This cross-sectional study was performed at Royan Institute, Tehran, Iran from April 2013-December 2015. After registering the ICSI cycles in Hakim's software system at Royan Institute, data regarding pregnancies were investigated, and all live births were monitored and followed retrospectively. The ICSI cycles and embryo transfer procedure were performed with standard protocols at Royan Institute. We collected the data regarding the cause of infertility and type of embryo transfer from participants' records. The characteristics of newborns were also collected and recorded from the follow-up clinic. Gestational age was determined as 14 days before oocyte pick-up until delivery. To exclude outliers, only children with gestational ages between 22 and 44 wk and birth weight between 400 and 7000 gr were included. Preterm birth was considered as delivery before 37 completed weeks of gestation. Low-birth weight (LBW) was defined as 2500 gr and very LBW as 1500 gr (18).
All children were assessed at birth by neonatologists and the premature infants were reevaluated at the expected date of delivery. The diagnosis of the genital anomaly was determined on the basis of the clinical examination at the expected date of delivery. Sonography was performed if the anomaly was not diagnosed by a physical exam. A diagnosis of hypospadias was made as a failure of fusion of the urethra was observed, and the urethral meatus was ectopically located. Cryptorchidism could not be diagnosed if the testis was in the inguinal canal or not palpable. Testis in a high scrotal position was not considered to be cryptorchidism (19). Micropenis was described as a penis 2.5 standard deviations (SD) smaller than the mean for the child's age and race. It was diagnosed by observing a stretched penis length of less than 1.9 centimeters at birth. Testicular regression syndrome or vanishing testis is reported to be due to the subsequent atrophy and disappearance in the fetal life of an initially normal testis, and its diagnosis is confirmed by surgery (20). Epispadias was defined by observing the opening of the urethra in the back of the penis (19).
All children were assessed at birth by neonatologists and the premature infants were reevaluated at the expected date of delivery. The diagnosis of the genital anomaly was determined on the basis of the clinical examination at the expected date of delivery. Sonography was performed if the anomaly was not diagnosed by a physical exam. A diagnosis of hypospadias was made as a failure of fusion of the urethra was observed, and the urethral meatus was ectopically located. Cryptorchidism could not be diagnosed if the testis was in the inguinal canal or not palpable. Testis in a high scrotal position was not considered to be cryptorchidism (19). Micropenis was described as a penis 2.5 standard deviations (SD) smaller than the mean for the child's age and race. It was diagnosed by observing a stretched penis length of less than 1.9 centimeters at birth. Testicular regression syndrome or vanishing testis is reported to be due to the subsequent atrophy and disappearance in the fetal life of an initially normal testis, and its diagnosis is confirmed by surgery (20). Epispadias was defined by observing the opening of the urethra in the back of the penis (19).
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