辅助生殖技术妊娠结局的分析

Analysis of Pregnancy Outcome of Assisted Reproductive Technology

目的分析辅助生殖技术(ART)子代结构异常状况,评价不同ART方式妊娠后子代结构异常的风险。方法回顾性分析该院2009年1月—2013年12月收治的不同助孕方式妊娠的2 955例患者妊娠结局,分析妊娠12周后发现的胎儿畸形及新生儿出生缺陷率,初步探讨不同助孕方法子代发生结构异常的风险。结果 2955例妊娠患者分娩新生儿2875个。新生儿出生后发现出生缺陷45例(45/2875,1.57%,其中ⅣF 16例(1.31%),ICSI-ET 26例(2.74%),新鲜周期出生缺陷42例(42/2172,1.93%),F-ET3例(3/703,0.43%)。IVF与ICSI出生缺陷差异有统计学意义(x^2=5.8,P=0.015)。新鲜移植周期与冷冻移植周期差异有统计学意义(x^2=7.83,P=0.005)。结论 ICSI有增加子代出生缺陷的风险,告知不孕患者ART的潜在风险是必要的,ART技术的应用应该慎重,评估ART子代安全性需要更长时间的随访。

Objective To analyze the condition of birth defects among offspring by assisted reproductive technology （ART） .To evaluate the risk of congenital malformation at birth of ART. Methods Review the different Zhuyun mode analysis the hospital in 2009 January to 2013 December were analyzed in 2955 patients with pregnancy outcome of pregnancy after 12 weeks of pregnancy, analysis of fetal malformation and defect rate found in the newborn, preliminary study of risk of abnormal structure of different Zhuyun methods offspring. Results Among 2875 newborns, 45 cases birth defects were found（1.57%）, including 16 cases（1.31%） of in vitro fertilization and embryo transfer （IVF-ET）, 26 cases （2.74%） of intracytoplasmic sperm injection and embryo transfer（ICSI-ET）, 3 cases （0.43%）of frozen thawed embryo transfer （F-ET） .The birth defets of ICSI was significant different with IVF（P〈0.05）. There was significant difference between the fresh and frozen embryo transplantation cycle in birth defets（P〈0.05）. Conclusion The risk of offspring birth defects may be increased by ICSI, the potential risk of ART should be informed. The application of ART should be carefully, the safety of ART should be evaluated in a long term.