Yin Li, Hang Fu, Gu Long-jie, Xu Bei, Ma Ding, Zhu Gui-jin
Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
Birth Defects Res A Clin Mol Teratol. 2013 Nov;97(11):744-9. doi: 10.1002/bdra.23116. Epub 2013 Feb 25.
Previous studies inconsistently suggest that assisted reproduction technology (ART) may increase the risk of birth defects in children.
METHOD(S): Live birth infants, conceived by in vitro fertilization fresh embryo transfer (IVF), intracytoplasmic sperm injection fresh embryo transfer (ICSI), or frozen-thawed embryo transfer (FET) in Reproductive Center of Tongji Hospital (Wuhan, China) between 1997 and 2008, were followed up at birth and after 3 years. Preterm pregnancy, multiple pregnancy, sex ratio (male/female), congenital malformation were compared.
RESULT(S): A total of 4,236 children were born after ART (IVF 2,543, ICSI 908, FET 785). Compared with IVF, the rate of preterm pregnancy and sex ratio in ICSI were lower (p < 0.05); the rate of multiple pregnancy in ICSI and FET were all lower than IVF (p < 0.05). Congenital defects were comparable in all groups at birth. In total, 2,908 children participated in the second follow-up from 34 months to 60 months with an average of 40 months, and the cases of birth defects had doubled (3 years: 5.16%, birth: 2.22%). The birth defect rate in boys conceived through ICSI was significantly higher than the IVF group after 3-year follow-up (ICSI boys: 8.62%, IVF boys: 5.21% [p < 0.05]), even though there was no significant difference at birth.
CONCLUSION(S): Compared with IVF, FET may not increase risk of birth defects. Children conceived through ICSI, especially males, had higher rates of congenital malformations that were inapparent at birth. So longitudinal monitoring may provide insights into the risks of ART.
以往研究结果不一，提示辅助生殖技术（ART）可能增加儿童出生缺陷风险。
对1997年至2008年期间在华中科技大学同济医学院附属同济医院生殖中心通过体外受精新鲜胚胎移植（IVF）、卵胞浆内单精子注射新鲜胚胎移植（ICSI）或冻融胚胎移植（FET）受孕的活产婴儿进行出生时及3岁后的随访。比较早产、多胎妊娠、性别比（男/女）、先天性畸形情况。
ART后共出生4236名儿童（IVF 2543例、ICSI 908例、FET 785例）。与IVF相比，ICSI的早产率和性别比更低（p<0.05）；ICSI和FET的多胎妊娠率均低于IVF（p<0.05）。出生时所有组的先天性缺陷情况相当。共有2908名儿童在34个月至60个月（平均40个月）时参与了第二次随访，出生缺陷病例增加了一倍（3岁时：5.16%，出生时：2.22%）。3年随访后，通过ICSI受孕的男孩出生缺陷率显著高于IVF组（ICSI男孩：8.62%，IVF男孩：5.21%[p<0.05]），尽管出生时无显著差异。
与IVF相比，FET可能不会增加出生缺陷风险。通过ICSI受孕的儿童，尤其是男性，先天性畸形发生率较高，出生时并不明显。因此，纵向监测可能有助于了解ART的风险。
