Live Birth Sex Ratio after In Vitro Fertilization and Embryo Transfer in China - An Analysis of 121,247 Babies from 18 Centers

Bu, Zhiqin; Chen, Zi‐Jiang; Huang, Gangliang; Zhang, Hanwang; Wu, Qiongfang; Ma, Yanping; Shi, Juanzi; Xu, Yanwen; Zhang, Songying; Zhang, Cuilian; Zhao, Xiaoming; Zhang, Bo; Huang, Yuanhua; Sun, Zhengyi; Kang, Yuefan; Wu, Rui; Wu, Xueqing; Sun, Haixiang; Sun, Yingpu

doi:10.1371/journal.pone.0113522

Cited by 63 publications

(61 citation statements)

References 26 publications

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“…Surprisingly, the sex ratio was significantly higher in group 1 than in groups 2, 3 and 4, and in group 2 compared with group 3 (P < 0.001). Some studies have reported differences in the sex ratio after blastocyst culture, with a higher male to female ratio (Bu et al, 2014;Chang et al, 2009;Maalouf et al, 2014). Moreover, Alfarawati et al (2011) showed that male embryos developed significantly faster than females, and using time-lapse technology.…”

Section: Discussionmentioning

confidence: 99%

Obstetric and perinatal outcomes of singletons after single blastocyst transfer: is there any difference according to blastocyst morphology?

Bouillon¹,

Celton²,

Kassem³

et al. 2017

Reproductive BioMedicine Online

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A strong correlation between blastocyst morphology and implantation has been shown by many studies. The consequences and effects of assisted reproductive techniques on children's short and long-term health have always been a source of discussion. The obstetric and perinatal outcome of singletons according to blastocyst morphology has rarely been evaluated. The aim of this observational study is to determine whether a relationship exists between blastocyst morphology and obstetric and perinatal outcomes. A total of 799 singleton clinical pregnancies were analysed after transfer of a single fresh blastocyst on day 5 between 2006 and 2013. Blastocysts were divided into four groups based on their morphology on day 5: group 1 = good morphology blastocysts; group 2 = fair morphology blastocysts; group 3 = poor morphology blastocysts and group 4 = early (B1/B2) blastocysts. Obstetric and perinatal outcomes were compared between the four groups. After adjustment for some confounding variables, main obstetric and perinatal outcomes after transfer of blastocysts with poor morphological characteristics were not associated with increased adverse obstetric and perinatal events. Sex ratio was significantly higher in group 1 compared with groups 2, 3 and 4, and in Group 2 compared with Group 3 (P < 0.001) even after adjustment (P < 0.05).

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Section: Discussionmentioning

confidence: 99%

Obstetric and perinatal outcomes of singletons after single blastocyst transfer: is there any difference according to blastocyst morphology?

Bouillon¹,

Celton²,

Kassem³

et al. 2017

Reproductive BioMedicine Online

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“…In the study by Orzack et al (2015), ART included both IVF and ICSI, and the sex ratio was determined for the combined IVF-and ISCI-produced embryos. In most previous studies, the sex ratios of IVF-or ICSI-produced embryos/offspring were analyzed separately, and IVF was shown to result in a male-biased sex ratio (Avery et al 1991, Gutierrez-Adan et al 2001, Wrenzycki et al 2002, Dean et al 2010, Maalouf et al 2014, Torner et al 2014, while ICSI resulted in a female-biased sex ratio (Bu et al 2014, Maalouf et al 2014, Tarin et al 2014. Therefore, ICSI and IVF may affect sex ratios via different mechanisms.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, sex-specific effects of IVF on postnatal metabolism and growth of IVF-conceived offspring has been confirmed in mouse models (Scott et al 2010, Feuer et al 2014). More importantly, recent studies indicate that IVF results in a skewed sex ratio at birth (Dean et al 2010, Bu et al 2014, Maalouf et al 2014, reflecting sex-biased or even specific disruption of embryonic development. Indeed, the suboptimal environment is known to affect the embryonic development in a sex-specific manner as early as the pre-implantation stage, causing either a short-term sex ratio adjustment or more long-term sexspecific effects on adult health (Laguna-Barraza et al 2012).…”

Section: Introductionmentioning

confidence: 99%

IVF affects embryonic development in a sex-biased manner in mice

Tan¹,

Wang²,

Zhang³

et al. 2016

Reproduction

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Increasing evidence indicates that IVF (IVF includes in vitro fertilization and culture) embryos and babies are associated with a series of health complications, and some of them show sex-dimorphic patterns. Therefore, we hypothesized that IVF procedures have sex-biased or even sex-specific effects on embryonic and fetal development. Here, we demonstrate that IVF-induced side effects show significant sexual dimorphic patterns from the pre-implantation to the prenatal stage. During the pre-implantation stage, female IVF embryos appear to be more vulnerable to IVF-induced effects, including an increased percentage of apoptosis (7.22G1.94 vs 0.71G0.76, P!0.01), and dysregulated expression of representative sex-dimorphic genes (Xist, Hprt, Pgk1 and Hsp70). During the mid-gestation stage, IVF males had a higher survival rate than IVF females at E13.5 (male:femaleZ1.33:1), accompanied with a female-biased pregnancy loss. In addition, while both IVF males and females had reduced placental vasculogenesis/angiogenesis, the compensatory placental overgrowth was more evident in IVF males. During the late-gestation period, IVF fetuses had a higher sex ratio (male:femaleZ1.48:1) at E19.5, and both male and female IVF placentas showed overgrowth. After birth, IVF males grew faster than their in vivo (IVO) counterparts, while IVF females showed a similar growth pattern with IVO females. The present study provides a new insight into understanding IVF-induced health complications during embryonic and fetal development. By understanding and minimizing these sex-biased effects of the IVF process, the health of IVF-conceived babies may be improved in the future.

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“…They quoted the following sex birth: IVF with a single blastocyst, 56.1% males; IVF with a single cleaved embryo, 51.6 males; ICSI with single blastocyst, 52.5% males; and ICSI with single cleaved embryo, 48.7% males. Recently, Bu et al [25] analyzed the data of 18 IVF centers in China. There were 62,700 male babies and 58,477 female babies, making the sex ratio 51.8% (male/female = 107∶100).…”

Section: Discussionmentioning

confidence: 99%

Effect of Assisted Reproductive Technology (ART) on Babies Born: Compared by IVF Laboratories of Two Countries

Wu¹,

Qin²,

Zhang³

et al. 2019

Embryology - Theory and Practice

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Assisted reproductive technology (ART) has been widely used for infertility treatment, but many people have concern about their baby's health. The objective of this chapter is to provide some detailed data about the effect of ART on human birth babies by analyzing the data from in vitro fertilization (IVF) centers in two countries. All recent records related to a baby's birth including mother's age, gestational days, baby's sex, and birth weight data were collected and analyzed according to fresh or frozen embryo transfer procedure. Normal delivery data without ART were used as control. The result showed that ART patient age is significantly older than non-IVF women; the gestation of fresh and frozen embryo transfer is the same as normal spontaneous conception gestation days, but women pregnant with multiple gestations have shorter gestational period and early birth rate as well as low birth weight; and there is no significant difference in the baby's weight between ART singleton babies and normal conception babies, but male babies weight is more than female babies, and multiple gestation's birth weights are significantly lower than singletons, while frozen embryo transfer babies have significantly heavier birth weight than fresh embryo transfer. Also, the frozen embryo transfer technique may significantly decrease premature birth rate. Thus, frozen embryo transfer may be recommended as a health strategy in ART.

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Live Birth Sex Ratio after In Vitro Fertilization and Embryo Transfer in China - An Analysis of 121,247 Babies from 18 Centers

Cited by 63 publications

References 26 publications

Obstetric and perinatal outcomes of singletons after single blastocyst transfer: is there any difference according to blastocyst morphology?

Obstetric and perinatal outcomes of singletons after single blastocyst transfer: is there any difference according to blastocyst morphology?

IVF affects embryonic development in a sex-biased manner in mice

Effect of Assisted Reproductive Technology (ART) on Babies Born: Compared by IVF Laboratories of Two Countries

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