体外受精-胚胎移植术中受精方式对新生儿出生缺陷影响的回顾性分析  

Birth defects after in vitro fertilization and embryo transfer with different fertilization methods:a retrospective analysis

作　　者：石缨 宋天然 杨美玲 陈时雨 张一鸣 牛天慧 童英 SHI Ying;SONG Tianran;YANG Meiling;CHEN Shiyu;ZHANG Yiming;NIU Tianhui;TONG Ying(Department of Obstetrics,Gynecology and Reproductive Medicine,Air Force Medical Center,Beijing 100142,China)

机构地区：[1]空军特色医学中心妇产与生殖医学科,北京100142

出　　处：《空军航空医学》2023年第2期156-160,共5页AVIATION MEDICINE OF AIR FORCE

摘　　要：目的比较不同受精方式是否对新生儿出生缺陷存在影响。方法回顾性分析2010年7月—2020年12月接受体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)治疗并进行了胚胎移植的周期数据,共7372个胚胎移植周期,出生婴儿3265名。按照受精方式分为常规体外受精(in vitro fertilization,IVF)组和卵胞浆内单精子注射(intracytoplasmic sperm injection,ICSI)组,补救ICSI(rescue intracytoplasmic sperm injection,R-ICSI)纳入ICSI组。每组又进一步分为鲜胚移植亚组和复苏移植亚组。比较各组及各亚组间患者平均年龄、体质量指数(BMI)、平均胚胎移植数、临床妊娠率、双胎率、剖宫产率、出生体质量、男女性别比及出生缺陷发生率。结果与IVF组比较,ICSI组的患者平均年龄、BMI和临床妊娠率均低于IVF组,平均胚胎移植数高于IVF组,差异有统计学意义(P<0.05);双胎率、剖宫产率、出生体质量以及男女性别比差异无统计学意义。IVF组内复苏移植亚组患者平均年龄、平均胚胎移植数、双胎率及剖宫产率均低于鲜胚移植亚组,临床妊娠率和出生体质量均高于鲜胚移植亚组,差异有统计学意义(P<0.05);BMI及男女性别比较差异无统计学意义。ICSI组内复苏移植亚组患者平均年龄、平均胚胎移植数低于鲜胚移植亚组,临床妊娠率和出生体质量均高于鲜胚移植亚组,差异有统计学意义(P<0.05);BMI、双胎率、剖宫产率及男女性别比较差异无统计学意义。在3265名新生儿中,共有出生缺陷儿27例,出生缺陷率为0.83%。IVF组与ICSI组、鲜胚移植亚组与复苏移植亚组、男婴与女婴之间出生缺陷率均差异无统计学意义(P>0.05)。出生缺陷与母亲年龄、胚胎移植时期比较差异无统计学意义(P>0.05)。结论ICSI周期临床妊娠率低于IVF周期,复苏移植周期临床妊娠率及新生儿出生体质量明显高于鲜胚移植周期,ICSI受精方式没有增加新生儿出Objective To compare different methods of fertilization and determine their effect on birth defects.Methods The data on 7372 embryo transfer cycles between July 2010 and December 2020 was retrospectively analyzed,in which there were 3265 newborns.The total transfer cycles were divided into the in vitro fertilization(IVF)group and intracytoplasmic sperm injection(ICSI)group according to fertilization methods.The cycles in the IVF group and ICSI group were then divided into the fresh embryo transfer subgroup and frozen-thawed embryo transfer subgroup.The average age,BMI,average number of embryo transfers,clinical pregnancy rate,twin pregnancy rate,cesarean section rate,birth weight,sex ratio and birth defect rate were compared between the two groups.Results Compared with the IVF group,the average age,BMI and clinical pregnancy rate were lower in the ICSI group,but the average number of embryo transfers was larger(P<0.05),there was,however,no statistically difference in the twin pregnancy rate,cesarean section rate,birth weight or sex ratio between the two groups.In the IVF group,the average age,average number of embryo transfers,twin pregnancy rate,cesarean section rate of the frozen-thawed embryo transfer subgroup were lower,while the clinical pregnancy rate and birth weight were higher than those in the fresh embryo transfer subgroup(P<0.05),but there was no difference in BMI or the sex ratio between the two subgroups(P>0.05).In the ICSI group,the average age and average number of embryo transfers of the frozen-thawed embryo transfer subgroup were lower,but the clinical pregnancy rate and birth weight were higher than those in the fresh embryo transfer subgroup(P<0.05);there was no difference in BMI,the pregnancy rate,cesarean section rate or sex ratio between the two subgroups(P>0.05).Among the 3265 newborns,there were 27 cases of birth defects(0.83%).There was no statistically difference in birth defect rates between the IVF group and ICSI group,or between the fresh embryo transfer subgroup and the frozen-thawe

关 键 词：体外受精-胚胎移植 卵胞浆内单精子注射 鲜胚移植 复苏移植 出生缺陷 

分 类 号：R715.5[医药卫生—妇产科学]