Medical and developmental outcome at 1 year for children conceived by intracytoplasmic sperm injection

Bowen, Jennifer R.; Gibson, Frances; Leslie, Garth I.; Saunders, Douglas M.

doi:10.1016/s0140-6736(98)10168-x

Cited by 302 publications

(140 citation statements)

References 28 publications

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“…There is a great need to understand the mechanisms controlling mammalian preimplantation development in order to develop rational interventions to either promote or inhibit fertility (3,5,241,242). Current research is addressing this need and is aimed at providing an eventual understanding of the causative events underlying early embryo loss and in ensuring that assisted reproductive technologies are applied in a safe and efficient way.…”

Section: Summary and Future Prospectsmentioning

confidence: 99%

Regulation of blastocyst formation

Watson¹

2001

Front Biosci

115

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Section: Summary and Future Prospectsmentioning

confidence: 99%

Regulation of blastocyst formation

Watson¹

2001

Front Biosci

115

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“…The details of the meta-analysis-including the literature search, the study selection and the data extraction processes-are described there. We found 19 studies [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] for inclusion in the meta-analysis and found that ART increased the risk of MM with an odds ratio of 1.29 (95% CI 1.01-1.67). Our major conclusion was that the risk we found may be inflated by the fact that none of the studies used the most appropriate control group, namely subfertile couples conceiving spontaneously.…”

Section: Introductionmentioning

confidence: 99%

A meta-analysis of the impact of IVF and ICSI on major malformations after adjusting for the effect of subfertility

Rimm

Katayama

Katayama³

2011

J Assist Reprod Genet

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Objective To estimate the effect of assisted reproductive technology (ART) on major malformation (MM) rate in ART offspring independent of the effect of subfertility on MM. Design Meta-analysis. Methods This meta-analysis is based on our previously published meta-analysis of observational studies evaluating the relationship between ART treatment and MM rates, as well as recent research by Zhu et al. to estimate the impact of subfertility alone on MM in subfertile couples conceiving spontaneously. Results The overall odds ratio for MM in our original metaanalysis, in which all studies used apparently inappropriate control groups of "normal" populations, was 1.29 (95% CI 1.01-1.67). Here we attempted to estimate the risk of subfertility and used this estimate to perform an adjusted meta-analysis. Zhu et al. found that about 40% of the odds of MM was due to subfertility. When we took Zhu's finding into account, the adjusted odds ratio in the meta-analysis was 1.01 (95% CI 0.82-1.23). Conclusions Our study suggests ART does not increase the risk of MM as much as previously reported. More research is needed to quantify the underlying risk of subfertility and separate it from the risk associated with ART. Physicians who counsel subfertile couples should recognize that previous studies of MM rates in ART patients probably overestimated the risk.

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“…Initial data [13] albeit conflicting [11], suggested that the mental development of ICSI babies was slower. The differences between these studies may be due to insufficient numbers or confounding factors such as differing socio-economic groups.…”

Section: Follow Up Of Babies Conceived By Icsimentioning

confidence: 99%

Traitement de l’azoospermie obstructive par injection Intracytoplasmique d’un spermatozoïde

Lewis

2006

Androl.

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Intracytoplasmic sperm injection (ICSI) allows the treatment of virtually every type of male infertility. Unlike in vitro fertilization (IVF), its success does not depend on sperm concentration, motility or morphology and most of the physical barriers to fertilisation are by-passed. Since ICSl does not require strongly motile sperm, its use has now been expanded to incorporate immature sperm from the testes and epididymides. Successful fertilisation, pregnancies and healthy babies have all been reported. However, concerns about the safety of ICSl remain due to its short clinical history and the lack of testing on animal models.Male fertility potential for assisted reproduction by ICSl cannot be measured by conventional parameters. Sperm DNA integrity is increasingly recognised as a more useful indicator. Studies have shown that sperm with higher levels of DNA damage have lower fertilisation rates after IVF and ICSI. Sperm with DNA damage above a certain threshold are associated with a longer time to conceive in otherwise apparently fertile couples and a higher miscarriage rate. DNA damage has been shown to be associated with impaired embryo cleavage. Our group has shown that sperm DNA from testicular sperm is less fragmented than that from epididymal sperm and suggest its preferred use in ICSI.In addition to nuclear (n) DNA we also assessed the quality of mitochondrial (mt) DNA from testicular sperm from men with obstructive azoospermia undergoing ICSI. We observed that couples achieving a pregnancy had both less mtDNA deletions and less nDNA fragmentation. We found inverse relationships between pregnancy and sperm mtDNA deletion numbers, size and nDNA fragmentation. No relationships were observed with fertilisation rates. With this knowledge, we designed an algorithm for the prediction of pregnancy based on the quality of sperm nDNA and mtDNA.Each year 40,000 men have a vasectomy in the UK but every year 2500 request a reversal to begin a second family. For such men, vasectomy reversal has recently been replaced in part by testicular biopsy via fine-needle testicular sperm aspiration (TESA) or percutaneous epididymal sperm aspiration (PESA) performed at an outpatient clinic and subsequently used in ICSI. Since these were previously fertile men it has been assumed that they had 'fertile' sperm. However the assisted conception success rates of these mens partners has not been assessed until recently. We have shown a significant reduction in the clinical pregnancy rates in the partners of men who had had a vasectomy >10yrs previously. There is also evidence to suggest that spermatogenesis is significantly impaired in vasectomised men. Marked decreases in spermatocytes, spermatids and spermatozoa have been observed. We have found this to be associated with concomitant increases in apoptotic markers, such as Fas, FasL and Bax. The quality of the remaining sperm is also compromised. Sperm DNA from vasectomized men shows substantial damage which increases with time after surgery. This new use of ICSI will be d...

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Medical and developmental outcome at 1 year for children conceived by intracytoplasmic sperm injection

Cited by 302 publications

References 28 publications

Regulation of blastocyst formation

Regulation of blastocyst formation

A meta-analysis of the impact of IVF and ICSI on major malformations after adjusting for the effect of subfertility

Traitement de l’azoospermie obstructive par injection Intracytoplasmique d’un spermatozoïde

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