Reproductive Center, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan Province, China.
Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan Province, China.
Reprod Biol Endocrinol. 2020 Jul 15;18(1):72. doi: 10.1186/s12958-020-00623-x.
To investigate the associations between blastocyst development and the sex ratio (male:female) among singleton live births resulting from single-blastocyst frozen embryo transfer (FET) cycles.
Patients with singleton live births following the first autologous single FET of non- preimplantation genetic testing (PGT) blastocysts in a single reproductive medicine department between January 2015 and February 2019 were included in this retrospective study. The primary outcome measure was the singleton sex ratio. Multivariable logistic regression models were used to estimate the associations between blastocyst quality and singleton sex ratio after adjustment for some potential confounders.
There were 638 high-quality and 572 poor-quality single blastocyst FETs, and the blastocysts were conceived via 855 IVF and 355 ICSI treatments. A total of 1210 singleton live births were assessed. High-quality single blastocyst FET resulted in a significantly higher sex ratio than did poor-quality single blastocyst FET (60% vs. 49.7%, P < 0.001). The infertility cause was not associated with sex ratio among singleton live births (P = 0.537). The results of a multivariate analysis revealed that a high-quality blastocyst has a 150% higher probability of being male than a poor-quality blastocyst (adjusted odds ratio (aOR) 1.57; 95% CI 1.24-2, P < 0.001). Among the three blastocyst morphological parameters, Grade B trophectoderm was significantly associated with a higher sex ratio than Grade C (aOR 1.71; 95% CI 1.33-2.21. P < 0.001). Neither expansion degree nor inner cell mass degree were significantly associated with the singleton sex ratio.
A single high-quality blastocyst FET has a higher chance of resulting in a male infant than a female infant. The results demonstrate that grade B trophectoderm confers benefits in improving the implantation potential of male blastocysts.
研究单囊胚冷冻胚胎移植（FET）周期中单囊胚发育与单胎活产儿性别比（男：女）之间的关系。
本回顾性研究纳入了 2015 年 1 月至 2019 年 2 月期间在单一生殖医学科接受首次自体单囊胚非植入前遗传学检测（PGT）囊胚 FET 的单胎活产儿。主要结局指标为单胎性别比。多变量逻辑回归模型用于估计囊胚质量与单胎性别比之间的关系，调整了一些潜在混杂因素的影响。
共有 638 例高质量和 572 例低质量单囊胚 FET，囊胚通过 855 次 IVF 和 355 次 ICSI 治疗获得。共评估了 1210 例单胎活产儿。高质量单囊胚 FET 导致的单胎性别比明显高于低质量单囊胚 FET（60%比 49.7%，P<0.001）。不孕病因与单胎活产儿的性别比无关（P=0.537）。多变量分析结果显示，高质量囊胚为男性的概率比低质量囊胚高 150%（调整优势比（aOR）1.57；95%置信区间 1.24-2，P<0.001）。在三个囊胚形态参数中，B 级滋养外胚层与较高的性别比显著相关（aOR 1.71；95%置信区间 1.33-2.21，P<0.001）。扩张程度和内细胞团程度均与单胎性别比无显著相关性。
单个高质量囊胚 FET 更有可能生出男婴，而不是女婴。结果表明，B 级滋养外胚层有利于提高男胚的着床潜能。
