human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To evaluate specific effects of ovarian hyperstimulation , the in vitro procedure , and a history of subfertility on neuromotor development at 3 months of age . DESIGN Prospect i ve , cohort study . SETTING University Medical Center Groningen , The Netherl and s. PATIENT(S ) Singletons conceived after controlled ovarian hyperstimulation-IVF/intracytoplasmic sperm injection ( COH-IVF ; n = 68 ) or modified natural cycle-IVF/intracytoplasmic sperm injection ( MNC-IVF ; n = 57 ) , and naturally conceived singletons of subfertile couples ( NC ; n = 90 ) . Data from a reference population were available ( n = 450 ) . INTERVENTION(S ) None . MAIN OUTCOME MEASURE(S ) Quality of general movements ( GMs ) , classified as normal-optimal , normal-suboptimal , mildly abnormal , or definitely abnormal . Definitely abnormal GMs indicate brain dysfunction , mildly abnormal GMs normal but non-optimal brain function . RESULT ( S ) Mildly abnormal and definitely abnormal GMs were observed equally frequently in COH-IVF , MNC-IVF , and NC singletons . The three subfertile groups showed a reduction in GM quality , in particular more mildly abnormal GMs , in comparison with the reference population . CONCLUSION ( S ) Singletons born after IVF ( with or without ovarian hyperstimulation ) are not at increased risk for abnormal GMs compared with naturally conceived peers of subfertile parents . Mildly abnormal GMs occur more often in infants of subfertile parents than in the general population , suggesting that factors associated with subfertility rather than those related to IVF procedures may be associated with less-optimal early neurodevelopmental outcome . These results need confirmation through replication and follow-up at older ages The use of a gonodotropin-releasing hormone ( Gn-RH ) agonist in an in vitro fertilization ( IVF ) program raises the question of any influence on the physical , neurologic , and mental development of the children . We compared the development of children born after long-acting Gn-RH agonist treatment with that of children born after spontaneous pregnancies . Children from singleton pregnancies and > or = 28 months of age were examined by a pediatric neurologist and a psychologist who did not know to which group the children belonged . The General Cognitive Index test was used . Each group included 30 children . Five children cooperated only partly . Physical and neurologic findings were normal in all children , except that one in the group born after in vitro fertilization had diffuse hypotonia , attention-deficit hyperactivity disorder , and hyperactivity . The General Cognitive Index for the 26 children in the study group and the 29 children in the control group who fully cooperated were 102 + /- 13.3 and 106 + /- 13.5 , respectively ( p = 0.37 ) . The verbal perception , motor , and memory indexes were not significantly different . We conclude that the long-acting Gn-RH agonist had no clinical ly identifiable influence on the development of these children BACKGROUND As a continuation of two large-scale , multicentre studies on the development of 5-year-old ICSI children , we present results of the follow-up study undertaken on the cognitive and motor development of 8-year-old ICSI children . METHODS Developmental outcomes of 151 8-year-old singletons born through ICSI after 32 weeks of gestation were compared with those of 153 singletons of the same age born after spontaneous conception ( SC ) . Part of this population was seen in a cohort at the age 5 years . Outcome measures include Wechsler Intelligence Scale for Children-Revised ( WISC-R ) and Movement Assessment Battery for Children ( ABC ) . RESULTS Regarding intellectual functioning , ICSI children tend to obtain significantly higher total ( P < 0.01 ) , verbal ( P < 0.01 ) and performance ( P < 0.05 ) intelligence scores than SC children , nevertheless remaining in similar ranges . These effects are small ( Cohen 's d < 0.50 ) . High maternal educational level stayed in the regression as a factor accounting for some of the variance in total IQ between the groups . In terms of motor development , no significant differences were found between ICSI and SC children regarding overall motor skills , manual , balance and ball skills . CONCLUSION In this follow-up study , ICSI and SC children show a comparable cognitive and motor development until the age of 8 years OBJECTIVE To study the health of children born after ICSI and of spontaneously conceived control children at the age of 4 - 6 years . DESIGN Prospect i ve , controlled , blinded study . SETTING Tertiary-care center . PATIENT(S ) Two hundred seventy-six term-born singletons conceived by ICSI and 273 matched spontaneously conceived singletons at the age of 5.5 years . INTERVENTION(S ) Detailed physical examination , interview of the parents , and collection of data from each child 's examination booklet . MAIN OUTCOME MEASURE(S ) Biometrical data ; current health status ; acute , chronic and childhood illnesses ; hospitalizations ; and surgeries . RESULT ( S ) Detailed physical examination did not reveal any relevant differences between ICSI and spontaneously conceived children . There were no relevant differences regarding the incidence of childhood illnesses , acute or chronic illnesses , accidents , and surgeries up to the age of 5.5 years . However , a history of undescended testicles was found significantly more often in boys born after ICSI  ( 5.4 % vs. 0.7 % ) , with the consequence that they had significantly more urogenital surgery ( 19.2 % vs. 8.9 % ) . Significantly more ICSI children had been hospitalized ( 37.6 % vs. 27.2 % ) , although we did not find any specific reason for the increased hospitalization rate . CONCLUSION ( S ) Other than an increased risk of undescended testicles and therefore an increase in urogenital surgeries in ICSI boys , the physical health of ICSI children was comparable to that of spontaneously conceived children at the age of 5.5 years A cohort of 91 children from cryopreserved embryos and 83 control children who were conceived normally had their development assessed using the Griffiths 's scales of mental development . The controls ( 81 singletons and two twins ) of a similar age , sex , and social class were selected from siblings , cousins , and peers of the  cryopreserved embryo group ( 68 singleton , 20 twins , and three triplets ) . Children from cryopreserved embryos had a lower mean birth weight and mean gestational age and a higher proportion were born by caesarean section .  One child from the cryopreserved embryo group had Down 's syndrome , three had squints , and four had conductive hearing loss while in the control children , six had squints , and nine had conductive hearing loss . In both groups , including the child with Down 's syndrome , the mean Griffiths 's quotient was greater than the st and ard 100 . In the children from cryopreserved embryos , the singleton and multiple birth subgroups had statistically similar assessment results . The mean ( SD ) Griffiths 's quotient was 105.69 ( 13.55 ) in children from cryopreserved embryos and 108.18 ( 9.80 ) in controls at a chronological age of 25.08 ( 12.86 ) and 29.19 ( 14.65 ) months respectively . Overall , the development in children from cryopreserved embryos did not cause concern though formal testing had highlighted small differences compared with other children conceived normally and of a similar social class Objective To investigate how pregnancy planning , time to conception , and infertility treatment influence cognitive development at ages 3 and 5 . Design Prospect i ve population based cohort study . Setting Millennium Cohort Study in the United Kingdom . Participants 18 818 children recruited at 9 months and followed up at 3 and 5 years . 11 790 singletons with available data on pregnancy , cognitive outcomes , and confounders were included in analyses at age 3 and 12 136 at age 5 . Exposure measures Mothers reported whether the pregnancy was planned , and their feelings when first pregnant ; those in whom the pregnancy was planned provided time to conception , and details of any assisted reproductive technologies . The population was divided into “ unplanned ” ( unplanned and unhappy ) , “ mistimed ” ( unplanned but happy ) , “ planned ” ( planned , time to conception < 12 months ) , “ subfertile ” ( planned , time to conception ≥12 months ) , “ induced ovulation ” ( received clomiphene citrate ) , and “ assisted reproduction ” ( in vitro fertilisation or intracytoplasmic sperm injection ) . The “ planned ” group was the comparison group in all analyses . Outcome measures Three components of the British Ability Scales ( BAS II ) . Naming vocabulary assessed verbal ability at age 3 ; this test was repeated at age 5 with the picture similarities and pattern construction subscales , which measure non-verbal and spatial abilities . Results In unadjusted analyses , the scores on all scales in children from unplanned pregnancies were significantly lower than in those from planned pregnancies — for example , the difference in mean verbal ability score at age 3 was −4.8 ( 95 % confidence interval −6.0 to −3.7 ; P<0.05 ) , equivalent to an average delay of four months . After adjustment for sociodemographic factors these differences were attenuated : −0.3 ( −1.3 to 0.7 ) , equivalent to no delay . Children born after assisted reproduction performed consistently better in verbal ability tests ( 3.8 ( −0.2 to 7.9 ) at age 3 and 3.5 ( 0.2 to 6.8 ) at age 5 ) , which suggests that on average these children are three to four months ahead ; this difference did not completely disappear with adjustment for confounders . Children born after infertility treatment had lower mean scores in non-verbal tests ( −1.2 ( −4.1 to 1.6 ) after assisted reproduction and −1.5 ( −3.5 to 0.4 ) after induced ovulation ) and in spatial ability tests ( −2.7 ( −6.9 to 1.6 ) after assisted reproduction ) , though the differences were not significant . Conclusions Pregnancy planning , subfertility , or assisted reproduction do not adversely affect children ’s cognitive development at age 3 or 5 . The differences observed in the unadjusted analyses are almost entirely explained by marked inequalities in socioeconomic circumstances between the groups Abstract Objective To compare neurological sequelae in twins born after assisted conception with singletons after assisted conception and naturally conceived twins and to assess neurological sequelae in children conceived after in vitro fertilisation ( IVF ) compared with intracytoplasmic sperm injection ( ICSI ) .  Design Controlled , national register based , cohort study . Participants Twins ( n = 3393 ) and singletons ( n = 5130 ) conceived by using assisted reproductive technologies and naturally conceived twins ( n = 10 239 ) born in Denmark between 1995 and 2000 . The children 's age at time of follow up was 2 - 7 years . Data sources Children were identified by cross linkage of the national medical birth registry and the national registry for in vitro fertilisation . Neurological and psychiatric diagnoses were retrieved from the national patients ' registry and the Danish psychiatric central registry . Main outcome measures Neurological sequelae , defined as cerebral palsy , mental retardation , severe mental developmental disturbances , and retarded psychomotor development . Further we made separate analyses on the specific cerebral palsy diagnosis . Results The crude prevalence rates per 1000 of neurological sequelae in twins and singletons after assisted conception and in naturally conceived twins were 8.8 , 8.2 , and 9.6 , and of cerebral palsy 3.2 , 2.5 , and 4.0 , respectively . In twins after assisted conception compared with control twins , the odds ratios of neurological sequelae and specifically of cerebral palsy , adjusted for child sex and year of birth , were 0.9 ( 95 % confidence interval 0.6 to 1.4 ) and 0.8 ( 0.4 to 1.6 ) , respectively . The corresponding odds ratios for twins after assisted conception compared with singletons after assisted conception were 1.1 ( 0.7 to 1.7 ) for neurological sequelae and 1.3 ( 0.6 to 2.9 ) for cerebral palsy . The odds ratio of neurological sequelae in children conceived by ICSI was 0.9 ( 0.5 to 1.7 ) ν children conceived by IVF . Conclusions Twins from assisted conception have a similar risk of neurological sequelae as their naturally conceived peers and singletons from assisted conception . Children born after ICSI have the same risk of neurological sequelae as children born after IVF BACKGROUND To examine the long-term child outcome  after IVF until the age of 3 years in Northern Finl and , we conducted a population -based cohort study . METHODS First , a cohort of 299 IVF children born in 1990 - 1995 was compared with a cohort of 558 controls representing the general population in terms of a multiple birth rate of 1.2 % , r and omly chosen from the Finnish Medical Birth Register ( FMBR ) and matched for sex , year of birth , area of residence , parity , maternal age and social class 
    Output:
    
agent
RESULT ( S ) For infants , studies on psychomotor development showed no deficits , but few investigated cognitive or behavioral development .
Studies on toddlers generally reported normal cognitive , behavioral , socio-emotional , and psychomotor development .
For children in middle childhood , development seems comparable in children born after assisted reproduction and controls , although fewer studies have been conducted with follow-up to this age .
( S ) It may tentatively be concluded that the neurodevelopment of children born after  fertility treatment  is overall comparable to that in children born after spontaneous conception
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To evaluate specific effects of ovarian hyperstimulation , the in vitro procedure , and a history of subfertility on neuromotor development at 3 months of age . DESIGN Prospect i ve , cohort study . SETTING University Medical Center Groningen , The Netherl and s. PATIENT(S ) Singletons conceived after controlled ovarian hyperstimulation-IVF/intracytoplasmic sperm injection ( COH-IVF ; n = 68 ) or modified natural cycle-IVF/intracytoplasmic sperm injection ( MNC-IVF ; n = 57 ) , and naturally conceived singletons of subfertile couples ( NC ; n = 90 ) . Data from a reference population were available ( n = 450 ) . INTERVENTION(S ) None . MAIN OUTCOME MEASURE(S ) Quality of general movements ( GMs ) , classified as normal-optimal , normal-suboptimal , mildly abnormal , or definitely abnormal . Definitely abnormal GMs indicate brain dysfunction , mildly abnormal GMs normal but non-optimal brain function . RESULT ( S ) Mildly abnormal and definitely abnormal GMs were observed equally frequently in COH-IVF , MNC-IVF , and NC singletons . The three subfertile groups showed a reduction in GM quality , in particular more mildly abnormal GMs , in comparison with the reference population . CONCLUSION ( S ) Singletons born after IVF ( with or without ovarian hyperstimulation ) are not at increased risk for abnormal GMs compared with naturally conceived peers of subfertile parents . Mildly abnormal GMs occur more often in infants of subfertile parents than in the general population , suggesting that factors associated with subfertility rather than those related to IVF procedures may be associated with less-optimal early neurodevelopmental outcome . These results need confirmation through replication and follow-up at older ages The use of a gonodotropin-releasing hormone ( Gn-RH ) agonist in an in vitro fertilization ( IVF ) program raises the question of any influence on the physical , neurologic , and mental development of the children . We compared the development of children born after long-acting Gn-RH agonist treatment with that of children born after spontaneous pregnancies . Children from singleton pregnancies and > or = 28 months of age were examined by a pediatric neurologist and a psychologist who did not know to which group the children belonged . The General Cognitive Index test was used . Each group included 30 children . Five children cooperated only partly . Physical and neurologic findings were normal in all children , except that one in the group born after in vitro fertilization had diffuse hypotonia , attention-deficit hyperactivity disorder , and hyperactivity . The General Cognitive Index for the 26 children in the study group and the 29 children in the control group who fully cooperated were 102 + /- 13.3 and 106 + /- 13.5 , respectively ( p = 0.37 ) . The verbal perception , motor , and memory indexes were not significantly different . We conclude that the long-acting Gn-RH agonist had no clinical ly identifiable influence on the development of these children BACKGROUND As a continuation of two large-scale , multicentre studies on the development of 5-year-old ICSI children , we present results of the follow-up study undertaken on the cognitive and motor development of 8-year-old ICSI children . METHODS Developmental outcomes of 151 8-year-old singletons born through ICSI after 32 weeks of gestation were compared with those of 153 singletons of the same age born after spontaneous conception ( SC ) . Part of this population was seen in a cohort at the age 5 years . Outcome measures include Wechsler Intelligence Scale for Children-Revised ( WISC-R ) and Movement Assessment Battery for Children ( ABC ) . RESULTS Regarding intellectual functioning , ICSI children tend to obtain significantly higher total ( P < 0.01 ) , verbal ( P < 0.01 ) and performance ( P < 0.05 ) intelligence scores than SC children , nevertheless remaining in similar ranges . These effects are small ( Cohen 's d < 0.50 ) . High maternal educational level stayed in the regression as a factor accounting for some of the variance in total IQ between the groups . In terms of motor development , no significant differences were found between ICSI and SC children regarding overall motor skills , manual , balance and ball skills . CONCLUSION In this follow-up study , ICSI and SC children show a comparable cognitive and motor development until the age of 8 years OBJECTIVE To study the health of children born after ICSI and of spontaneously conceived control children at the age of 4 - 6 years . DESIGN Prospect i ve , controlled , blinded study . SETTING Tertiary-care center . PATIENT(S ) Two hundred seventy-six term-born singletons conceived by ICSI and 273 matched spontaneously conceived singletons at the age of 5.5 years . INTERVENTION(S ) Detailed physical examination , interview of the parents , and collection of data from each child 's examination booklet . MAIN OUTCOME MEASURE(S ) Biometrical data ; current health status ; acute , chronic and childhood illnesses ; hospitalizations ; and surgeries . RESULT ( S ) Detailed physical examination did not reveal any relevant differences between ICSI and spontaneously conceived children . There were no relevant differences regarding the incidence of childhood illnesses , acute or chronic illnesses , accidents , and surgeries up to the age of 5.5 years . However , a history of undescended testicles was found significantly more often in boys born after ICSI  ( 5.4 % vs. 0.7 % ) , with the consequence that they had significantly more urogenital surgery ( 19.2 % vs. 8.9 % ) . Significantly more ICSI children had been hospitalized ( 37.6 % vs. 27.2 % ) , although we did not find any specific reason for the increased hospitalization rate . CONCLUSION ( S ) Other than an increased risk of undescended testicles and therefore an increase in urogenital surgeries in ICSI boys , the physical health of ICSI children was comparable to that of spontaneously conceived children at the age of 5.5 years A cohort of 91 children from cryopreserved embryos and 83 control children who were conceived normally had their development assessed using the Griffiths 's scales of mental development . The controls ( 81 singletons and two twins ) of a similar age , sex , and social class were selected from siblings , cousins , and peers of the  cryopreserved embryo group ( 68 singleton , 20 twins , and three triplets ) . Children from cryopreserved embryos had a lower mean birth weight and mean gestational age and a higher proportion were born by caesarean section .  One child from the cryopreserved embryo group had Down 's syndrome , three had squints , and four had conductive hearing loss while in the control children , six had squints , and nine had conductive hearing loss . In both groups , including the child with Down 's syndrome , the mean Griffiths 's quotient was greater than the st and ard 100 . In the children from cryopreserved embryos , the singleton and multiple birth subgroups had statistically similar assessment results . The mean ( SD ) Griffiths 's quotient was 105.69 ( 13.55 ) in children from cryopreserved embryos and 108.18 ( 9.80 ) in controls at a chronological age of 25.08 ( 12.86 ) and 29.19 ( 14.65 ) months respectively . Overall , the development in children from cryopreserved embryos did not cause concern though formal testing had highlighted small differences compared with other children conceived normally and of a similar social class Objective To investigate how pregnancy planning , time to conception , and infertility treatment influence cognitive development at ages 3 and 5 . Design Prospect i ve population based cohort study . Setting Millennium Cohort Study in the United Kingdom . Participants 18 818 children recruited at 9 months and followed up at 3 and 5 years . 11 790 singletons with available data on pregnancy , cognitive outcomes , and confounders were included in analyses at age 3 and 12 136 at age 5 . Exposure measures Mothers reported whether the pregnancy was planned , and their feelings when first pregnant ; those in whom the pregnancy was planned provided time to conception , and details of any assisted reproductive technologies . The population was divided into “ unplanned ” ( unplanned and unhappy ) , “ mistimed ” ( unplanned but happy ) , “ planned ” ( planned , time to conception < 12 months ) , “ subfertile ” ( planned , time to conception ≥12 months ) , “ induced ovulation ” ( received clomiphene citrate ) , and “ assisted reproduction ” ( in vitro fertilisation or intracytoplasmic sperm injection ) . The “ planned ” group was the comparison group in all analyses . Outcome measures Three components of the British Ability Scales ( BAS II ) . Naming vocabulary assessed verbal ability at age 3 ; this test was repeated at age 5 with the picture similarities and pattern construction subscales , which measure non-verbal and spatial abilities . Results In unadjusted analyses , the scores on all scales in children from unplanned pregnancies were significantly lower than in those from planned pregnancies — for example , the difference in mean verbal ability score at age 3 was −4.8 ( 95 % confidence interval −6.0 to −3.7 ; P<0.05 ) , equivalent to an average delay of four months . After adjustment for sociodemographic factors these differences were attenuated : −0.3 ( −1.3 to 0.7 ) , equivalent to no delay . Children born after assisted reproduction performed consistently better in verbal ability tests ( 3.8 ( −0.2 to 7.9 ) at age 3 and 3.5 ( 0.2 to 6.8 ) at age 5 ) , which suggests that on average these children are three to four months ahead ; this difference did not completely disappear with adjustment for confounders . Children born after infertility treatment had lower mean scores in non-verbal tests ( −1.2 ( −4.1 to 1.6 ) after assisted reproduction and −1.5 ( −3.5 to 0.4 ) after induced ovulation ) and in spatial ability tests ( −2.7 ( −6.9 to 1.6 ) after assisted reproduction ) , though the differences were not significant . Conclusions Pregnancy planning , subfertility , or assisted reproduction do not adversely affect children ’s cognitive development at age 3 or 5 . The differences observed in the unadjusted analyses are almost entirely explained by marked inequalities in socioeconomic circumstances between the groups Abstract Objective To compare neurological sequelae in twins born after assisted conception with singletons after assisted conception and naturally conceived twins and to assess neurological sequelae in children conceived after in vitro fertilisation ( IVF ) compared with intracytoplasmic sperm injection ( ICSI ) .  Design Controlled , national register based , cohort study . Participants Twins ( n = 3393 ) and singletons ( n = 5130 ) conceived by using assisted reproductive technologies and naturally conceived twins ( n = 10 239 ) born in Denmark between 1995 and 2000 . The children 's age at time of follow up was 2 - 7 years . Data sources Children were identified by cross linkage of the national medical birth registry and the national registry for in vitro fertilisation . Neurological and psychiatric diagnoses were retrieved from the national patients ' registry and the Danish psychiatric central registry . Main outcome measures Neurological sequelae , defined as cerebral palsy , mental retardation , severe mental developmental disturbances , and retarded psychomotor development . Further we made separate analyses on the specific cerebral palsy diagnosis . Results The crude prevalence rates per 1000 of neurological sequelae in twins and singletons after assisted conception and in naturally conceived twins were 8.8 , 8.2 , and 9.6 , and of cerebral palsy 3.2 , 2.5 , and 4.0 , respectively . In twins after assisted conception compared with control twins , the odds ratios of neurological sequelae and specifically of cerebral palsy , adjusted for child sex and year of birth , were 0.9 ( 95 % confidence interval 0.6 to 1.4 ) and 0.8 ( 0.4 to 1.6 ) , respectively . The corresponding odds ratios for twins after assisted conception compared with singletons after assisted conception were 1.1 ( 0.7 to 1.7 ) for neurological sequelae and 1.3 ( 0.6 to 2.9 ) for cerebral palsy . The odds ratio of neurological sequelae in children conceived by ICSI was 0.9 ( 0.5 to 1.7 ) ν children conceived by IVF . Conclusions Twins from assisted conception have a similar risk of neurological sequelae as their naturally conceived peers and singletons from assisted conception . Children born after ICSI have the same risk of neurological sequelae as children born after IVF BACKGROUND To examine the long-term child outcome  after IVF until the age of 3 years in Northern Finl and , we conducted a population -based cohort study . METHODS First , a cohort of 299 IVF children born in 1990 - 1995 was compared with a cohort of 558 controls representing the general population in terms of a multiple birth rate of 1.2 % , r and omly chosen from the Finnish Medical Birth Register ( FMBR ) and matched for sex , year of birth , area of residence , parity , maternal age and social class 
    Output:
    