More information about this project, the principal investigator and the research teamon http://emgerege.vub.ac.be/Follow_up.php
ART children are those born as a result of the use of artificial reproductive techniques (ART).
Why is this research necessary?
UZ Brussel plays an internationally pioneering role in fertility medicine. We have been involved on more than one occasion in developing new fertility techniques such as ICSI (injection of a single sperm into the oocyte) and PGD (genetic diagnosis of the embryo).
This progressive medical and scientific approach does, however, entail certain responsibilities. UZ Brussel has therefore always followed up all the children born using ART techniques, as a form of quality control. This follow-up is carried out by the CMG. This research, which has taken place over many years, allows us to give the scientific community and parents the fullest possible perspective on the implications of fertility treatment.
There is no legal obligation to maintain a follow-up database, either in Belgium or in most other countries. In Belgium, fertility and genetics centres are only obliged to record the number of children born as a result of fertility treatment, not details about their health.
There is no doubt, however, that research of this kind is very important. The CMG therefore carries out its research largely with the help of sponsorship. It applies for some of this from the FWO, while a proportion also comes from companies in the private sector.
What is it and how is it done?
Our centre systematically follows up the populations of IVF and ICSI children: there are now more than 15,000 of them (as of the end of July 2010). We do the same for children born using the latest techniques such as PGD and PGD-AS. A paediatrician carries out a physical examination at the age of two months, one year and two years. He or she also monitors the children's psychomotor development.
At about five years, eight years and ten years of age more detailed assessments of the child's continuing physical, mental and motor development are carried out. The way the child is functioning within the family is also assessed, in collaboration with the Psychology department at VUB. This is done for both IVF and ICSI children and also for children born after natural conception. At about 14 years of age the development of puberty is also studied in ICSI and control children, and the possible inherited nature of any fertility problems that were already present in the parents is studied.
A number of these studies are carried out in collaboration with universities abroad. This makes the results more statistically valuable and also allows us to identify possible differences between fertility centres.
A number of results have already become known.
Overall, the differences between ICSI and IVF children are minimal. There is no increased risk of malformations.
There may be an increased risk of multiple pregnancy if more than one embryo is returned to the uterus.
In singleton births there is a slightly increased risk of prematurity and low birth weight within both groups.
Karyograms of ICSI children indicate a slightly increased risk of disorders. We are able to identify this at an early stage in pregnancy, however, using chorionic villus biopsy or amniocentesis. These disorders are mainly due to the often poor quality of sperm cells from men for whom an ICSI procedure is the only way of becoming the biological father of a child.
PGD children from whom one or two cells have been removed at the eight-cell embryo stage are of course closely followed up as a group. Although only a few thousand PGD children have been born throughout the world, the results have been reassuring so far. Some 1000 children have been born in the PGD clinic at UZ Brussel (a collaboration between the CMG and the CRG), and no increased risk of abnormalities has been identified within this group.