الفهرس | Only 14 pages are availabe for public view |
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. |