辅助生殖技术出生婴儿性别比及出生缺陷相关影响因素分析

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目的 探讨影响辅助生殖技术(ART)出生婴儿性别比及出生缺陷发生率的相关因素.方法 回顾性分析2012年1月-2016年7月在河北省计划生育科学技术研究院生殖医学中心接受ART治疗并成功分娩的患者396例,出生婴儿504例.分析年龄、受精方式、精液来源、胚胎来源和分娩胎数等因素对于出生婴儿性别及出生缺陷的影响.结果 ①504例出生婴儿中,男婴270例,女婴234例,性别比为115∶100,不同因素对出生婴儿性别比均无显著影响(P>0.05).②出生缺陷儿9例,出生缺陷率为1.79%,其中年龄20 ~ 24岁组出生缺陷率显著高于25~29岁组(P<0.05),冷冻胚胎移植组出生缺陷率低于新鲜胚胎移植组(P<0.05),双胎分娩组出生缺陷率显著高于单胎分娩组(P<0.05).③双胎出生缺陷儿占出生缺陷儿总数的88.89%(8/9),补救-卵胞浆内单精子注射(R-ICSI) 20 ~ 24岁组较25 ~29岁组双胎出生缺陷率高(P<0.05),冷冻胚胎移植组双胎出生缺陷率显著低于新鲜胚胎移植组(P<0.05).结论 患者年龄、受精方式、精液来源、胚胎来源和分娩胎数等因素不影响ART出生婴儿性别比,冷冻胚胎移植和单胎妊娠均能一定程度上降低出生缺陷风险.“,”Objective To explore gender ratio of neonates conceived by assisted reproductive technology (ART) and the related influencing factors.Methods A retrospective analysis was performed in 396 pregnant women treated by ART from January 2012 to July 2016,504 new babies were born.The effects of age,mode of fertilization,source of semen,source of embryo,and number of fetal childbirth on neonatal gender ratio and birth defects were analyzed.Results Among 504 neonates,270 male babies and 234 female babies were included,the gender ratio was 115:100,these factors had no significant impact on neonatal gender ratio (P>0.05).Nine babies were found with birth defects,the incidence rate of birth defects was 1.79%,the incidence rate of birth defects in babies born by pregnant women aged 20-24 years old was statistically significantly higher than that in babies born by pregnant women aged 25-29 years old (P<0.05).The incidence rate of birth defects in frozen embryo transfer group was statistically significantly lower than that in fresh embryo transfer group (P<0.05).The incidence rate of birth defects in twin group was statistically significantly higher than that in single birth group (P<0.05).The proportion of twin with birth defects accounted for 88.89% (8/9) of the total babies with birth defects.Among the pregnant women treated by rescue-intracytoplasmic sperm injection (R-1CSI),the incidence rate of birth defects in 20-24-year-old group was statistically significantly higher than that in 25-29-year-old group (P<0.05).The incidence rate of twin birth defects in frozen embryo transfer group was statistically significantly lower than that in fresh embryo transfer group (P<0.05).Conclusion Age,mode of fertilization,source of semen,source of embryo,and number of fetal childbirth have no impact on gender ratio of neonates conceived by ART,frozen embryo transfer and single pregnancy can reduce the risk of birth defects to a certain extent.
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