冻融胚胎移植周期中不同辅助生殖技术助孕方式和移植不同发育阶段胚胎对出生性别比的影响

Sex ratio at birth of different assisted reproductive technologies and embryo transfer at different developmental stages in frozen-thawed embryo transfer cycles

目的探讨冻融胚胎移植(frozen-thawed embryo transfer,FET)周期中不同辅助生殖技术(assisted reproductive technology,ART)助孕方式和移植不同发育阶段胚胎对新生儿性别的影响。方法回顾性队列研究分析2010年4月至2018年10月期间于广州市妇女儿童医疗中心生殖中心接受体外受精(in vitro fertilization,IVF)、卵胞质内单精子注射(intracytoplasmic sperm injection,ICSI)和胚胎植入前遗传学检测(preimplantation genetic testing,PGT)治疗并进行FET且成功分娩的患者和新生儿临床资料。比较不同助孕方式及移植不同发育阶段胚胎对新生儿性别的影响。结果①IVF-FET共898对夫妇(920个周期),1166名新生儿,出生性别比为106.7。移植桑葚期前、桑葚期或囊胚期胚胎,出生性别比逐渐增高(99.0,135.4,142.6),但各组间差异无统计学意义(P>0.05)。②ICSI-FET(含PGT)共415对夫妇(433个周期),555名新生儿,出生性别比为111.0。移植不同发育阶段胚胎,出生性别比(116.0、87.2、137.5)差异无统计学意义(P>0.05)。③PGT-FET共33对夫妇(33个周期),33名新生儿,出生性别比为153.8。移植IVF、ICSI或PGT解冻囊胚对出生性别比没有显著影响(P>0.05)。结论在FET周期中,采用IVF技术助孕,移植较晚发育阶段胚胎可能会增加出生性别比的风险;ICSI技术移植不同发育阶段胚胎或移植IVF、ICSI或PGT囊胚对新生儿性别没有显著影响。

Objective To investigate the effect of different assisted reproductive technologies(ART)and transplanted embryos at different developmental stages on live birth sex ratio in frozen-thawed embryo transfer(FET)cycles.Methods From April 2010 to October 2018,the clinical data of patients and neonatal underwent in vitro fertilization-frozen-thawed embryo transfer(IVF-FET),intracytoplasmic sperm injection-frozen-thawed embryo transfer(ICSI-FET)and preimplantation genetic testing-frozen-thawed embryo transfer(PGT-FET)cycles that led to birth in the Center of Reproductive Medicine,Guangzhou Women and Children's Medical Center were retrospectively analyzed.The relationship of the sex ratio of the live births to different ART and transplanted embryos at different developmental stages was studied.Results 1)IVF-FET cycles included 898 couples(920 FET cycles)and 1166 babies,with a general sex ratio of 106.7.The live birth sex ratio increased gradually at pre-morula stage,morula stage and blastocyst stage embryo transfer(99.0,135.4,142.6),but no statistical difference was observed between the groups(P>0.05).2)ICSI-FET cycles included 415 couples(433 FET cycles)and 555 babies,with a general live birth sex ratio of 111.0.After the transfer of embyos at different stages the proportion of male babies displayed no significant difference(P>0.05).3)PGT-FET cycles included 33 couples(33 FET cycles)and 33 babies,with a general live birth sex ratio of 153.8.Transplantation of blastocysts in IVF,ICSI or PGT had no significant effect on the proportion of male babies(P>0.05).Conclusion In FET cycles,compared with embryo transfer at early stage,late stage embryo transfer may be associated with a higher live birth sex ratio.The transfer of ICSI-FET embryos at different developmental stages and the transfer of blastocysts by IVF,ICSI or PGT technique did not affect the sex ratio of live birth.