Hudson Institute of Medical Research, Clayton, VIC, Australia.
Department of Obstetrics and Gynecology, Monash University, Clayton, VIC, Australia.
Andrology. 2018 Sep;6(5):635-653. doi: 10.1111/andr.12526. Epub 2018 Sep 17.
A significant increase in the use of intracytoplasmic sperm injection (ICSI) since its introduction in 1992 has been observed worldwide, including beyond its original intended use for severe male factor infertility. Concerns regarding ICSI include the effects of poor quality spermatozoa on offspring health and future fertility, and of the technique itself. The health and development of ICSI-conceived children beyond early infancy have not been comprehensively assessed.
A systematic review of health outcomes of ICSI-conceived offspring beyond the neonatal period compared to spontaneously conceived (SC) offspring.
PubMed, OVID Medline/Embase, InformIT, Web of Science, and ProQuest databases were searched for studies reporting on health outcomes in ICSI-conceived offspring beyond 28 days after birth.
MAIN OUTCOMES MEASURE(S): Physical and psychosocial health.
The search strategy yielded 2826 articles. Of these, 2580 were not relevant or did not meet inclusion criteria and 138 were duplicates. One hundred and eight full-text papers were evaluated further, and 48 satisfied the inclusion criteria. Most studies reported on neurodevelopment during early infancy and childhood with reassuring results. Growth, vision, and hearing of ICSI and SC offspring also appear comparable, although important differences in general physical health, and particularly metabolic and reproductive health have been described, including recently poorer semen quality among ICSI-conceived young adult men compared to SC peers.
Whilst neurodevelopment, growth, vision, and hearing appear similar between ICSI and SC children, evidence suggests differences in general physical health, and metabolic and reproductive endpoints. The clinical significance of many findings, however, remains unclear, and further prospective, large, and good quality studies with a focus on all these health outcomes in ICSI-conceived young adults are required.
自 1992 年引入卵胞浆内单精子注射（ICSI）以来，全球范围内观察到其使用量显著增加，包括超出其最初用于严重男性因素不育的预期用途。人们对 ICSI 的担忧包括精子质量差对后代健康和未来生育能力的影响，以及该技术本身的影响。ICSI 受孕儿童在婴儿期后的健康和发育情况尚未得到全面评估。
系统评价 ICSI 受孕后代在新生儿期后与自然受孕（SC）后代相比的健康结局。
在 PubMed、OVID Medline/Embase、InformIT、Web of Science 和 ProQuest 数据库中搜索报告 ICSI 受孕后代出生后 28 天以上健康结局的研究。
身体和心理社会健康。
搜索策略产生了 2826 篇文章。其中，2580 篇文章不相关或不符合纳入标准，138 篇文章为重复。进一步评估了 108 篇全文论文，其中 48 篇符合纳入标准。大多数研究报告了 ICSI 和 SC 后代的早期婴儿期和儿童期的神经发育情况，结果令人欣慰。ICSI 和 SC 后代的生长、视力和听力似乎也相似，尽管在一般身体健康方面，特别是在代谢和生殖健康方面，已经描述了重要差异，包括最近 ICSI 受孕的年轻成年男性的精液质量比 SC 同龄人差。
尽管 ICSI 和 SC 儿童的神经发育、生长、视力和听力似乎相似，但有证据表明在一般身体健康方面以及代谢和生殖终点存在差异。然而，许多发现的临床意义仍不清楚，需要进一步进行前瞻性、大型和高质量的研究，重点关注所有这些 ICSI 受孕的年轻成年人的健康结局。
