Study On The Outcomes Of Assisted Reproductive Therapy And Birth Defects Of Children Conceived By Assisted Reproductive Technology

Objective:Through the analysis and comparison of the pregnancy outcome and birth defects with or without assisted reproductive therapy,the effectiveness and safety of assisted reproductive technology were further discussed.Methods:From January 1997 to December 2016,all of the clinical pregnancy cycles after assisted reproductive treatment at the Center for Reproductive Medicine,Tianjin Central Hospital of Gynecology and Obstetrics were obtained.According to the medical registration system and follow-up records,the pregnancy and delivery outcomes of different assisted reproductive technologies were compared.The same comparisions were conducted respectively(eg.single pregnancy group vs.mutiple pregnancy group,advanced aged female group vs.lower aged female group).The incidence and distribution of birth defects were compared among the groups as well.All the statistical analyses were performed through IBM-SPSS v.20.0.Cases of successful delivery and congenital malformation of newborns after receiving assisted reproductive treatment in reproductive centers from January 2010 to December 2017 and cases of congenital malformations born at obstetric delivery in the hospital and natural conception were collected.With the aid of the medical record registration system and the follow-up records,the basic condition and birth defect of children with ART deficiency and spontaneous pregnant SPD were compared,and the distribution of each type of malformation in the two samples was compared and analyzed.Results:(1)In the frozen-thawed transfer group,the multiple pregnancy rate(35.57%vs.28.85%),preterm delivery rate(21.04%vs.17.02%)and multiple delivery rate(33.38%vs.25.71%)were all increased compared with the fresh transfer group(P<0.05).There was no significant difference between group IVF and group ICSI(P>0.05).(2)In ART and non-ART pregnancy,statistical indices of multiple pregnancy all indicated adverse pregnancy and delivery outcomes.However,the incidence of congenital malformation in the multiple pregnancy offspring was not increased compared with that of a singleton(1.27%vs.1.05%)(P>0.05).(3)The rate of abortion(23.37%vs.13.85%)and induce labor(1.78%vs.1.15%)of advanced female aged(?35 years old)group were higher than those of low female aged(<35 years old)group,while the former group has a lower multiple pregnancy rate(22.92%vs.34.40%)and preterm birth rate(17.66%vs.19.90%)than the latter group.All differences were significant(P<0.05).(4)The incidence of congenital malformations in IVF and ICSI offspring(0.92%vs.0.64%)was similar(P>0.05).The incidence of congenital malformations was higher in the frozen-thawed transfer group than that in the fresh transfer group(1.47%vs.0.83%).The rate of birth defect in the advanced female aged group was higher than that in the low female aged group(1.52%vs.0.97%).The difference was statistically significant(P<0.05).(5)In the ART group,there was a significant difference in the distribution of congenital malformations between single pregnancy and multiple pregnancy subgroups.Significant difference were also observed after comparing the preterm and full-term subgroups(P<0.05).In the SP group,the distribution of the preterm subgroup and that of full-term subgorps were signicicantly different.Significant difference were also observed between the the advanced female aged subgourp and low female aged subgroup(P<0.05).(6)Compared with group SP,preterm birth rate(37.14%vs.62.14%)and multiple ptegnancy rate(56.43%vs.5.48%)of group ART were higher.The rate of pregnancy complication(6.43%vs.36.29%),cesarean section(12.14%vs.25.71%)in group ART were lower than that in group SP.All differences were statistically significant(P<0.05).Conclusion(1)Due to the increased risk of adverse pregnancy outcomes,multiple pregnancy should be one of the most severe clinical outcomes that ART should avoid.(2)There was no difference in the risk of birth defects between IVF and ICSI.Both increased female age and frozen-thawed embryo transfer increased the risk of birth defects in offspring.(3)The most common defect in newborns was congenital heart disease.The Distribution of birth defects of birth defects in ART and SP groups were different,but they all suggested a high incidence of defects in the cardiovascular system.