Influencing factors of secondary sex ratio at birth after in-vitro
fertilization and embryo transfer

doi:10.3760/cma.j.issn.1007-1245.2022.15.019

Abstract

Abstract: Objectives　To explore the influencing factors of secondary sex ratio (SSR) at birth after in-vitro fertilization and embryo transfer (IVF-ET). Methods　The sex data of the babies delivered by the women treated by IVF-ET at Department of Reproductive Medicine, Second Affiliated Hospital of Guangzhou University of Chinese Medicine from June 2013 to June 2021 were collected. The SSR were analyzed by different embryo stages (cleavage stage or blastocyst stage), different fertilization methods [in vitro fertilization (IVF) or intracytoplasmic sperm insemination (ICSI)], and different sources of sperms (epididymal, testicular, or ejaculation). The data were analyzed by multivariate logistic regression analysis. The measurement data were analyzed by one-way ANOVA, and the enumeration data by χ² test and Fisher's exact test. Results　The overall SSR was 116∶100 (1 158∶998). The SSR's of cleavage-stage embryo transfer (1 310 deliver cycles) and blastocyst stage embryo transfer (433 deliver cycles) were 108∶100 (870/809) and 147∶100 (277/189), with a statistical difference (P<0.05). The SSR's of IVF treatment (1 306 cycles) and ICSI treatment (433 cycles) were 121∶100 (879/724) and 97∶100 (264/272), with a statistical difference (P<0.05). The SSR of sperms from puncture was 90.2∶100 (37∶41). There was no statistical difference in SSR between different sperm sources treated by ICSI (P>0.05). The SSR of sperms from testicular puncture was slightly higher than that of sperms from epididymal puncture. Conclusions　Blastocyst stage transfer might be associated with a higher SSR than cleavage stage embryo transfer. The SSR of embryos transferred from IVF treatment is higher than that of embryos transferred from ICSI treatment. The stage of transferred embryos is an independent risk factor for the SSR at birth.

Key words: In vitro fertilization, Intracytoplasmic sperm injection, Blastocyst, Cleavage stage embryo, Sperm sources, Secondary sex ratio at birth

摘要： 目的　探讨行体外受精-胚胎移植（in vitro fertilization and embryo transfer，IVF-ET）治疗出生子代性别比（secondary sex ratio，SSR）的相关影响因素。方法　收集2013年6月至2021年6月在广州中医药大学第二附属医院生殖医学科接受体外受精-胚胎移植治疗分娩的胎儿性别数据，分别按移植卵裂期胚胎与囊胚、体外受精与卵胞浆内单精子显微注射（intracytoplasmic sperm insemination，ICSI）受精胚胎、不同来源精子行ICSI治疗胚胎进行分组比较，并按多因素logistic回归分析法进行分析。计量资料采用单因素ANOVA检验（方差齐），计数资料采用χ^２检验及Fisher’s确切概率法。结果　IVF-ET治疗男女出生性别比为116∶100（1 158∶998）。移植卵裂期胚胎1 310个分娩周期与移植囊胚433个分娩周期进行比较，出生男女性别比：108∶100（870/809）比147∶100（277/189），差异存在统计学意义（P<0.05）。移植IVF胚胎1 306个分娩周期与移植ICSI 胚胎433个分娩周期进行比较，出生男女性别比为121∶100（879/724）比97∶100（264/272），差异有统计学意义（P<0.05）。穿刺取精来源精子男女出生性别比为90.2∶100（37∶41），不同来源精子行ICSI治疗出生子代性别比差异无统计学意义（P>0.05），睾丸穿刺来源精子子代出生性别比略高于附睾穿刺来源精子子代出生性别比。logistic回归分析显示移植胚胎期别是影响出生性别比的独立危险因素。结论　囊胚移植出生性别比高于卵裂期胚胎出生性别比，移植IVF受精胚胎出生性别比高于移植ICSI受精胚胎出生性别比。胚胎期别是影响出生性别比的独立危险因素。

关键词: 体外受精, 卵胞浆内单精子注射, 囊胚, 卵裂期胚胎, 精子来源, 出生性别比

Ni Yunping, Hong Ruifang, Lu Shan, Chen Xulong, Deng Xuemei, Yuan Qilong. Influencing factors of secondary sex ratio at birth after in-vitro fertilization and embryo transfer[J]. International Medicine and Health Guidance News, 2022, 28(15): 2154-2159.

倪运萍　洪锐芳　陆杉　陈旭龙　邓雪梅　袁启龙. 体外受精-胚胎移植出生子代性别比影响因素分析[J]. 国际医药卫生导报, 2022, 28(15): 2154-2159.

References

[1] Glujovsky D, Quinteiro Retamar AM, Alvarez Sedo CR, et al. Cleavage-stage versus blastocyst-stage embryo transfer in assisted reproductive technology[J]. Cochrane Database Syst Rev, 2022,5(5):CD002118. DOI: 10.1002/14651858.CD002118.pub6.
[2] Tarín JJ, García-Pérez MA, Hermenegildo C, et al. Changes in sex ratio from fertilization to birth in assisted- reproductive-treatment cycles[J]. Reprod Biol Endocrinol, 2014,12:56. DOI: 10.1186/1477-7827-12-56.
[3] 丁锦丽,张怡,尹太郎,等.卵裂期与囊胚期新鲜胚胎移植对子代出生性别比例影响的Meta分析[J].中华生殖与避孕杂志,2018,38(12):991-999.DOI:10.3760/cma.j.issn. 2096-2916.2018.12.006.
[4] Palermo G, Joris H, Devroey P, et al. Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte[J]. Lancet, 1992,340(8810):17-18. DOI: 10.1016/0140-6736(92)92425-f.
[5] 胡琳莉,孙莹璞.中国辅助生殖技术发展历程和现状[J].生殖医学杂志,2019,28(10):1113-1114.DOI:10.3969/j.issn.1004-3845.2019.10.001.
[6] 李智,张燕,全星,等.云南省出生人口性别比三十年变迁[J].国际医药卫生导报,2017,23(10):1643-1646.DOI:10.3760/cma.j.issn.1007-1245.2017.10.057.
[7] Supramaniam PR, Mittal M, Ohuma EO, et al. Secondary sex ratio in assisted reproduction: an analysis of 1 376 454 treatment cycles performed in the UK[J]. Hum Reprod Open,2019,2019(4):hoz020. DOI: 10.1093/hropen/hoz020.
[8] Dean JH, Chapman MG, Sullivan EA. The effect on human sex ratio at birth by assisted reproductive technology (ART) procedures--an assessment of babies born following single embryo transfers, Australia and New Zealand, 2002-2006[J]. BJOG, 2010,117(13):1628-1634. DOI: 10.1111/j.1471-0528.2010.02731.x.
[9] Narvaez JL, Chang J, Boulet SL, et al. Trends and correlates of the sex distribution among U.S. assisted reproductive technology births[J]. Fertil Steril, 2019,112(2):305-314. DOI: 10.1016/j.fertnstert.2019.03.034.
[10] Bu Z, Chen ZJ, Huang G, et al. Live birth sex ratio after in vitro fertilization and embryo transfer in China--an analysis of 121,247 babies from 18 centers[J]. PLoS One, 2014,9(11):e113522. DOI: 10.1371/journal.pone.0113522.
[11] 田莉峰,伍琼芳,夏雷震,等.冻融卵裂期胚胎与囊胚移植后单孕囊妊娠患者母婴结局的比较[J].现代妇产科进展,2021,30(7):514-519.DOI:10.13283/j.cnki.xdfckjz.2021.07.037.
[12] Guo L, Zhang Q, Ma X, et al. miRNA and mRNA expression analysis reveals potential sex-biased miRNA expression[J]. Sci Rep, 2017,7:39812. DOI: 10.1038/srep39812.
[13] Orzack SH, Stubblefield JW, Akmaev VR, et al. The human sex ratio from conception to birth[J]. Proc Natl Acad Sci U S A, 2015,112(16):E2102-2111. DOI: 10.1073/pnas. 1416546112.
[14] Ray PF, Conaghan J, Winston RM, et al. Increased number of cells and metabolic activity in male human preimplantation embryos following in vitro fertilization[J]. J Reprod Fertil, 1995,104(1):165-171. DOI: 10.1530/jrf. 0.1040165.
[15] Bouillon C, Celton N, Kassem S, et al. Obstetric and perinatal outcomes of singletons after single blastocyst transfer: is there any difference according to blastocyst morphology?[J]. Reprod Biomed Online, 2017,35(2):197-207. DOI: 10.1016/j.rbmo.2017.04.009.
[16] Parazzini F, Chatenoud L, Maffioletti C, et al. Periconceptional smoking and male:female ratio of newborns[J]. Eur J Public Health, 2005,15(6):613-614. DOI: 10.1093/eurpub/cki052.
[17] Milki AA, Jun SH, Hinckley MD, et al. Incidence of monozygotic twinning with blastocyst transfer compared to cleavage-stage transfer[J]. Fertil Steril, 2003,79(3):503-506. DOI: 10.1016/s0015-0282(02)04754-4.
[18] Lou H, Li N, Zhang X, et al. Does the sex ratio of singleton births after frozen single blastocyst transfer differ in relation to blastocyst development?[J]. Reprod Biol Endocrinol, 2020,18(1):72. DOI: 10.1186/s12958-020- 00623-x.
[19] Chang HJ, Lee JR, Jee BC, et al. Impact of blastocyst transfer on offspring sex ratio and the monozygotic twinning rate: a systematic review and meta-analysis[J]. Fertil Steril, 2009,91(6):2381-2390. DOI: 10.1016/j.fertnstert.2008.03.066.
[20] Ding J, Yin T, Zhang Y, et al. The effect of blastocyst transfer on newborn sex ratio and monozygotic twinning rate: an updated systematic review and meta-analysis[J]. Reprod Biomed Online, 2018,37(3):292-303. DOI: 10.1016/j.rbmo.2018.05.015.
[21] Hattori H, Kitamura A, Takahashi F, et al. The risk of secondary sex ratio imbalance and increased monozygotic twinning after blastocyst transfer: data from the Japan Environment and Children's Study[J]. Reprod Biol Endocrinol, 2019,17(1):27. DOI: 10.1186/s12958-019-0471-1.
[22] Shaia K, Truong T, Pieper C, et al. Pre-implantation genetic testing alters the sex ratio: an analysis of 91 805 embryo transfer cycles[J]. J Assist Reprod Genet, 2020,37(5):1117-1122. DOI: 10.1007/s10815-020-01746-1.
[23] 孙文枫,谢宝国,张毅,等.借助辅助生殖技术受孕分娩不孕症患者的出生婴儿性别比影响因素分析[J].山东医药,2017,57(27):93-95.DOI:10.3969/j.issn.1002- 266X. 2017.27.029.
[24] Luke B, Brown MB, Grainger DA, et al. The sex ratio of singleton offspring in assisted-conception pregnancies[J]. Fertil Steril, 2009,92(5):1579-1585. DOI: 10.1016/j.fertnstert.2008.08.107.
[25] Setti AS, Figueira RC, Braga DP, et al. Gender incidence of intracytoplasmic morphologically selected sperm injection-derived embryos: a prospective randomized study[J]. Reprod Biomed Online, 2012,24(4):420-423. DOI: 10.1016/j.rbmo.2012.01.007.
[26] Arikawa M, Jwa SC, Kuwahara A, Irahara M, Saito H. Effect of semen quality on human sex ratio in in vitro fertilization and intracytoplasmic sperm injection: an analysis of 27,158 singleton infants born after fresh single-embryo transfer[J]. Fertil Steril, 2016 ,105(4):897-904. DOI: 10.1016/j.fertnstert.2015.12.009.
[27] Fedder J, Gabrielsen A, Humaidan P, et al. Malformation rate and sex ratio in 412 children conceived with epididymal or testicular sperm[J]. Hum Reprod, 2007,22(4):1080-1085. DOI: 10.1093/humrep/del488.
[28] Lu YH, Gao HJ, Li BJ, et al. Different sperm sources and parameters can influence intracytoplasmic sperm injection outcomes before embryo implantation[J]. J Zhejiang Univ Sci B, 2012,13(1):1-10. DOI: 10.1631/jzus.B1100216.
[29] Zhu J, Zhuang X, Chen L, et al. Effect of embryo culture media on percentage of males at birth[J]. Hum Reprod, 2015,30(5):1039-45. DOI: 10.1093/humrep/dev049.
[30] 冯双苗,苏迎春,孙莹璞,等.附睾和睾丸精子活力对卵胞浆内单精子注射结局的影响[J].生殖医学杂志,2009,18(1):29-32.DOI:10.3969/j.issn.1004-3845.2009.01.008.

Influencing factors of secondary sex ratio at birth after in-vitro fertilization and embryo transfer

体外受精-胚胎移植出生子代性别比影响因素分析

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