Selected chronic diseases in children and adolescents conceived with intracytoplasmic sperm injection

• Published in: European journal of obstetrics & gynecology and reproductive biology 2025-01, Vol.304, p.127-133
• Main Authors: Wod, Mette, Thorarinsson, Caroline Theilgaard, Jølving, Line Riis, Nielsen, Jan, Friedman, Sonia, Fedder, Jens, Nørgård, Bente Mertz
• Format: Article
• Language: English
• Subjects: Adolescent; Assisted reproduction therapy; Child; Chronic Disease - epidemiology; Cohort Studies; Cohort study; Denmark - epidemiology; Female; Fertilization in Vitro - adverse effects; Fertilization in Vitro - statistics & numerical data; Humans; Intracytoplasmic sperm injection; Male; Nationwide; Neurodevelopmental Disorders - epidemiology; Neurodevelopmental Disorders - etiology; Pregnancy; Registries; Sperm Injections, Intracytoplasmic - adverse effects; Sperm Injections, Intracytoplasmic - statistics & numerical data; Young Adult
• ISSN: 0301-2115; 1872-7654; 1872-7654
• DOI: 10.1016/j.ejogrb.2024.11.023

•About 12.5% of all children are conceived using ART.•ICSI was introduced without knowledge of possible long-term adverse consequences.•Risk of psychiatry, asthma, epilepsy, IBD, RA, thyroid disease and diabetes.•No increased risk in ICSI offspring vs IVF and natural conception. Today about 12.5% of all children are conceived using assisted reproductive technology. Intracytoplasmic sperm injection (ICSI) was introduced without knowledge of the possible long-term adverse consequences on the offspring health. We aimed to examine risk of neurodevelopmental disorders, asthma, epilepsy, inflammatory bowel disease, rheumatoid arthritis, thyroid disease, and diabetes in the offspring conceived with ICSI, compared with offspring conceived with in vitro fertilization (IVF) and natural conception. All offspring conceived using ICSI, IVF, and natural conception in Denmark from July 9th, 1994 until December 31st, 2019 were included in this nationwide cohort study using Danish national health registries. Median follow-up time was 10 years (6–16 years, interquartile range (IQR)) for offspring conceived with ICSI (n = 22,906), 13 years (7–20 years, IQR) for offspring conceived with IVF (n = 32,458), and 13 years (8–20, IQR) for offspring born after natural conception (n = 1,397,791). Several of the outcomes occurred rarely. The most frequent outcome in offspring conceived with ICSI was neurodevelopmental disorder which did not show an increased risk when comparing offspring conceived with ICSI with offspring conceived with IVF (hazard ratio 1.02 (95 % CI: 0.92;1.12)) and natural conception (hazard ratio 0.96 (95 % CI: 0.88;1.40)). Reassuringly, there were no statistically significantly increased risks of the examined outcomes in offspring conceived with ICSI. Before any firm conclusions are made, this study should be replicated in large populations with longer follow-up time.