和教师用）评估行为表现。使用荷兰韦氏学前和小学智力量表第 3 版评估认知表现。使用荷兰儿童运动评估电池第 2 版评估运动表现。通过体格检查和病史评估身体发育情况。
行为、认知和运动表现以及身体发育情况。
89 名儿童在 5 岁时接受了完整评估，14 名儿童部分评估。与一般人群的理论分布相比，5 岁组在行为和认知表现方面显著更好，在运动表现方面显著更差（但仍在正常范围内）。5 岁组中有 4 名儿童（3.8%）存在发育问题/延迟。其中 2 例以前被诊断为自闭症（广泛性发育障碍-未特定）。另外 2 名儿童的发育问题是基于我们的行为、认知和/或运动评估得出的。
TESE-ICSI 后出生的儿童的长期发育和健康影响似乎令人放心。
