Abstract: Objective To analyse the cognitive development of 4 year old children conceived by intracytoplasmic sperm injection (ICSI). Methods Children enrolled into our study were conceived by ICSI from January 2009,through to the end of December 2009 in the State key Laboratory of Reproductive Medicine Department of Nanjing Maternal and Child Health Care Hospital.18 ICSI alive single born underwent cognitive assessments and 36 spontaneously conceived (SC) singletons as control subjects were matched with respect to age,gender,and birth number.The children were excluded if their gestational weeks less than 32 weeks,birth weight less than 1 500 g,with fetal distress or birth asphyxia history.Children's cognitive development was assessed with the Chinese-Wechsler preschool and primary scale of intelligence (C-WPPSI). Results Singletons conceived by ICSI achieved lower IQ scores than SC singletons (full-scale IQ:ICSI 100.67±11.45,SC 115.33±10.82; verbal IQ:97.72±14.21,111.72±12.40;performance IQ:104.83±7.87,SC 116.50±10.68,P<0.05).However,ICSI children obtained lower scores on the "picture completion" subtests (ICSI 4/18,SC 0/36,χ²=8.64,P<0.05). Conclusion In the relatively limited sample investigated,cognitive development among ICSI singletons is lower than SC singletons.By refining assessment content,expanding the sample size and extending follow-up time,we can provide more powerful evidence for judgment of the long-term developmental outcomes of assisted reproductive offspring.

Key words: assisted reproductive technology, intracytoplasmic sperm injection, offspring, cognitive

摘要： 目的 分析卵胞浆内单精子注射(ICSI)子代4岁龄智能发育情况。方法 选取2009年1月-2009年12月在南京市妇幼保健院进行卵胞浆内单精子注射的单胎活产子代作为研究对象(ICSI，n=18例)，以年龄、性别为匹配条件，选取该院出生的自然受孕单胎活产婴儿为作对照组(SC，n=36例);排除标准:孕周<32周，体重<1 500g，有宫内窘迫，出生窒息史者。利用中国韦氏学前儿童智力量表(C-WPPSI)分别比较两组儿童4岁龄的智力发育水平。结果 比较两组儿童4岁龄智能发育水平后发现，韦氏智力测验中ICSI子代总智商、言语智商及操作智商均值在正常范围，但得分均低于SC组(总智商:ICSI 100.67±11.45，SC 115.33±10.82;言语智商:97.72±14.21，111.72±12.40;操作智商:104.83±7.87，116.50±10.68)，两者差异具有统计学意义(P<0.05)。进一步分析两组智力异常的发生率，发现ICSI子代图画填充项目量表分<7的人数明显高于SC组(ICSI 4/18，SC 0/36，χ²=8.64，P<0.05)。结论 有限的样本量结果提示，ICSI子代4岁龄智能发育在正常范围，但韦氏智力测验IQ值低于SC组。ICSI子代远期智能情况需要通过更广泛、长期、系统的随访跟踪才能得出更为详实的结论。

关键词: :辅助生殖技术, 卵胞浆内单精子注射, 子代, 智能