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2004 - 2014年队列研究:通过辅助生殖技术受孕的不孕妇女所生婴儿的先天性异常情况

Congenital anomalies in infants conceived by infertile women through assisted reproductive technology: A cohort study 2004-2014.

作者信息

Han Ying, Luo Haining, Zhang Yunshan

机构信息

School of Medicine, Nankai University, Tianjin 300071, P.R. China.

Center for Reproductive Medicine, Tianjin Central Hospital of Obstetrics and Gynecology, Tianjin 300100, P.R. China.

出版信息

Exp Ther Med. 2018 Oct;16(4):3179-3185. doi: 10.3892/etm.2018.6572. Epub 2018 Aug 3.

Abstract

This retrospective cohort study aimed to analyse the risk of congenital anomalies (CAs) in infants conceived by infertile women through assisted reproductive technology (ART). A total of 9,013 clinical pregnancy cycles resulting in 9,101 live births between 2004 and 2014 were analysed. Congenital anomalies were evaluated and compared with spontaneous pregnancies in infertile women. A total of 9,101 infants were born following ART. Three subgroups were established: fertilisation fresh embryo transfer (IVF-ET), n=2,919, intracytoplasmic sperm injection fresh embryo transfer (ICSI), n=1,996 and frozen-thawed embryo transfer (FET), n=4,186. No significant differences in perinatal outcomes were observed between the three subgroups. A total of 105 (1.15%) infants were born with CAs. The birth defect rate was slightly higher in the IVF-ET subgroup compared with the other subgroups. Among infants in the IVF-ET and ICSI-ET subgroup, the probability of birth defects increased with increased maternal age (>35 years), male factors and diminished ovarian reserve. In the FET group, the risk of birth defects was significantly increased with multiple births and maternal age >35 years. The risk of congenital anomalies following ART was not significantly different compared with spontaneous conceptions within the infertile study population. The results of the present study may provide guidance for patients who are considering treatment for infertility in China.

摘要

这项回顾性队列研究旨在分析不孕女性通过辅助生殖技术(ART)受孕的婴儿出现先天性异常(CA)的风险。对2004年至2014年间共9013个临床妊娠周期所产生的9101例活产进行了分析。对先天性异常进行了评估,并与不孕女性的自然妊娠进行了比较。共有9101名婴儿通过ART出生。建立了三个亚组:体外受精新鲜胚胎移植(IVF-ET),n = 2919;卵胞浆内单精子注射新鲜胚胎移植(ICSI),n = 1996;冻融胚胎移植(FET),n = 4186。三个亚组之间围产期结局未观察到显著差异。共有105例(1.15%)婴儿患有先天性异常。IVF-ET亚组的出生缺陷率略高于其他亚组。在IVF-ET和ICSI-ET亚组的婴儿中,出生缺陷的概率随着母亲年龄增加(>35岁)、男性因素和卵巢储备功能减退而增加。在FET组中,多胎妊娠和母亲年龄>35岁时出生缺陷风险显著增加。与不孕研究人群中的自然受孕相比,ART后先天性异常的风险没有显著差异。本研究结果可为中国正在考虑治疗不孕症的患者提供指导。

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