中华妇产科杂志
中華婦產科雜誌
중화부산과잡지
CHINESE JOUNAL OF OBSTETRICS AND GYNECOLOGY
2010年
2期
124-127
,共4页
韩金兰%陈华%牛志宏%孙贻娟%孙晓溪%赵晓明%匡延平%滕晓明%纪亚忠%汪玉宝%冯云
韓金蘭%陳華%牛誌宏%孫貽娟%孫曉溪%趙曉明%劻延平%滕曉明%紀亞忠%汪玉寶%馮雲
한금란%진화%우지굉%손이연%손효계%조효명%광연평%등효명%기아충%왕옥보%풍운
受精,体外%胚胎移植%先天畸形%妊娠,多胎
受精,體外%胚胎移植%先天畸形%妊娠,多胎
수정,체외%배태이식%선천기형%임신,다태
Fertilization in vitro%Embryo transfer%Congenital abnormalities%Pregnancy,multiple
目的 对1998-2007年上海市体外受精-胚胎移植(IVF-ET)子代出生缺陷情况进行分析,了解影响出生缺陷发生的因素.方法 回顾性分析1998-2007年于上海市7个生殖医学中心(包括上海集爱遗传与不育诊疗中心、上海交通大学医学院附属仁济医院生殖医学中心、上海交通大学医学院附属瑞金医院生殖医学中心、国际和平妇幼保健院生殖医学中心、上海第一妇婴保健院生殖医学中心、上海市第九人民医院及上海长海医院生殖氏学中心)接受辅助生殖技术助孕并妊娠28周后分娩活产新生儿的产妇及其子代的随访资料.共收集产妇6551例及其子代8507例.了解子代的出生缺陷类型及发生率,并分析不同辅助生殖技术、子代性别、产妇年龄、妊娠胚胎数及精子获取方式对出生缺陷发生的影响.结果 8507例子代中,出生缺陷发生率为1.08%(92/8507),其中循环系统畸形的发生率最高,占所有出生缺陷的34%(31/92).IVF后移植新鲜胚胎、IVF后移植冻融胚胎、卵母细胞胞质内单精子注射(ICSI)后移植新鲜胚胎及ICSI后移植冻融胚胎者的出生缺陷率分别为1.21%(34/2799)、1.07%(20/1871)、1.04%(23/2212)和0.92%(15/1625),分别比较,差异均无统计学意义(P>0.05).男性和女性子代出生缺陷的发生率分别为1.12%(49/4371)和1.02%(42/4136),两者比较,差异无统计学意义(P>0.05);子代出生缺陷的发生率随母亲年龄的增加而增长,其中母亲年龄<30岁者为0.84%(41/4884),与>35岁者[1.77%(16/902)]比较,差异有统计学意义(P<0.05);单胎、双胎及三胎妊娠者的子代出生缺陷发生率分别为0.53%(25/4679)、1.59%(57/3576)和3.97%(10/252),分别比较,差异均有统计学意义(P<0.05);采用自然射精、附睾穿刺和他人供精方式出生的子代出生缺陷发生率分别为1.09%(81/7419)、1.21%(7/579)和0.79%(4/509),分别比较,差异均无统计学意义(P>0.05).结论 IVF-ET未增加子代出生缺陷的发生率,不同授精方式、胚胎处理方式及精子获取方式也与子代出生缺陷发生率无关,而高龄产妇和多胎妊娠则明显增加子代出生缺陷的发生率.
目的 對1998-2007年上海市體外受精-胚胎移植(IVF-ET)子代齣生缺陷情況進行分析,瞭解影響齣生缺陷髮生的因素.方法 迴顧性分析1998-2007年于上海市7箇生殖醫學中心(包括上海集愛遺傳與不育診療中心、上海交通大學醫學院附屬仁濟醫院生殖醫學中心、上海交通大學醫學院附屬瑞金醫院生殖醫學中心、國際和平婦幼保健院生殖醫學中心、上海第一婦嬰保健院生殖醫學中心、上海市第九人民醫院及上海長海醫院生殖氏學中心)接受輔助生殖技術助孕併妊娠28週後分娩活產新生兒的產婦及其子代的隨訪資料.共收集產婦6551例及其子代8507例.瞭解子代的齣生缺陷類型及髮生率,併分析不同輔助生殖技術、子代性彆、產婦年齡、妊娠胚胎數及精子穫取方式對齣生缺陷髮生的影響.結果 8507例子代中,齣生缺陷髮生率為1.08%(92/8507),其中循環繫統畸形的髮生率最高,佔所有齣生缺陷的34%(31/92).IVF後移植新鮮胚胎、IVF後移植凍融胚胎、卵母細胞胞質內單精子註射(ICSI)後移植新鮮胚胎及ICSI後移植凍融胚胎者的齣生缺陷率分彆為1.21%(34/2799)、1.07%(20/1871)、1.04%(23/2212)和0.92%(15/1625),分彆比較,差異均無統計學意義(P>0.05).男性和女性子代齣生缺陷的髮生率分彆為1.12%(49/4371)和1.02%(42/4136),兩者比較,差異無統計學意義(P>0.05);子代齣生缺陷的髮生率隨母親年齡的增加而增長,其中母親年齡<30歲者為0.84%(41/4884),與>35歲者[1.77%(16/902)]比較,差異有統計學意義(P<0.05);單胎、雙胎及三胎妊娠者的子代齣生缺陷髮生率分彆為0.53%(25/4679)、1.59%(57/3576)和3.97%(10/252),分彆比較,差異均有統計學意義(P<0.05);採用自然射精、附睪穿刺和他人供精方式齣生的子代齣生缺陷髮生率分彆為1.09%(81/7419)、1.21%(7/579)和0.79%(4/509),分彆比較,差異均無統計學意義(P>0.05).結論 IVF-ET未增加子代齣生缺陷的髮生率,不同授精方式、胚胎處理方式及精子穫取方式也與子代齣生缺陷髮生率無關,而高齡產婦和多胎妊娠則明顯增加子代齣生缺陷的髮生率.
목적 대1998-2007년상해시체외수정-배태이식(IVF-ET)자대출생결함정황진행분석,료해영향출생결함발생적인소.방법 회고성분석1998-2007년우상해시7개생식의학중심(포괄상해집애유전여불육진료중심、상해교통대학의학원부속인제의원생식의학중심、상해교통대학의학원부속서금의원생식의학중심、국제화평부유보건원생식의학중심、상해제일부영보건원생식의학중심、상해시제구인민의원급상해장해의원생식씨학중심)접수보조생식기술조잉병임신28주후분면활산신생인적산부급기자대적수방자료.공수집산부6551례급기자대8507례.료해자대적출생결함류형급발생솔,병분석불동보조생식기술、자대성별、산부년령、임신배태수급정자획취방식대출생결함발생적영향.결과 8507례자대중,출생결함발생솔위1.08%(92/8507),기중순배계통기형적발생솔최고,점소유출생결함적34%(31/92).IVF후이식신선배태、IVF후이식동융배태、란모세포포질내단정자주사(ICSI)후이식신선배태급ICSI후이식동융배태자적출생결함솔분별위1.21%(34/2799)、1.07%(20/1871)、1.04%(23/2212)화0.92%(15/1625),분별비교,차이균무통계학의의(P>0.05).남성화녀성자대출생결함적발생솔분별위1.12%(49/4371)화1.02%(42/4136),량자비교,차이무통계학의의(P>0.05);자대출생결함적발생솔수모친년령적증가이증장,기중모친년령<30세자위0.84%(41/4884),여>35세자[1.77%(16/902)]비교,차이유통계학의의(P<0.05);단태、쌍태급삼태임신자적자대출생결함발생솔분별위0.53%(25/4679)、1.59%(57/3576)화3.97%(10/252),분별비교,차이균유통계학의의(P<0.05);채용자연사정、부고천자화타인공정방식출생적자대출생결함발생솔분별위1.09%(81/7419)、1.21%(7/579)화0.79%(4/509),분별비교,차이균무통계학의의(P>0.05).결론 IVF-ET미증가자대출생결함적발생솔,불동수정방식、배태처리방식급정자획취방식야여자대출생결함발생솔무관,이고령산부화다태임신칙명현증가자대출생결함적발생솔.
Objective To survey birth defects of neonates conceived by using various types of in vitro fertilization and embryo transfer (IVF-ET) between 1998 and 2007 in Shanghai. Methods From 1998 to 2007, 8507 neonates from 6551 pregnancies conceived through assistant reproductive technology (ART) from 7 reproductive medicine center in Shanghai were enrolled in this retrospective study, including Shanghai Ji-Ai Genetics and IVF Institute, Shanghai Jiaotong University School of Medicine affiliated Renji Hospital,Buijin Hospital, China Welfare Institute International Maternal and Infant Health Hospital, Shanghai First Maternity and Infant Health Hospital, Shanghai the Ninth People's Hospital and the Second Military Medical University affiliated Changhal Hospital. The clinical data about the type and incidence of birth defect were analyzed. Meanwhile, the factors associated with birth defect were investigated, such as various ART,gender, mother age, numbers of gestational sac, the source and quality of sperm. Results The birth defect rate was 1.08% (92/8507) and the most remarkable malformation occurred in circulation system [34% (31/92)]. The rates of major congenital malformations were 1.21% (34/2799) in fresh conventional IVF-ET, 1.07% (20/1871) in IVF-frozen-thawed embryo transfer(IVF-FET), 1.04% (23/2212) in fresh intracyto plasmic sperm injection (ICSI)-ET and 0.92% (15/1625) in ICSI-FET, which did not show statistical difference (P>0.05). There was also no significantly different incidence of malformations between 1.12% (49/4371) in male neonates and 1.02% (42/4136) in female neonates (P >0.05).However, the occurrence of congenital malformation is positively related with maternal age, the rates were 0.84% (41/4884) in mother's age less than 30 years and 1.77% (16/902) in mother' age more than 35 years, which reached statistical difference (P < 0.05). It also showed remarkable different incidence among 0.53% (25/4679) in singletons, 1.59% (57/3576) in twins and 3.97% (10/252) in triplets (P< 0.05). No remarkable difference of malformation rate among sperm sources used in fertilization were observed, including 1.09% (81/7419)in ejaculated sperm, 1.21% (7/579)in percutaneous epididymal aspiration (PESA) and 0. 79% (4/509) in donor sperm (P>0.05). Conclusions The overall incidence of birth defect in neonates from ART is similar to those conceived naturally and is not associated with different types of IVF-ET, embryo cryopreservation, sperm sources. However, maternal age and multiple pregnancies coder the higher possibility of birth defect.
