The Pregnancy Outcomes And Offspring Birth Defects Of Assisted Reproductive Technology

ObjectivePregnancy outcomes and offspring birth defects of assisted reproductive technology( ART) were retrospectively analyzed to evaluate the effect of different ART on pregnancy outcomes and offspring birth defects.MethodsAll 5798 clinical pregnancy cycles after ART, including fresh embryo transfer and frozen-thawed embryo transfer, in the Center for Reproductive Medicine, Tianjin Central Hospital of Obstetric and Gynecology from January 2009 to December 2013 were retrospectively analyzed. The rates of clinical pregnancy, multiple pregnancy,miscarriage, ectopic pregnancy, preterm labor, live birth delivery, sex ratio at birth,pregnancy complication and birth defects in fresh cycle embryo transfer group and frozen-thawed embryo transfer group, in vitro fertilization and fresh embryo transfer group and intracytoplasmic sperm injection fresh embryo transfer group were compared. The effect of advanced age and multiple pregnancy on pregnancy outcomes and birth defects were analysed.Results⑴ The rates of clinical pregnancy, multiple pregnancy, miscarriage, preterm labor, cesarean section, multiple delivery, low birth weight and pregnancy complication in frozen-thawed embryo transfer were higher than fresh cycle embryo transfer. But the ectopic pregnancy rate was lower than fresh cycle embryo transfer.⑵ The ectopic pregnancy rate and male sex ratio in in vitro fertilization and fresh embryo transfer group were higher than intracytoplasmic sperm injection fresh embryo transfer group.⑶ The rates of preterm labor, cesarean section, low birth weight, live birth delivery and pregnancy complication in multiple pregnancy group were higher than singleton pregnancy group. But the miscarriage rate and the birth weight of neonatal were lower than singleton pregnancy group.⑷ The rates of miscarriage, malformation induced labor and birth weight of neonatal in advanced maternal aged group were higher than low maternal aged group.But the rates of clinical pregnancy, multiple pregnancy, multiple delivery and live birth delivery were lower than low maternal aged group.⑸ ART may not increase the risk of birth defects. The rate of birth defect in fresh cycle embryo transfer is similar to frozen-thawed embryo transfer. And there is also no difference between IVF-ET and ICSI-ET.Conclusion⑴ Compared with fresh embryo transfer, frozen-thawed embryo transfer can enhance the clinical pregnancy rate and decrease the ectopic pregnancy rate. But the risk of multiple pregnancy are increased at the same time.⑵ ICSI may not increased the risk of adverse pregnancy outcomes. But the proportion of boy babies born after ICSI is lower than IVF.⑶ Multiple pregnancy and advanced maternal age are important factors that lead to adverse pregnancy outcomes.⑷ Birth defect rate of ART is similar to the rate of nationwide.Compared with conventional IVF, ICSI and FET don’t increase the risk of birth defect.