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比较行卵胞浆内单精子注射和常规体外受精的患者的妊娠结局和后代先天畸形:一项回顾性队列研究。

A comparison of pregnancy outcomes and congenital malformations in offspring between patients undergoing intracytoplasmic sperm injection and conventional in vitro fertilization: a retrospective cohort study.

机构信息

Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, People's Republic of China; National Clinical Research Center for Obstetrics and Gynecology, Beijing, People's Republic of China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, People's Republic of China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, People's Republic of China; National Clinical Key Specialty Construction Program (2023), Beijing, People's Republic of China; State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, People's Republic of China.

Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, People's Republic of China; National Clinical Research Center for Obstetrics and Gynecology, Beijing, People's Republic of China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, People's Republic of China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, People's Republic of China; National Clinical Key Specialty Construction Program (2023), Beijing, People's Republic of China; State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, People's Republic of China.

出版信息

Fertil Steril. 2024 Jun;121(6):982-990. doi: 10.1016/j.fertnstert.2024.01.025. Epub 2024 Jan 20.

Abstract

OBJECTIVE

To explore whether intracytoplasmic sperm injection (ICSI) would increase the malformation risk in fetuses and live births compared with conventional in vitro fertilization (IVF).

DESIGN

Retrospective cohort study.

PATIENT(S): Data were collected from couples who underwent conventional IVF or ICSI from January 2009 to December 2019 at the Center for Reproductive Medicine of Peking University Third Hospital in the People's Republic of China. A total of 46,167 conventional IVF fresh transfer cycles and 33,247 ICSI fresh transfer cycles were included.

INTERVENTION(S): Intracytoplasmic sperm injection and conventional IVF.

MAIN OUTCOME MEASURE(S): The primary outcomes were congenital abnormalities in live births. The secondary outcomes included the pregnancy outcomes, the malformations among the miscarriages, specific types of malformations in live births, birth weight, and sex.

RESULT(S): The rates of congenital malformations in conventional IVF and ICSI were 5.44‰ and 5.78‰, respectively. There was no statistically significant difference between the two groups, as indicated by the adjusted odds ratio of 1.098 (95% confidence interval 0.787, 1.532). The rates of specific malformations were comparable between ICSI and IVF. Additionally, no discernible disparities were noted in pregnancy outcomes, the malformations among the miscarriages,birth weight between the two groups.

CONCLUSION

Our study suggested the safety of ICSI and provided novel evidence by comparing pregnancy outcomes and congenital malformations in offspring between patients undergoing conventional IVF and ICSI.

摘要

目的

探讨与传统体外受精(IVF)相比,卵胞浆内单精子注射(ICSI)是否会增加胎儿和活产儿的畸形风险。

设计

回顾性队列研究。

患者

数据来自于 2009 年 1 月至 2019 年 12 月在中国人民共和国北京大学第三医院生殖医学中心接受常规 IVF 或 ICSI 的夫妇。共纳入 46167 例常规 IVF 新鲜移植周期和 33247 例 ICSI 新鲜移植周期。

干预措施

卵胞浆内单精子注射和常规 IVF。

主要观察指标

主要结局为活产儿的先天性异常。次要结局包括妊娠结局、流产中的畸形、活产儿的特定畸形类型、出生体重和性别。

结果

常规 IVF 和 ICSI 的先天性畸形率分别为 5.44‰和 5.78‰。两组间无统计学显著差异,调整后的优势比为 1.098(95%置信区间 0.787,1.532)。ICSI 和 IVF 的特定畸形率相当。此外,两组间妊娠结局、流产中的畸形、出生体重均无明显差异。

结论

本研究提示 ICSI 是安全的,并通过比较接受常规 IVF 和 ICSI 的患者的妊娠结局和后代的先天性畸形,提供了新的证据。

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