The German ICSI follow-up study was done from 1998 to 2007. 59 IVF centres all over Germany performed this prospective, controlled cohort study. 3372 children/fetuses from pregnancy after ICSI (intracytoplasmic sperm injection) were compared to 8016 spontaneously conceived pregnancies. Analysed were all pregnancies in case that they proceeded over the 16 th week of gestation - independently, whether they ended as spontaneous abortions, induced abortions, stillbirths or livebirths. The spontaneously conceived pregnancies were recruited via the "Fehlbildungsmonitoring Sachsen-Anhalt" (Magdeburg). Primary outcome parameter was the rate of major malformations. This rate was increased in pregnancies after ICSI with 8.7% (295/3372) as compared to 6.1% (488/8016) in spontaneously conceived pregnancies. The relative risk (RR) was 1.44 (95% confidence interval [CI]: 1.25-1.65). After adjustment of the cohorts the RR dropped to 7.24 (95% CI: 1.02-1.50). This says, that in each 12 th pregnancy after ICSI and each 15 th pregnancy after spontaneous conception a major malformation has to be expected. These data meanwhile are used in daily counsellation of the couples before starting infertility treatment. Besides the major malformation rate the study could demonstrate an increased risk after ICSI for pregnancy course and birth. This was e.g. an increased risk for preeclampsia, premature birth and intrauterine growth retardation. Other studies about this topic meanwhile could confirm these problems. However, these other studies also showed the same risks for pregnancies conceived after conventional IVF (in vitro fertilization), without ICSI. ICSI itself, therefore, seems not to be the relevant risk factor. Also the severeness of the male factor was not a relevant risk factor, as shown by the German ICSI follow-up study. More studies regarding subfertile couples, published during the last 15 years, could consistently show, that a time-to-pregnancy exceeding 12 months lead to similiar increased risks - even when after this time span the couples could conceive spontaneously. Therefore, subfertile couples always must be counselled about those risks - not only in case that they conceive after IVF or ICSI.
|Titel in Übersetzung||The German ICSI follow-up study - A summary of published results in view of the recent study situation|
|Zeitschrift||Journal fur Reproduktionsmedizin und Endokrinologie|
|Seiten (von - bis)||151-162|
|Publikationsstatus||Veröffentlicht - 27.10.2005|