使用供体精子行IVF/ICSI-ET助孕的新生儿结局回顾性分析

A retrospective analysis of neonatal outcomes resulting from IVF/ICSI-ET with donor sperm

目的探讨使用供体精子行体外受精/卵胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)助孕,是否会给新生儿结局带来不良影响。方法回顾性分析2011年4月至2021年4月于我院生殖医疗中心行IVF/ICSI-ET治疗后获临床妊娠并活产的6926例新生儿及其母亲的临床资料。根据不同精子来源分为两组:夫精组(n=6153)和供精组(n=773),比较两组不孕女性的一般资料、助孕资料、不同分娩胎数(单胎/双胎)及不同助孕方式(IVF/ICSI)的新生儿结局。结果两组间不孕女性的平均年龄比较无显著差异(P>0.05),供精组的平均不孕年限[(5.99±3.66)年vs.(4.57±3.13)年]、原发不孕女性占比(61.19%vs.40.32%)、IVF助孕受精方式占比(95.34%vs.83.16%)、移植优质胚胎率(96.63%vs.95.22%)、双胎分娩数占比(47.09%vs.42.16%)均显著高于夫精组(P<0.05);而体质量指数(BMI)显著低于夫精组[(21.15±2.69)kg/m^(2) vs.(21.57±2.82)kg/m^(2),P<0.05]。两组间平均移植胚胎数、新生儿性别比比较无显著差异(P>0.05);无论是不同分娩胎数(单胎或双胎),还是不同助孕方式(IVF/ICSI),两组间的新生儿在平均分娩孕周、平均新生儿体重、剖宫产率、胎儿早产率、巨大儿发生率、低体重儿发生率以及出生缺陷率方面比较均无显著差异(P>0.05);两组新生儿中最常见的出生缺陷类型均分布在循环系统和泌尿生殖系统。结论使用供体精子行IVF/ICSI-ET助孕并没有增加不良新生儿结局的风险,但仍需要在未来长期随访过程中密切关注子代安全并评估相关风险。

Objective:To explore neonatal outcomes resulting from in vitro fertilization/intracytoplasmic sperm injection and embryo transfer(IVF/ICSI-ET)with donor sperm and husband’s sperm.Methods:A retrospective analysis was conducted with clinical data from 6926 newborns and their mothers who underwent IVF/ICSI-ET treatment at Reproductive Medicine Center of the Third Affiliated Hospital of Guangxi Medical University from April 2011 to April 2021.The participants were divided into two groups based on different sperm sources:husband sperm group(n=6153)and donor sperm group(n=773).General information and assisted reproduction data of infertile women in the two groups were compared.The newborn outcomes of singleton and twin births,as well as the outcomes of newborns born through different assisted reproduction methods(IVF/ICSI),were also compared.Results:There were 6153 neonates in the husband sperm group and 773 neonates in the donor sperm group.There was no significant difference in the average age between the two groups(P>0.05).The mean infertility years[(5.99±3.66)years vs.(4.57±3.13)years],the proportion of primary infertility women(61.19%vs.40.32%),the proportion of fertilization mode of IVF assisted pregnancy(95.34%vs.83.16%),the rate of high-quality embryos transferred(96.63%vs.95.22%)and the proportion of twin births(47.09%vs.42.16%)in the donor sperm group were significantly higher than those of the husband sperm group(P<0.05),while the mothers’BMI[(21.15±2.69)kg/m^(2)]was significantly lower when compared with the husband sperm group[(21.57±2.82)kg/m^(2),P<0.05].There were no significant differences in the mean number of transplanted embryos and newborn sex ratio between the two groups(P>0.05).The number of births(single or twin)and the method of pregnancy assistance(IVF/ICSI)had no impact on gestational weeks,birth weight,cesarean section rate,premature birth rate,macrosomia birth rate,low birth weight rate and birth defect rate(P>0.05).The most common types of birth defects in both groups were abnormalities in circulatory and genitourinary systems.Conclusions:IVF/ICSI-ET with donor sperm could not increase the risk of adverse neonatal outcomes.However,there is still a need to pay close attention to offspring safety and assess associated risks during future long-term follow-ups.