不同受精方式对单胎妊娠临床结局及出生缺陷发生情况的影响  

Effects of different fertilization methods on clinical outcome ofsingleton pregnancy and occurrence of birth defects

作　　者：张坤[1] 曹金凤[1] 杨阳[1] 孙庆云[1] 曹明雅 郝桂敏[1] ZHANG Kun;CAO Jin-feng;YANG Yang;SUN Qing-yun;CAO Ming-ya;HAO Gui-min(Deparment of Reproductive Medicine,the Second Hospital of Hebei Medical University,Shijiazhuang,Hebei 050000,China)

机构地区：[1]河北医科大学第二医院生殖医学科,河北石家庄050000

出　　处：《中国妇幼保健》2024年第3期492-496,共5页Maternal and Child Health Care of China

基　　金：河北省医学科学研究重点课题(20210602);河北省重点研发计划项目(20377714D)。

摘　　要：目的 探讨不同受精方式对单胎妊娠临床结局及出生缺陷发生情况的影响。方法 回顾性分析2012年1月—2019年12月在河北医科大学第二医院生殖医学科进行体外受精-胚胎移植(IVF-ET)后单胎妊娠的4 998个周期,按不同受精方式,分为IVF组(3 590个周期)和卵胞浆内单精子注射(ICSI)组(1 408个周期)。比较两组患者的一般情况、妊娠结局。按年龄分层,分为年龄≤30岁组、30岁<年龄≤35岁组、年龄>35岁组,比较各组不同受精方式患者的妊娠结局。结果 IVF组和ICSI组平均年龄分别为(30.3±4.0)岁和(29.0±4.0)岁,早期流产率分别为14.0%和11.1%,足月产率分别为74.5%和79.1%,差异均有统计学意义(均P<0.05)。在年龄≤30岁组,IVF和ICSI患者早期流产率分别为11.9%和8.7%,足月产率分别为77.5%和82.4%,差异均有统计学意义(均P<0.05)。年龄≤30岁组、30岁<年龄≤35岁组、年龄>35岁组,IVF新生儿出生缺陷发生率分别为1.2%、1.1%、2.3%,ICSI新生儿出生缺陷发生率分别为1.8%、2.4%、3.0%,差异均无统计学意义(均P>0.05)。结论 年龄是影响单胎妊娠结局的主要因素,随着年龄增加,新生儿出生缺陷发生率有逐渐增高的趋势。年龄≤30岁的患者,ICSI组早期流产率低,足月产率高;在年龄>30岁的患者中,两种受精方式的单胎妊娠结局相似,提示适龄生育非常重要。在不同受精方式中,ICSI组出生缺陷发生率有高于IVF组的趋势,应严格把控ICSI适应证。Objective To explore the effects of different fertilization methods on clinical outcome of singleton pregnancy and occurrence of birth defects.Methods A total of 4998 cycles of singleton pregnancy after in vitro fertilization-embryo transfer(IVF-ET)in Department of Reproductive Medicine,the Second Hospital of Hebei Medical University from January 2012 to December 2019 were analyzed retrospectively and divided into IVF group(3590 cycles)and intracytoplasmic sperm injection(ICSI)group(1408 cycles)according to different fertilization methods.The general data and pregnancy outcomes in the two groups were compared.The cases were divided into≤30-year-old group,30<age≤35-year-old group,and>35-year-old group,the pregnancy outcomes were compared.Results The average ages in IVF group and ICSI group were(30.3±4.0)years old and(29.0±4.0)years old,respectively,the rates of early abortion were 14.0%and 11.1%,respectively,the rates of full-term birth were 74.5%and 79.1%,respectively,there were statistically significant differences(P<0.05).In≤30-year-old group,the rates of early abortion of IVF and ICSI patients were 11.9%and 8.7%,respectively,the rates of full-term birth were 77.5%and 82.4%,respectively,there were statistically significant differences(P<0.05).In≤30-year-old group,30<age≤35-year-old group,and>35-year-old group,the incidence rates of birth defects of IVF neonates were 1.2%,1.1%,and 2.3%,respectively,the incidence rates of birth defects of ICSI neonates were 1.8%,2.4%,and 3.0%,respectively,there was no statistically significant difference(P>0.05).Conclusion Age is the main influencing factor of singleton pregnancy outcomes,the incidence rate of birth defects increases with age.In patients aged or less than 30 years old,the rate of early abortion is low,the rate of full-term birth is high;in patients more than 30 years old,the pregnancy outcomes of IVF and ICSI are similar,which indicates that the appropriate age of fertility is very important.Among different fertilization methods,the incidence rate of

关 键 词：单胎妊娠 体外受精 卵胞浆内单精子注射 年龄 出生缺陷 

分 类 号：R715.5[医药卫生—妇产科学]