体外受精-胚胎移植出生子代性别比影响因素分析  

Influencing factors of secondary sex ratio at birth after in-vitro fertilization and embryo transfer

作　　者：倪运萍 洪锐芳 陆杉 陈旭龙 邓雪梅 袁启龙 Ni Yunping;Hong Ruifang;Lu Shan;Chen Xulong;Deng Xuemei;Yuan Qilong(Department of Reproductive Medicine,Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510006,China;Guangdong Reproductive Hospital,Guangzhou 510006,China)

机构地区：[1]广州中医药大学第二附属医院生殖医学科,广州510006 [2]广东省生殖医院,广州510006

出　　处：《国际医药卫生导报》2022年第15期2154-2159,共6页International Medicine and Health Guidance News

基　　金：广州中医药大学第二附属医院横向课题(F561)。

摘　　要：目的探讨行体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)治疗出生子代性别比(secondary sex ratio,SSR)的相关影响因素。方法收集2013年6月至2021年6月在广州中医药大学第二附属医院生殖医学科接受体外受精-胚胎移植治疗分娩的胎儿性别数据,分别按移植卵裂期胚胎与囊胚、体外受精与卵胞浆内单精子显微注射(intracytoplasmic sperm insemination,ICSI)受精胚胎、不同来源精子行ICSI治疗胚胎进行分组比较,并按多因素logistic回归分析法进行分析。计量资料采用单因素ANOVA检验(方差齐),计数资料采用χ^(2)检验及Fisher’s确切概率法。结果IVF-ET治疗男女出生性别比为116∶100(1158∶998)。移植卵裂期胚胎1310个分娩周期与移植囊胚433个分娩周期进行比较,出生男女性别比:108∶100(870/809)比147∶100(277/189),差异存在统计学意义(P<0.05)。移植IVF胚胎1306个分娩周期与移植ICSI胚胎433个分娩周期进行比较,出生男女性别比为121∶100(879/724)比97∶100(264/272),差异有统计学意义(P<0.05)。穿刺取精来源精子男女出生性别比为90.2∶100(37∶41),不同来源精子行ICSI治疗出生子代性别比差异无统计学意义(P>0.05),睾丸穿刺来源精子子代出生性别比略高于附睾穿刺来源精子子代出生性别比。logistic回归分析显示移植胚胎期别是影响出生性别比的独立危险因素。结论囊胚移植出生性别比高于卵裂期胚胎出生性别比,移植IVF受精胚胎出生性别比高于移植ICSI受精胚胎出生性别比。胚胎期别是影响出生性别比的独立危险因素。Objectives To explore the influencing factors of secondary sex ratio(SSR)at birth after in-vitro fertilization and embryo transfer(IVF-ET).Methods The sex data of the babies delivered by the women treated by IVF-ET at Department of Reproductive Medicine,Second Affiliated Hospital of Guangzhou University of Chinese Medicine from June 2013 to June 2021 were collected.The SSR were analyzed by different embryo stages(cleavage stage or blastocyst stage),different fertilization methods[in vitro fertilization(IVF)or intracytoplasmic sperm insemination(ICSI)],and different sources of sperms(epididymal,testicular,or ejaculation).The data were analyzed by multivariate logistic regression analysis.The measurement data were analyzed by one-way ANOVA,and the enumeration data by χ^(2) test and Fisher's exact test.Results The overall SSR was 116∶100(1158∶998).The SSR's of cleavage-stage embryo transfer(1310 deliver cycles)and blastocyst stage embryo transfer(433 deliver cycles)were 108∶100(870/809)and 147∶100(277/189),with a statistical difference(P<0.05).The SSR's of IVF treatment(1306 cycles)and ICSI treatment(433 cycles)were 121∶100(879/724)and 97∶100(264/272),with a statistical difference(P<0.05).The SSR of sperms from puncture was 90.2∶100(37∶41).There was no statistical difference in SSR between different sperm sources treated by ICSI(P>0.05).The SSR of sperms from testicular puncture was slightly higher than that of sperms from epididymal puncture.Conclusions Blastocyst stage transfer might be associated with a higher SSR than cleavage stage embryo transfer.The SSR of embryos transferred from IVF treatment is higher than that of embryos transferred from ICSI treatment.The stage of transferred embryos is an independent risk factor for the SSR at birth.

关 键 词：体外受精 卵胞浆内单精子注射 囊胚 卵裂期胚胎 精子来源 出生性别比 

分 类 号：R714.8[医药卫生—妇产科学]