Physical health at 5.5 years of age of term-born singletons after intracytoplasmic sperm injection: results of a prospective, controlled, single-blinded study

Objective: To study the health of children born after ICSI and of spontaneously conceived control children at the age of 4-6 years. Design: Prospective, controlled, blinded study. Setting: Tertiary-care center. Patient(s): Two hundred seventy-six term-born singletons conceived by ICSI and 273 matched spontaneously conceived singletons at the age of 5.5 years. Intervention(s): Detailed physical examination, interview of the parents, and collection of data from each child's examination booklet. Main Outcome Measure(s): Biometrical data; current health status; acute, chronic and childhood illnesses; hospitalizations; and surgeries. Result(s): Detailed physical examination did not reveal any relevant differences between ICSI and spontaneously conceived children. There were no relevant differences regarding the incidence of childhood illnesses, acute or chronic illnesses, accidents, and surgeries up to the age of 5.5 years. However, a history of undescended testicles was found significantly more often in boys born after ICSI (5.4% vs. 0.7%), with the consequence that they had significantly more urogenital surgery (19.2% vs. 8.9%). Significantly more ICSI children had been hospitalized (37.6% vs. 27.2%), although we did not find any specific reason for the increased hospitalization rate. Conclusion(s): Other than an increased risk of undescended testicles and therefore an increase in urogenital surgeries in ICSI boys, the physical health of ICSI children was comparable to that of spontaneously conceived children at the age of 5.5 years.