南方医科大学学报

南方医科大学学报 ›› 2015, Vol. 35 ›› Issue (07): 977-.

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辅助生殖技术中影响出生婴儿性别比的相关因素分析

张力佳，全松   

  • 出版日期:2015-07-20 发布日期:2015-07-20

Factors affecting live birth sex ratio in assisted reproductive technology procedures

  • Online:2015-07-20 Published:2015-07-20

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摘要： 目的探讨辅助生殖技术（ART）中影响出生婴儿性别比的相关因素。方法收集2008年1月~2014年3月于我院接受ART
治疗并成功分娩的4348个周期的患者的临床资料，包括男女双方年龄、不孕原因、授精方式、移植胚胎期别、移植胚胎类型、分
娩类型（单胎、双胎分娩）、既往ART流产次数、ART分娩次数和分娩的5607名新生儿的性别，分析不同因素对于分娩新生儿性
别的影响。结果共有3019名男婴和2588名女婴出生，性别比为116∶100；单胎分娩的3087名新生儿出生性别比为117∶100；双
胎分娩的2520名新生儿性别比为116:100；经ART治疗一胎分娩5542名新生儿出生性别比为117∶100；二胎分娩新生儿65名，
出生性别比为117∶100。在单胎妊娠活产婴儿中，若女方或男方高龄，出生男婴比例较对照组（年龄<35 岁）显著增高(分别为
58.4% vs 52.8%，P=0.012；56.4% vs 52.3%；P=0.026），同时观察到ICSI组出生男婴比例较IVF组明显较低（45.7% vs 55.6%，P<
0.001），其它因素则对出生婴儿性别比无显著影响；在双胎妊娠活产新生儿组中，上述不同因素对出生新生儿性别比均无显著
性差异。ART治疗后生育一胎新生儿中，女方高龄组出生男婴比例显著高于对照组（57.4% vs 53.0%, P=0.009），并可知ICSI组
中出生男婴比例显著低于IVF组（48.6% vs 55.4%, P=0.001）；而ART治疗后生育二胎新生儿中，不同因素各组间出生婴儿性别
比均无显著性差异。单因素Logistic 回归分析提示，女方年龄（OR：0.836，95% CI 0.731~0.955，P<0.05）、授精方式（OR∶
1.151，95% CI 1.027~1.289，P<0.05）对出生婴儿性别比产生的影响有统计学意义，其它因素对出生婴儿性别比则无显著影响。
进一步行多因素Logistic回归分析提示，无独立的预测因素。结论经ART治疗后高龄女性生育男性婴儿比例更高，在单胎活
产婴儿中男方高龄与出生男婴比例增加相关，而ICSI授精方式较IVF女性婴儿比例更高。

Abstract: Objectives To study the factors that affect the sex ratio of live births in procedures of assisted reproductive technology
(ART). Methods The clinical data were collected from 4348 IVF-ET/freeze-thawed embryo transfer cycles that led to the birth of
5606 babies of known gender between 2008 and 2014. We assessed the impact of maternal age, paternal age, insemination
method, the type of embryo transferred, stage of embryo transferred, single and twin births, previous abortion following ART,
and cause of infertility on the sex ratio of the live births. Results The total cohort included 3019 male and 2588 female babies,
with a general sex ratio of 116:100. The sex ratio was 117:100 among singleton deliveries and 116:100 among twin deliveries. The
sex ratio was 117:100 among the first births with ART treatment and 117:100 among the second births. For singleton deliveries,
an advanced maternal age or paternal age was significantly correlated with an elevated sex ratio of births (58.4% vs 52.8%, P=
0.012; 56.4% vs 52.3%, P=0.026), while ICSI was significantly correlated with a decreased sex ratio of births (45.7% vs 55.6%, P<
0.001); for twin deliveries, none of the these factors was significantly correlated with the sex ratio of birth. For the first baby born
after ART treatment, an advanced maternal age was significantly related to an increased sex ratio of births (57.4% vs 53.0%, P=
0.009), while ICSI was significantly related to a decreased sex ratio of births (48.6% vs 55.4%, P=0.001); for the second baby born
with ART treatment, none of these factors was significantly correlated with the sex ratio of birth. Univariate logistic regression
analysis showed that the maternal age (OR:0.836, 95% CI 0.731-0.955, P<0.05) and insemination method (OR:1.151, 95% CI
1.027-1.289, P<0.05) were significantly related to the sex ratio of birth, but in multivariable logistic regression analysis, after
controlling for compounding factors, none of these factors was identified as independent predictive factors for sex ratio of
births. Conclusions An advanced maternal age is related to a higher live birth sex ratio, while ICSI is related to a decreased
percentage of male babies. For singleton deliveries, an advanced paternal age is related to a higher sex ratio of births.