[1]梁玉玲,董悦芝,孙致敏,等.不同辅助生殖技术及子代性别与出生缺陷的关系[J].新乡医学院学报,2023,40(5):468-472.[doi:10.7683/xxyxyxb.2023.05.013]
 LIANG Yuling,DONG Yuezhi,SUN Zhimin,et al.Relationship between different assisted reproductive technology and offspring gender and birth defects[J].Journal of Xinxiang Medical University,2023,40(5):468-472.[doi:10.7683/xxyxyxb.2023.05.013]
点击复制

不同辅助生殖技术及子代性别与出生缺陷的关系
分享到:

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
40卷
期数:
2023年5
页码:
468-472
栏目:
临床研究
出版日期:
2023-05-05

文章信息/Info

Title:
Relationship between different assisted reproductive technology and offspring gender and birth defects
作者:
梁玉玲董悦芝孙致敏杨丽
(郑州大学第一附属医院生殖医学中心,河南 郑州 450000)
Author(s):
LIANG YulingDONG YuezhiSUN ZhiminYANG Li
(Reproductive Medicine Center,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan Province,China)
关键词:
出生缺陷辅助生殖技术体外受精卵胞浆内单精子注射性别
Keywords:
birth defectsassisted reproductive technologyin vitro fertilizationintracytoplasmic sperm injectiongender
分类号:
R711.6
DOI:
10.7683/xxyxyxb.2023.05.013
文献标志码:
A
摘要:
目的 探讨不同辅助生殖技术(ART)及子代性别与出生缺陷的关系。
方法 选择2017年1月至2021年12月于郑州大学第一附属医院生殖医学中心接受ART助孕治疗后获得的围产儿为研究对象。本研究共纳入34 626例围产儿,根据父母采用的ART将围产儿分为体外受精(IVF)组(n=12 449)、卵胞浆内单精子注射技术(ICSI)组(n=4 680)、冻融胚胎移植(FET)组(n=13 888)和夫精人工授精(AIH)/供精人工授精(AID)组(n=3 609);另根据性别,将围产儿分为男婴组(n=18 018)和女婴组(n=16 608)。通过电话或门诊问诊的方式对围产儿出生情况进行随访。统计出生缺陷情况及出生缺陷类型,并计算出生缺陷发生率。
结果 本研究纳入的34 626例围产儿中,出生缺陷患儿295例,总出生缺陷率为85.20/万。2017~2021年每年出生缺陷率分别为83.27/万(55/6 605)、95.01/万(64/6 736)、92.68/万(69/7 445)、87.50/万(59/6 743)、67.63/万(48/7 097);2017~2021年每年出生缺陷率比较差异无统计学意义(χ2=3.925,P>0.05)。2017~2021年,IVF组、ICSI组、FET组、AIH/AID组出生缺陷发生率比较差异均无统计学意义(χ2=3.666、2.791、2.071、3.005、2.282,P>0.05)。295例出生缺陷儿中,构成比位居前3位的出生缺陷类型依次为心血管循环系统(27.80%)、骨骼肌肉系统(15.25%)、胃肠消化系统(14.92%);IVF组、ICSI组、FET组、AIH/AID组的出生缺陷类型构成比最高的均为心血管循环系统畸形。2017~2021年,男婴组与女婴组的出生缺陷发生率比较差异均无统计学意义(χ2=0.842、0.228、0.087、0.016、1.180,P>0.05)。男婴组和女婴组中构成比位居前3位的出生缺陷类型均为心血管循环系统、胃肠道消化系统、骨骼肌肉系统。
结论 采用不同ART助孕出生的子代中最常见的出生缺陷类型为心血管循环系统,不同ART及子代性别不会影响子代出生缺陷发生率。
Abstract:
Objective To investigate the relationship between different assisted reproductive technology (ART) and the gender of offspring and birth defects.
Methods Perinatal infants who received ART assisted pregnancy treatment at the Reproductive Medicine Center,the First Affiliated Hospital of Zhengzhou University from January 2017 to December 2021 were selected as the study subjects.A total of 34 626 perinatal infants were included in this study.They were divided into the in vitro fertilization (IVF) group (n=12 449),intracytoplasmic sperm injection technology (ICSI) group (n=4 680),frozen thawed embryo transfer (FET) group (n=13 888),and artificial insemination by husband (AIH)/artificial insemination by donor (AID) group (n=3 609) based on the ART adopted by their parents;according to gender,the perinatal infants were divided into the male infant group (n=18 018) and female infant group (n=16 608).Perinatal infants were followed up by telephone or outpatient consultation.The situation and types of birth defects were recorded,and the incidence of birth defects was calculated.
Results Among the 34 626 perinatal infants included in this study,295 cases had birth defects,with a total birth defect rate of 85.20/10 000.The birth defect rates from 2017 to 2021 were 83.27/10 000 (55/6 605),95.01/10 000 (64/6 736),92.68/10 000 (69/7 445),87.50 /10 000 (59/6 743),and 67.63/10 000 (48/7 097),respectively;there was no significant difference in birth defect rates among 2017 to 2021(χ2=3.925,P>0.05).From 2017 to 2021,there was no significant difference in the incidence of birth defects among the IVF group,ICSI group,FET group and AIH/AID group (χ2=3.666,2.791,2.071,3.005,2.282;P>0.05).Among the 295 cases of birth defects,the top three types of birth defects in terms of composition ratio were cardiovascular system (27.80%),skeletal muscle system (15.25%),and gastrointestinal digestive system (14.92%);the highest proportion of birth defect types in the IVF group,ICSI group,FET group and AIH/AID group was cardiovascular circulatory system abnormalities.From 2017 to 2021,there was no significant difference in the incidence of birth defects between the male infant group and female infant group (χ2=0.842,0.228,0.087,0.016,1.180;P>0.05).The top three types of birth defects in the male infant group and female infant group were cardiovascular system,gastrointestinal digestive system,and skeletal muscle system.
Conclusion The most common birth defect type among offspring born with different ART assisted pregnancies is the cardiovascular system,and different ART and offspring gender do not affect the incidence of birth defects in offspring.

参考文献/References:

[1] CARSON S A,KALLEN A N.Diagnosis and management of infertility:a review[J].JAMA,2021,326(1):65-76.
[2] CHAMBERS G M,DYER S,ZEGERS-HOCHSCHILD F,et al.International Committee for Monitoring Assisted Reproductive Technologies world report:assisted reproductive technology,2014[J].Hum Reprod,2021,36(11):2921-2934.
[3] PINBORG A,HENNINGSEN A K,MALCHAU S S,et al.Congenital anomalies after assisted reproductive technology[J].Fertil Steril,2013,99(2):327-332.
[4] WEN J,JIANG J,DING C,et al.Birth defects in children conceived by in vitro fertilization and intracytoplasmic sperm injection:a meta-analysis[J].Fertil Steril,2012,97(6):1331-7.e74.
[5] SERAFIN D,GRABAREK B O,BORON D,et al.Evaluation of the risk of birth defects related to the use of assisted reproductive technology:an updated systematic review[J].Int J Environ Res Public Health,2022,19(8):4914.
[6] THE LANCET.ICD-11[J].Lancet,2019,393(10188):2275.
[7] 姚莉琴,邹团标,张山山,等.1986~2014年中国出生缺陷发生率的变化趋势及地理分布[J].中国优生与遗传杂志,2020,28(3):351-356,359.
YAO L Q,ZOU T B,ZHANG S S,et al.Trends and geographical distribution of birth defects in China from 1986 to 2014[J].Chin J Birth Health Hered,2020,28(3):351-356,359..
[8] 贺木兰,孙晓溪.辅助生殖技术子代安全性及对策思考[J].中华生殖与避孕杂志,2019,39(10):838-843.
HE M L,SUN X X.Research advance in the risk of offspring with assisted reproductive technology and strategies to improve the safety of maternity and progeny[J].Chin J Reprod Contracept,2019,39(10):838-843.
[9] LUKE B,BROWN M B,WANTMAN E,et al.The risk of birth defects with conception by ART[J].Hum Reprod,2021,36(1):116-129.
[10] YU H T,YANG Q,SUN X X,et al.Association of birth defects with the mode of assisted reproductive technology in a Chinese data-linkage cohort [J].Fertil Steril,2018,109(5):849-856.
[11] 吉梦露,王兴玲.辅助生殖技术对子代出生缺陷的影响 [J].中国计划生育学杂志,2017,25(9):639-643.
JI M L,WANG X L.Effects of assisted reproductive technology on offspring birth defects[J].Chin J Fam Plan,2017,25(9):639-643.
[12] BERNTSEN S,LAIVUORI H,LA COUR FREIESLEBEN N,et al.A systematic review and meta-analysis on the association between ICSI and chromosome abnormalities[J].Hum Reprod Update,2021,27(5):801-847.
[13] PELKONEN S,HARTIKAINEN A L,RITVANEN A,et al.Major congenital anomalies in children born after frozen embryo transfer:a cohort study 1995-2006[J].Hum Reprod,2014,29(7):1552-1557.
[14] YANG M,LIN L,SHA C,et al.Which is better for mothers and babies:fresh or frozen-thawed blastocyst transfer[J].BMC Pregnancy Childbirth,2020,20(1):559.
[15] 刘广宝,康冉冉,焦志,等.中国使用精子库冷冻精液助孕对子代出生缺陷影响的meta分析[J].中华生殖与避孕杂志,2021,41(4):342-351.
LIU G B,KANG R R,JIAO Z,et al.Effect of frozen semen from sperm bank on birth defects in assisted reproduction technology in China:a meta-analysis[J].Chin J Reprod Contracept,2021,41(4):342-351.
[16] 谢宝国,马燕琳,黄元华.辅助生殖技术不同受精方式对子代出生缺陷的临床研究[J].海南医学院学报,2021,27(22):1704-1708.
XIE B G,MA Y L,HUANG Y H.Clinical study of different fertilization methods of assisted reproductive technology on neonatal birth defects[J].J Hainan Med Univ,2021,27(22):1704-1708.
[17] 杨静薇,邓成艳,黄学锋,等.中华医学会生殖医学分会2018年度辅助生殖技术数据报告[J].生殖医学杂志,2021,30(4):419-425.
YANG J W,DENG C Y,HUANG X F,et al.Annual report on assisted reproductive technology of Chinese Society of Reproductive Medicine in 2018[J].J Reprod Med,2021,30(4):419-425.
[18] XIE D,YANG T,LIU Z,et al.Epidemiology of birth defects based on a birth defect surveillance system from 2005 to 2014 in Hunan province,China[J].PLoS One,2016,11(1):e0147280.
[19] 梁丽芳,韦洁,韦慧,等.2013—2019年广西地区围生儿出生缺陷监测结果分析[J].中国妇幼保健,2022,37(1):133-136.
LIANG L F,WEI J,WEI H,et al.Analysis on monitoring results of perinatal birth defects in Guangxi from 2013 to 2019[J].Matern Child Health Care Chin,2022,37(1):133-136.
[20] 郭薇,王树松,刘帅,等.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 [J].中国妇幼保健,2017,32(23):5977-5980.
GUO W,WANG S S,LIU S,et al.Analysis on gender ratio of neonates conceived by assisted reproductive technology and the related influencing factors[J].Matern Child Health Care Chin,2017,32(23):5977-5980.
[21] JIA Q,FANG L,WANG Z,et al.Ovarian hyperstimulation syndrome is associated with a high secondary sex ratio in fresh IVF cycles with cleavage-stage embryo transfer:results for a cohort study[J].Reprod Sci,2021,28(12):3341-3351.
[22] 张红艳,胡孟彩,陈露,等.河南省2008-2017年围产儿出生缺陷监测情况分析 [J].中国妇幼卫生杂志,2019,10(2):35-40.
ZHANG H Y,HU M C,CHEN L,et al.Analysis of birth defects surveillance among perinatal infant in Henan Province from 2008 to 2017[J].Chin J Women Child Health,2019,10(2):35-40.
[23] WEN S W,MIAO Q,TALJAARD M,et al.Associations of assisted reproductive technology and twin pregnancy with risk of congenital heart defects[J].JAMA Pediatr,2020,174(5):446-454.
[24] GIORGIONE V,PARAZZINI F,FESSLOVA V,et al.Congenital heart defects in IVF/ICSI pregnancy:systematic review and meta-analysis[J].Ultrasound Obstet Gynecol,2018,51(1):33-42.

相似文献/References:

[1]王晓虹.河南省汝阳县出生缺陷儿调查分析 [J].新乡医学院学报,2007,24(03):252.
[2]李 静,黄岩杰,杨晓青,等.出生缺陷和(或)发育迟缓儿童的染色体核型分析[J].新乡医学院学报,2020,37(2):152.[doi:10.7683/xxyxyxb.2020.02.012]
 LI Jing,HUANG Yanjie,YANG Xiaoqing,et al.Karyotype analysis of children with birth defects and(or) growth retardation[J].Journal of Xinxiang Medical University,2020,37(5):152.[doi:10.7683/xxyxyxb.2020.02.012]

更新日期/Last Update: 2023-05-05