| Objective:Pregnancy and neonatal outcomes of patients conceived follow assisted reproductive treatments were retrospectively analyzed to evaluate the safety of assisted reproductive technology (ART).Methods:All the 1463 ART cycles resulted in a delivery of one or more babies in the Center of Reproductive medicine, Tongji Hospital from 1st January 2002 to 31th December 2006 were retrospectively analyzed. Their pregnancy outcomes and neonatal outcomes were collected through case reviews and follow-up. Multiple birth rate, premature birth rate, birth weight and the risk of congenital malformation were compared between pregnancies after in vitro fertilization-embryo transfer (IVF-ET) and intracytoplasmic sperm injection (ICSI) treatment。3175 cases of naturally conceived pregnancy were used as control group。Multiple pregnancy rate, premature birth rate, rates of low birth weight and congenital malformation were compared between the ART-conceived group and the naturally conceived group。Results:(1) 1463 deliveries after ART treatment showed a multiple pregnancy rate of 30.01%, and a preterm labor rate of 24.33%, which were significantly higher than those in the natural pregnancy, multiple pregnancy rate (2.90%) and preterm labor rate (12.85%), respectively. The differences between the two groups were found to be statistically significant (P=0.000, P=0.000).(2) Preterm labor rate of ART singleton pregnancies, twin pregnancies and triplet pregnancies were 11.44%,54.21%,100.00%, respectively. The difference were found to be statistically significant (P= 0.000).(3) In babies born after ART treatment, twins suffered more from the lower birth weights than singleton, the differences between the two groups were found to be statistically significant (P=0.000). Multiple births after ART resulting in lower birth weight than naturally conceived multiple births, the differences were statistically significant.(4) Congenital malformations were found in 49(2.57%) babies out of 1904 ART infants, among the 3269 infants conceived naturally,66 (2.02%) were found to be suffered from congenital malformations. No significant difference of incidences of congenital malformations was found between the two groups (P= 0.243).(5) 24 cases (1.26%) of ART group and 10 cases (0.3%) of naturally conceived group ended in either death of fetus, stillbirth or neonatal deaths. The differences between the two groups were found to be statistically significant (P= 0.000). The differences in mortality of preterm labor between the two groups were found to be statistically significant. (P= 0.023). No statistically significant difference was found in mortality of full-term birth between the two group (P= 0.686).(6) Multiple pregnancy rate for IVF cycles was higher than ICSI (31.95% vs.23.86%), the difference was statistically significant (P= 0.004). There was no statistically significant difference in incidence of premature delivery, low birth weights and congenital malformation between IVF and ICSI group.(7) Sex ratio at birth of IVF babies is higher than that in the ICSI group, the difference was statistically significant (P= 0.000). Conclusion:Increased incidences of multiple pregnancy and preterm labor were seen among women conceived after ART, when compared to women conceived naturally. High mortality rate and low birth weight rates in ART conceived women were seemed to be associated with multiple births and premature delivery. No significant difference was found in the incidences of congenital malformations between ART babies and naturally conceived babies. Rates of multiple births and sex ratio in IVF babies is higher than that in ICSI babies, the different were found to be statistically significant. The incidence of premature delivery and congenital malformation in IVF patients showed no statistically significant difference when compared to ICSI patients.Objective:To assess spontaneous abortion after assisted reproductive technology treatment.Methods:Retrospective analysis was performed on 1810 pregnancies achieved after ART treatment. Incidence of spontaneous abortion was calculated. Association between maternal age, number of fetuses and abortion were estimated in either fresh or freeze-thaw IVF/ICSI cycles.Results:The overall incidence of spontaneous abortion of the 1810 pregnancies achieved after ART treatment was 15.58%. The incidence of biochemical pregnancy, early pregnancy loss, and late abortion were 9.67%,4.75% and 0.07%, respectively. The incidence of abortion in ICSI and IVF cycles were 14.29% and 15.97%, respectively. There was no statistically significant difference between the two groups. Pregnancy loss significantly increases in freezing-thaw ICSI cycles (P= 0.005). Incidence of miscarriage in twins was significantly lower than those in singletons and triplets. the risk of abortion (per gestational sac) in twins is higher than those in singletons. For women over age 35, the risk of abortion is significantly increased.Conclusion:Pregnancy loss significantly increases in freezing-thaw ICSI cycles. Incidence of miscarriage in twins was significantly lower than those in singletons and triplets. Risk of abortion increased with maternal age, significantly in patients over age 35.Objective:To evaluate the children outcome of intracytoplasmic sperm injection in male infertile patients.Methods:Retrospective analysis of the children outcome of 298 male factor infertility cases treated by ICSI in our hospital from 2002-2006.879 cases of female infertility treated by IVF was use as a control. Incidences of premature labor, multiple birth, low birth weight, and congenital malformation were compared.Results:The mean age was similar in both IVF and ICSI groups. There were significant differences in incidence of multiple pregnancy and preterm labor between the two groups (p<0.05), higher risk of multiple pregnancy and preterm labor were observed in female infertility group. No significant difference were found in birth weight (P=0.104) and incidence of congenital malformation (P=0.278) between male infertility group and female infertility group, while significant difference were seen in multiple birth rate (P=0.03) and preterm labor (P=0.042)Conclusion:In conclusion, perinatal outcome after ICSI showed similarity in the number of pathologies in comparison with IVF. |
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