Pregnancies, growth and development of children conceived by subzonal injection of spermatozoa

Subzonal injection of spermatozoa (SUZI) was one of the first micromanipula tion techniques efficient in treating male factor infertility and unexplain ed in-vitro fertilization failures. The aim of this retrospective study was to evaluate the in-vitro development of embryos conceived by SUZI, the obs tetric outcome, the rate of congenital malformations and subsequent follow- np in children. Fifty-five pregnancies were obtained between 1991 and 1994 (54 after fresh embryos were transferred and one after cryopreserved embryo s were transferred). Among the 50 clinical pregnancies, there were seven mi scarriages (14%) and two ectopic pregnancies (4%), Among the 41 resulting e volutive pregnancies, the discovery of one anencephaly led to a medical abo rtion. Forty deliveries including six twin pregnancies occurred, leading to the births of 45 Live neonates and one stillbirth. The gender distribution of the offspring included 17 males and 29 females (ratio 0.59:1). Birth we ight, length and head circumference were within the expected ranges. Two ch ildren presented a malformation: the first one had one thumb with congenita l shelf and the second a polymalformative neurological syndrome. Growth cur ves were normal for all these children except one (weight above the 2 SD cu rve). Medical follow-up detected no pathological features in these children apart from a physical disability in one girl, In this small series a 4.2% rate of malformation was observed, particularly affecting the neural tube, in SUZI offspring. However, no firm conclusions can be drawn since the stud y was carried out on a small cohort. SUZI is no longer performed but these observations suggest that it is necessary to collect extensive data about c hildren conceived by microfertilization.