Jwa Junna, Jwa Seung Chik, Kuwahara Akira, Yoshida Atsumi, Saito Hidekazu
Division of Reproductive Medicine, Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan; Kiba Park Clinic, Tokyo, Japan.
Division of Reproductive Medicine, Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan.
Fertil Steril. 2015 Jul;104(1):71-8. doi: 10.1016/j.fertnstert.2015.03.029. Epub 2015 Apr 29.
To assess perinatal risk of major congenital anomalies in children born after embryo transfer with assisted hatching (AH).
Retrospective cohort study.
Not applicable.
PATIENT(S): Cycles registered from 2010 to 2012 and conceived via single-embryo transfer were included for the analysis. Live births, still births after 22 weeks of gestation, and selectively terminated cases because of congenital anomalies were included.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): Major congenital anomaly.
RESULT(S): AH was performed in 35,488 cycles among 72,125 included cycles (49.2%). A total of 1,046 major congenital anomalies (1.4%) were identified (1.36% in AH group vs. 1.50% in non-AH group). Overall risks for major congenital anomalies were not significantly different between AH and non-AH groups adjusting for maternal age, calendar year, fetal sex, embryo stage at transfer, and status of cryopreservation. There were 1,009 cases of twins (1.5%) and 10 cases of triplets (0.015%) among all included cycles. No specific organ system demonstrated significant association between AH and non-AH groups. Subgroup analysis demonstrated no significant association between AH and non-AH groups in intracytoplasmic sperm injection cycles or in vitro fertilization in fresh cycles. Similar nonsignificant association was observed between early-cleavage or blastocyst stage at transfer in frozen-thawed cycles.
CONCLUSION(S): Our results suggest that AH alone does not increase the risk of major congenital anomaly.
评估辅助孵化（AH）后胚胎移植出生儿童的围产期主要先天性异常风险。
回顾性队列研究。
不适用。
纳入2010年至2012年登记并通过单胚胎移植受孕的周期进行分析。包括活产、妊娠22周后的死产以及因先天性异常而选择性终止妊娠的病例。
无。
主要先天性异常。
在纳入的72125个周期中，35488个周期进行了AH（49.2%）。共识别出1046例主要先天性异常（1.4%）（AH组为1.36%，非AH组为1.50%）。在调整产妇年龄、日历年、胎儿性别、移植时胚胎阶段和冷冻保存状态后，AH组和非AH组主要先天性异常的总体风险无显著差异。在所有纳入的周期中，有1009例双胞胎（1.5%）和10例三胞胎（0.015%）。没有特定器官系统在AH组和非AH组之间显示出显著关联。亚组分析显示，在卵胞浆内单精子注射周期或新鲜周期体外受精中，AH组和非AH组之间无显著关联。在冻融周期中，移植时早期卵裂或囊胚阶段之间也观察到类似的非显著关联。
我们的结果表明，单独的AH不会增加主要先天性异常的风险。
