Fertility Clinic, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Fertil Steril. 2011 Mar 1;95(3):959-63. doi: 10.1016/j.fertnstert.2010.07.1075.
To compare the perinatal outcome of singleton siblings conceived differently.
National population-based registry study.
Denmark, from 1994 to 2008.
PATIENT(S): Pairs of siblings (13,692 pairs; n = 27,384 children) conceived after IVF, intracytoplasmatic sperm injection (ICSI), frozen embryo replacement (FER), or spontaneous conception subcategorized into five groups according to succession: [1] IVF-ICSI vs. spontaneous conception (n = 7,758), [2] IVF-ICSI vs. FER (n = 716), [3] FER vs. FER (n = 34), [4] IVF-ICSI vs. IVF-ICSI (n = 2,876), and [5] spontaneous conception vs. spontaneous conception (n = 16,000).
INTERVENTION(S): Observations were obtained from national registries.
MAIN OUTCOME MEASURE(S): Birth weight, gestational age, low birth weight (<2,500 g), preterm birth (<37 weeks' gestation) and perinatal deaths.
RESULT(S): Mean birth weight was 65 g (95% confidence interval [CI], 41-89] lower in all assisted reproductive technology children compared with their spontaneously conceived siblings. FER children were 167 g (95% CI, 90-244] heavier than siblings born after replacement of fresh embryos. The difference in birth weight between firstborn and second born sibling depended on order of conception method. Higher risk of low birth weight with (odds ratio [OR], 1.4; 95%CI, 1.1-1.7] and preterm birth (OR, 1.3; 95% CI, 1.1-1.6] was observed in IVF/ICSI compared with spontaneous conception.
CONCLUSION(S): When differentiating between order and mode of conception, it seems that assisted reproductive technology plays a role in mean birth weight and risk of low birth weight and preterm birth. Birth weight was higher in siblings born after FER compared with fresh embryos replacement.
比较不同受孕方式的单卵双胎的围产结局。
全国基于人群的注册研究。
丹麦，1994 年至 2008 年。
IVF、胞浆内单精子注射（ICSI）、冷冻胚胎移植（FER）或自然受孕的单卵双胎姐妹对（13692 对，n=27384 例），根据顺序分为 5 组：[1]IVF-ICSI 与自然受孕（n=7758）、[2]IVF-ICSI 与 FER（n=716）、[3]FER 与 FER（n=34）、[4]IVF-ICSI 与 IVF-ICSI（n=2876）和[5]自然受孕与自然受孕（n=16000）。
观察结果来自全国登记处。
出生体重、胎龄、低出生体重（<2500g）、早产（<37 周妊娠）和围产儿死亡。
与自然受孕的兄弟姐妹相比，所有辅助生殖技术儿童的平均出生体重低 65g（95%置信区间[CI]，41-89）。FER 儿童比新鲜胚胎移植后出生的兄弟姐妹重 167g（95%CI，90-244）。第一胎和第二胎兄弟姐妹之间的出生体重差异取决于受孕方法的顺序。与自然受孕相比，IVF/ICSI 组低出生体重的风险（比值比[OR]，1.4；95%CI，1.1-1.7）和早产（OR，1.3；95%CI，1.1-1.6）的风险更高。
在区分受孕顺序和方式时，辅助生殖技术似乎对平均出生体重以及低出生体重和早产的风险起作用。与新鲜胚胎移植相比，FER 后出生的兄弟姐妹的出生体重更高。
