辅助生殖技术助孕出生单胎新生儿第二性别比分析  

Secondary sex ratio analysis of singleton babies born following assisted reproductive technology

作　　者：吴丽敏[1] 高敏 王晓涵 桑美英 许波[1] 周桂香 付应云 栾红兵 骆丽华 刘雨生 金仁桃 童先宏 Wu Limin;Gao Min;Wang Xiaohan;Sang Meiying;Xu Bo;Zhou Guixiang;Fu Yingyun;Luan Hongbing;Luo Lihua;Liu Yusheng;Jin Rentao;Tong Xianhong(Reproductive Medicine Center,the First Affiliated Hospital of USTC(Anhui Provincial Hospital),Hefei 230001,China;Medical Laboratory Center of Anhui No.2 Provincial People's Hospital,Hefei 230012,China)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)生殖中心,合肥230001 [2]安徽省第二人民医院医学检验中心,合肥230012

出　　处：《中华生殖与避孕杂志》2022年第6期615-620,共6页Chinese Journal of Reproduction and Contraception

基　　金：国家重点研发计划(2018YFC1003900);国家自然科学基金面上项目(81971446)。

摘　　要：目的探究辅助生殖技术中出生单胎新生儿第二性别比(secondary sex ratio,SSR)的影响因素。方法回顾性队列研究分析2000年1月至2018年12月期间在中国科学技术大学附属第一医院(安徽省立医院)生殖中心通过辅助生殖技术治疗出生的7020例单胎新生儿的临床资料,分析新生儿的母亲年龄、授精方式、移植胚胎类型、移植胚胎期别等因素对单胎新生儿性别的影响。结果在7020例新生儿中,男婴3730例,女婴3290例,总SSR为113∶100。体外受精(in vitro fertilization,IVF)方式出生新生儿SSR明显高于卵胞质内单精子注射(intracytoplasmic sperm injection,ICSI)授精方式(121∶100比95∶100,P<0.001),其他因素对出生新生儿SSR无显著影响。分层分析中,在IVF组和ICSI组间除了母亲年龄≥35岁组、囊胚期胚胎移植组的IVF和ICSI出生的SSR差异无统计学意义(P>0.05)外,其余各组的IVF出生新生儿的SSR都高于ICSI(<35岁组:P<0.001;新鲜胚胎组:P=0.001;冻融胚胎组:P=0.003;卵裂期胚胎移植组:P<0.001)。在IVF组内和ICSI组内分析显示各影响因素之间的SSR差异没有统计学意义(P>0.05)。单因素logistic回归分析显示,单胎妊娠中授精方式对新生儿SSR产生的影响有统计学意义(OR=0.792,95%CI=0.712~0.881,P<0.001)。去除混杂因素后logistic回归分析显示,单胎妊娠中授精方式对新生儿SSR影响有统计学意义(aOR=0.793,95%CI=0.713~0.883,P<0.001)。结论授精方式是辅助生殖技术中影响出生单胎SSR的因素,IVF较ICSI可提高SSR比值。Objective To explore the influencing factors of the secondary sex ratio(SSR)of singleton babies born following assisted reproductive technology.Methods A total of 7020 single babies delivered by assisted reproductive technology at the Reproductive Medicine Center of the First Affiliated Hospital of USTC(Anhui Provincial Hospital)from January 2000 to December 2018 were collected in a retrospective cohort study.The effect of influencing factors,such as maternal age,fertilization method,embryo transfer type and embryo transfer period on the sex of singleton babies were analyzed.Results Among 7020 babies,3730 were boys and 3290 were girls.The total SSR was 113∶100.The SSR of in vitro fertilization(IVF)was significantly higher than that of intracytoplasmic sperm injection(ICSI)fertilization(121∶100 vs.95∶100,P<0.001),while other factors had no significant effect on the SSR of infants born.In the stratified analysis,there was no difference in SSR between IVF and ICSI in the blastocyst embryo transfer group with mother's age 35 years or older(P<0.05),while the SSR of IVF in the other groups was higher than that of ICSI(<35 years old group:P<0.001;fresh embryo group:P=0.001;frozen-thawed embryo group:P=0.003;cleavage embryo transfer group:P<0.001).Univariate logistic regression analysis showed that the fertilization method in singleton pregnancy had a statistically significant effect on baby SSR(OR=0.792,95%CI=0.712-0.881,P<0.001).After removing confounding factors,logistic regression analysis showed that the fertilization method in singleton pregnancy had a statistically significant effect on neonatal SSR(aOR=0.793,95%CI=0.713-0.883,P<0.001).Conclusion The fertilization method of assisted reproductive technology can affect the SSR of singleton newborns.The SSR of IVF is significantly higher than that of ICSI and the difference was significant.

关 键 词：生殖技术 辅助 精子注射 细胞质内 常规体外受精 第二性别比 

分 类 号：R714[医药卫生—妇产科学]