供体精子对体外受精-卵胞浆内单精子注射及胚胎移植周期围产期和新生儿结局的影响：一项回顾性队列研究
Effects of donor sperm on perinatal and neonatal outcomes resulting from in vitro fertilization-intracytoplasmic sperm injection and embryo transfer cycles: a retrospective cohort study.
作者信息
Gao Xinyan, Sun Shihu, Xie Lei, Lu Shaoming
机构信息
Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.
National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China.
出版信息
Ann Transl Med. 2022 Aug;10(15):819. doi: 10.21037/atm-21-5492.
BACKGROUND
The impact of donor sperm on pregnancy outcomes is controversial. The aim of this study was to investigate whether donor sperm in in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment could reduce the rate of live births or increase the incidence of adverse pregnancy outcomes and birth defects in neonates.
METHODS
This single-centre, retrospective cohort study included 1,559 patients with infertility who received donor sperm at our hospital from 2015 to 2019. All the patients received fresh embryos and underwent first-cycle transfer. After propensity score matching, 4,677 controls who received their partners' sperm were matched at 1:3. Clinical pregnancy, perinatal, and neonatal outcomes were compared between the donor sperm and partner sperm groups.
RESULTS
The embryo development was better in the donor sperm group than in the partner sperm group. The high-quality embryo and available embryo rates were significantly higher in the donor sperm group (P<0.05 for both groups). The rate of high-quality embryos transferred from the donor sperm group was higher than that from the partner sperm group (P<0.05). The clinical pregnancy (62.99% 59.65%; P=0.02) and live birth (54.65% 51.59%; P=0.036) rates were higher in the donor sperm group. After adjusting for confounding factors, no significant difference in live birth rates was observed between the two groups (adjusted P=0.057). The low birthweight (18.21% 21.39%; P=0.023) and small for gestational age (SGA) (7.60% 11.97%; P<0.001) rates were lower in the donor sperm group. To exclude the effect of multiple pregnancies, we evaluated neonatal outcomes of singleton pregnancies. No significant differences were noted in preterm and very preterm birth, SGA, mean birthweight, high birthweight, and low birth weight (LBW) and very low birth weight (VLBW) rates (P>0.05 for both groups). Further, no significant between group differences were observed in the ectopic pregnancy rate, early and late spontaneous abortion rates, gestational age, rate of large for gestational age (LGA), and neonatal defects.
CONCLUSIONS
Compared with partner sperm, donor sperm did not reduce live birth rate and did not increase neonatal LBW or low birth defects.
背景
供体精子对妊娠结局的影响存在争议。本研究旨在调查体外受精（IVF）/卵胞浆内单精子注射（ICSI）治疗中使用供体精子是否会降低活产率或增加不良妊娠结局及新生儿出生缺陷的发生率。
方法
这项单中心回顾性队列研究纳入了2015年至2019年在我院接受供体精子的1559例不孕症患者。所有患者均接受新鲜胚胎并进行首次周期移植。经过倾向得分匹配后，按1:3匹配了4677例接受配偶精子的对照者。比较了供体精子组和配偶精子组的临床妊娠、围产期和新生儿结局。
结果
供体精子组的胚胎发育情况优于配偶精子组。供体精子组的优质胚胎率和可用胚胎率显著更高（两组均P<0.05）。供体精子组移植的优质胚胎率高于配偶精子组（P<0.05）。供体精子组的临床妊娠率（62.99%对59.65%；P=0.02）和活产率（54.65%对51.59%；P=0.036）更高。在调整混杂因素后，两组之间的活产率未观察到显著差异（校正P=0.057）。供体精子组的低出生体重率（18.2l%对21.39%；P=0.023）和小于胎龄儿（SGA）率（7.60%对11.97%；P<0.001）更低。为排除多胎妊娠的影响，我们评估了单胎妊娠的新生儿结局。在早产和极早产、SGA、平均出生体重、高出生体重以及低出生体重（LBW）和极低出生体重（VLBW）率方面，两组之间未观察到显著差异（两组均P>0.05）。此外，在宫外孕率、早期和晚期自然流产率、孕周、大于胎龄儿（LGA）率和新生儿缺陷方面，两组之间也未观察到显著差异。
结论
与配偶精子相比，供体精子不会降低活产率，也不会增加新生儿低出生体重或低出生缺陷。
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