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Abstract
Since the birth of Louise Brown in 1978, In Vitro
Fertilization (IVF) has proved to be useful in
alleviating long standing infertility (Steptone and
Edwards, 1978). Within years the assisted reproductive
technology (ART) has enabled many couples to achieve
long-awaited dreams of having children (Partrat et al.,
1999). Nevertheless, IVF success rates were
dramatically reduced in patients with male factor
infertility, therefore, several methods of assisted
fertilization have been attempted with varying degree
of success such as subzonal insemination of
spermatozoa (SUZI) (Ng et al., 1988). With delivery of
the first health child after intracytoplasmic sperm
injection (ICSI) in 1992, microfertilization was adopt
as a routine treatment throughout the world (Palermo et
al., 1992).
The aim of this study was to establish base line
data about the size and distribution of communicative
disorders among the children conceived through the
ART procedures in order to put a plan of early
detection, proper assessment, intervention and
prevention of these problems if possible.
Two hundred of children were included in this
study. One hundred of them were conceived by the
ART procedures(52 males and 48 females) and 100 of
the children were naturally conceived (56 males and 44
females). The mean age for the ART children was
41.41 months and the mean age for the naturally
conceived children was 43.63 months. The children in
the two groups were matched in their age, sex, mother’s
age, mother’s education level, prenatal and perinatal
data as much as possible in order to evaluate the effect
of the ART procedures in the children.
The children of this study were subjected to the
protocol of language assessment which applied in The
Phoniatrics Unit of Ain Shams University Hospital:
Elementary diagnostic procedures:
(patient’s interview, general examination,
vocal tract examination, neurological
examination and ENT examination).
Clinical diagnostic aids: (Evaluation of
the various aptitudes by formal testing,
psychiatric evaluation, audiological
examination and language evaluation by
using the Arabic Language test).
Additional instrumental measures:
(computerized tomography scanning CT
and EEG if indicated).
Other protocols of communicative disorders
(protocols of Stuttering, nasality, dysarthia, dyslalia and
voice) were applied to the children with speech or voice
disorders.
The results obtained from this study showed
that:
• There was no significant difference between the two
groups as regard the postnatal outcomes and the
percentage of congenital anomalies.
• There was no significant difference between the two
groups as regard the sitting age, the walking age, the
age of utterance of the first word and the age of
utterance of the sentence.
• There was no significant difference between the two
groups as regard the weight, length and head
circumference.
• There was no significant difference between the two
groups as regard the vocal tract, ENT, neurological
examination the audiological evaluation.
• There was no significant difference between the two
groups as regard the I.Q, mental and social age.
• There was significant difference between the two
groups as regard the receptive, semantics and total
language test scores.
• There was no significant difference between the two
groups as regard the expressive, pragmatic and
prosodic language test scores.
• There was no significant difference between the two
groups as regard the percentage of the children with
DLD- MR, DLD-HL and DLD-BDMH.
• There was significant difference between the two
groups as regard the percentage of the children with
DLD- autism and DLD-SLI.
• There was no significant difference between the two
groups as regard the percentage of the children with
speech and voice disorders.
• There was significant difference between the
singletons and twins in the study group as regard the
receptive language scores, semantics language
scores, IQ and mental age.
• There was high significant difference between the
singletons and twins in the study group as regard the
expressive language scores and total language
scores.
• There was positive significant correlation between
the language scores and the gestational age and the
mother education level.
• There was high negative significant correlation
between the language scores and the multiple birth
and the admission in the NICU.
The results from this study revealed that the low
birth weight, poor neonatal outcome, premature and
multiple birth (risk factors) were important factors for
worsen the communicative abilities of the children
conceived by assisted reproductive technologies more
than the mode of conception by the ART procedures.
So, early consultation is recommended for the ART
children with high risk factors for early detection and
proper management of any communicative disorders.