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Zhao J, Shen H, Zhu Q, Liu J, Han J, Yi R, Li J, Lin Y, Liu T, Zhong X. Assisted reproductive technology induces different secondary sex ratio: parental and embryonic impacts. Reprod Health 2023; 20:184. [PMID: 38097997 PMCID: PMC10722851 DOI: 10.1186/s12978-023-01723-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 11/30/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Assisted reproduction technology (ART) has advanced significantly, raising concerns regarding its impact on the secondary sex ratio (SSR), which is the sex ratio at birth in offspring. This study aimed to explore factors affecting SSR in singletons, singletons from twin gestation, and twins from twin gestation within the context of ART. METHODS A retrospective analysis was conducted on data from 8335 births involving 6,223 couples undergoing ART. Binary logistic regression assessed relationships between parental and embryonic factors and SSR in singletons and singletons from twin gestation. Multinomial logistic regression models were utilized to identify factors influencing SSR in twins from twin gestation. RESULTS Secondary infertility (OR = 1.164, 95% CI: 1.009-1.342), advanced paternal age (OR = 1.261, 95% CI: 1.038-1.534), and blastocyst embryo transfer (OR = 1.339, 95% CI: 1.030-1.742) were associated with an increased SSR, while frozen embryo transfer (FET) showed a negative association with SSR (OR = 0.738, 95% CI: 0.597-0.912) in singletons. A longer duration of gonadotropin (Gn) usage reduced SSR in singletons (OR = 0.961, 95% CI: 0.932-0.990) and singletons from twin gestation (OR = 0.906, 95% CI: 0.838-0.980). In singletons from twin gestation, male-induced infertility (OR = 2.208, 95% CI: 1.120-4.348) and higher Gn dosage (OR = 1.250, 95% CI: 1.010-1.548) were significantly associated with an increased SSR. Women aged > 35 years and intracytoplasmic sperm injection (ICSI) were associated with lower SSR (OR = 0.539, 95% CI: 0.293-0.990 and OR = 0.331, 95% CI: 0.158-0.690, respectively). In twins from twin gestation, paternal age exceeded maternal age (OR = 0.682, 95% CI: 0.492-0.945) and higher Gn dosage (OR = 0.837, 95% CI: 0.715-0.980) were associated with a higher proportion of male twins. Cleavage stage transfer (OR = 1.754, 95% CI: 1.133-2.716) resulted in a higher percentage of boy-girl twins compared to blastocyst transfer. CONCLUSION This study demonstrates the complex interplay of various factors in determining the SSR in ART, highlighting the importance of considering infertility type, paternal age, fertilization method, embryo transfer stage, and Gn use duration when assessing SSR. Nevertheless, further research with a large sample size is necessary to confirm and expand upon the findings of this study.
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Affiliation(s)
- Jiansen Zhao
- Nanshan School, Guangzhou Medical University, Guangzhou, 511436, China
| | - Haoran Shen
- Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Qijiong Zhu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, 510632, China
| | - Jiong Liu
- Nanshan School, Guangzhou Medical University, Guangzhou, 511436, China
| | - Jianhua Han
- Nanshan School, Guangzhou Medical University, Guangzhou, 511436, China
| | - Ruiting Yi
- Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Junxing Li
- Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Yanshan Lin
- Department of Reproductive Center, The Third Affiliated Hospital of Guangzhou Medical University, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangzhou, 510150, China.
| | - Tao Liu
- China Greater Bay Area Research Center of Environment Health, School of Medicine, Jinan University, Guangzhou, 510006, China.
| | - Xinqi Zhong
- Department of Neonatology, The Third Affiliated Hospital of Guangzhou Medical University, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangzhou, 510150, China.
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Bakkensen JB, Speedy S, Mumm M, Boots C. Sex ratio of offspring is not statistically altered following pre-implantation genetic testing under a specific sex selection policy. Arch Gynecol Obstet 2023; 308:1605-1610. [PMID: 37610634 DOI: 10.1007/s00404-023-07190-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/08/2023] [Indexed: 08/24/2023]
Abstract
PURPOSE To determine whether the use of pre-implantation genetic testing (PGT) under a specific sex selection policy is associated with alterations in offspring sex ratio. METHODS This was a single-center retrospective cohort study of singleton live births from January 2018-December 2020 achieved via single blastocyst non-PGT or PGT frozen embryo transfer (FET). Per institutional policy, sex may be disclosed following PGT. If both sexes are available and morphologic grade is similar, patients may select the sex of the embryo to be transferred. Demographics and cycle characteristics were compared between non-PGT vs. PGT cycles with Mann-Whitney U or χ2. Poisson regression with robust variance estimates was used to model the probability of female vs. male offspring among non-PGT vs. PGT cycles, reported as risk ratio (RR) and 95% confidence interval (CI). RESULTS(S) Among 541 live births, 350 (64.7%) were achieved with PGT and 191 (35.3%) without PGT. In both groups, female sex was more common, representing 59.4% of PGT-offspring and 55.0% of non-PGT offspring. After adjusting for potential confounders, the use of PGT was not significantly associated with an increased likelihood of female offspring (RR 1.04, 95% CI 0.98-1.11, p = 0.22). CONCLUSION(S) Singletons born following FET had a higher rate of female sex than male. Allowing sex selection per institutional policy did not increase this ratio. These results contrast with those of prior publications and should motivate individual centers to monitor their own sex ratios. As utilization of PGT increases, local, regional, and national monitoring will become increasingly important.
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Affiliation(s)
- Jennifer B Bakkensen
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 2310, Chicago, IL, 60611, USA.
| | - Sedona Speedy
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Margaret Mumm
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Christina Boots
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 2310, Chicago, IL, 60611, USA
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Zhang L, Cai H, Li W, Tian L, Shi J. Duration of infertility and assisted reproductive outcomes in non-male factor infertility: can use of ICSI turn the tide? BMC Womens Health 2022; 22:480. [DOI: 10.1186/s12905-022-02062-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 11/10/2022] [Indexed: 11/29/2022] Open
Abstract
Abstract
Background
Intracytoplasmic sperm injection (ICSI) is increasingly used among in vitro fertilization (IVF) cycles without male factor infertility. For couples with prolonged infertility duration, the preferred insemination method may vary across laboratories and clinics. We analyzed whether ICSI is effective for non-male factor infertility with long infertility duration.
Methods
Seventeen thousand four hundred seventy-seven IVF/ICSI cycles from women with non-male factor infertility were included, of these 4177 women with infertility duration ≥ 5 years were in the final analysis. Primary outcome was the live birth rate after first embryo transfer. Secondary outcomes were rates of clinical pregnancy and fertilization.
Results
A nonlinear relationship was observed between infertility duration and IVF fertilization rate, which decreased with infertility years up to the turning point (4.8 years). 4177 women with infertility ≥ 5 years were categorized by IVF (n = 3806) or ICSI (n = 371). Live birth rate after first embryo transfer was 43.02% in ICSI and 47.85% in IVF group (adjusted odds ratio (aOR), 0.91; 95% confidence interval (CI), 0.72–1.15). Fertilization rate per metaphaseII (aOR, 1.10; 95% CI, 0.86–1.40) and clinical pregnancy rate (aOR, 0.89; 95% CI, 0.71–1.13) were similar between the two groups. Sensitive analyses (women ≥ 35 years) did not show a benefit of ICSI over IVF.
Conclusions
Women with infertility exceeding 4.8 years had decreased incidence of IVF fertilization. The use of ICSI showed no significant improvement in fertilization and live birth rates for non-male factor couples with ≥ 5 years of infertility.
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Carrasco B, Pons MC, Parriego M, Boada M, García S, Polyzos NP, Veiga A. Male and female blastocyst: any difference other than the sex? Reprod Biomed Online 2022; 45:851-857. [DOI: 10.1016/j.rbmo.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 04/29/2022] [Accepted: 05/08/2022] [Indexed: 10/18/2022]
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Cai H, Ren W, Wang H, Shi J. Sex ratio imbalance following blastocyst transfer is associated with ICSI but not with IVF: an analysis of 14,892 single embryo transfer cycles. J Assist Reprod Genet 2022; 39:211-218. [PMID: 34993711 PMCID: PMC8866591 DOI: 10.1007/s10815-021-02387-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/21/2021] [Indexed: 01/03/2023] Open
Abstract
PURPOSE Assisted reproductive technology (ART) has an impact on secondary sex ratio (SSR), which is seemed to be elevated after blastocyst transfer (BT) but decreased following ICSI procedure. We aim to assess whether the higher SSR associated with BT could be influenced by fertilization method used. METHODS All consecutive IVF/ICSI cycles (fresh and frozen) involving single embryo transfer (SET) resulting in a live birth between 2015 and 2019 were retrospective analyzed. Logistic regression was used to model the effect on the SSR of maternal and specific ART characteristics. RESULTS Six thousand nine hundred twenty-two women were included with the crude SSR of 54.8%. The impact of BT on SSR is influenced by the fertilization method used. After adjustment for potential confounders, the SSR in the ICSI BT group was significantly higher when compared to ICSI cleavage-stage embryo SET (aOR 1.24; 95% CI 1.10-1.40, P < 0.001). However, this effect was not detected among SBT with IVF treatment (aOR 1.04; 95% CI 0.97-1.12, P = 0.260). Assessing blastocyst morphological parameters, high trophectoderm quality was significantly associated with elevated SSR (aOR 1.76, 95% CI 1.34-2.31 [A vs. C], and aOR 1.28, 95% CI 1.14-1.44 [B vs. C]). No significant difference was shown in expansion, inner cell mass, or days of blastocyst formation between male and female blastocysts. CONCLUSIONS The impact of BT on SSR could be influenced by the fertilization method used. The higher SSR was observed after BT with ICSI procedures but not with IVF. Interpretation of the findings is limited by the potential for selection and confounding bias.
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Affiliation(s)
- He Cai
- grid.440257.00000 0004 1758 3118Assisted Reproduction Center, Northwest Women’s and Children’s Hospital, Xi’An, China
| | - Wenjuan Ren
- grid.440257.00000 0004 1758 3118Assisted Reproduction Center, Northwest Women’s and Children’s Hospital, Xi’An, China
| | - Hui Wang
- grid.440257.00000 0004 1758 3118Assisted Reproduction Center, Northwest Women’s and Children’s Hospital, Xi’An, China
| | - Juanzi Shi
- grid.440257.00000 0004 1758 3118Assisted Reproduction Center, Northwest Women’s and Children’s Hospital, Xi’An, China
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Hou W, Shi G, Ma Y, Liu Y, Lu M, Fan X, Sun Y. Impact of preimplantation genetic testing on obstetric and neonatal outcomes: a systematic review and meta-analysis. Fertil Steril 2021; 116:990-1000. [PMID: 34373103 DOI: 10.1016/j.fertnstert.2021.06.040] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 06/21/2021] [Accepted: 06/23/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate whether preimplantation genetic testing (PGT) increases the risk of adverse obstetric and neonatal outcomes. DESIGN Systematic review and meta-analysis. SETTING Not applicable. PATIENT(S) Pregnancies achieved after PGT or in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). INTERVENTION(S) Systematic search of databases until December 2020 with cross-checking of references from relevant articles in English. MAIN OUTCOME MEASURE(S) Obstetric and neonatal outcomes after PGT and IVF/ICSI, including mean birth weight, low birth weight, very low birth weight (VLBW), mean gestational age at birth, preterm birth, very preterm birth, birth defects, intrauterine growth retardation (IUGR), sex ratio, cesarean section, hypertensive disorders of pregnancy, gestational diabetes mellitus, placenta disorder (placenta previa, placenta abruption, placenta accreta), and preterm premature rupture of membranes. RESULT(S) Ultimately, a total of 785,445 participants were enrolled in this meta-analysis, and these participants were divided into a PGT group (n = 54,294) and an IVF/ICSI group (n = 731,151). The PGT pregnancies had lower rates of low birth weight (risk ratio [RR] 0.85, 95% confidence interval [CI] 0.75 to 0.98), VLBW (RR 0.52, 95% CI 0.33 to 0.81), and very preterm births (RR 0.55, 95% CI 0.42 to 0.70) than those of IVF/ICSI pregnancies. However, the PGT group had a higher rate of the obstetric outcome of hypertensive disorders of pregnancy (RR 1.30, 95% CI 1.08 to 1.57). The PGT did not increase the risk of other adverse obstetric and neonatal outcomes, such as those associated with mean birth weight, mean gestational age at birth, birth defects, IUGR, sex ratio, cesarean section, gestational diabetes mellitus, placental disorder (placenta previa, placenta abruption, placenta accreta), or preterm premature rupture of membranes. We performed subgroup analysis with only blastocyst biopsies and found that PGT with blastocyst biopsies was associated with a lower rate of VLBW (RR 0.55, 95% CI 0.31 to 0.95). The PGT with blastocyst biopsies did not increase the risk of other adverse obstetric and neonatal outcomes. Additionally, we performed subgroup analysis with only frozen-thawed embryo transfer cycles, and we found that PGT pregnancies were associated with a lower rate of VLBW (RR 0.55, 95% CI 0.31 to 0.97), a lower rate of cesarean birth (RR 0.90, 95% CI 0.82 to 0.99), a higher rate of preterm birth (RR 1.10, 95% CI 1.02 to 1.18), and a higher rate of IUGR (RR 1.21, 95% CI 1.06 to 1.38) than those of IVF/ICSI pregnancies. The PGT with frozen-thawed embryo transfer did not increase the risk of other adverse obstetric and neonatal outcomes. CONCLUSION(S) The pooled analysis suggested that PGT did not increase the risk of adverse obstetric outcomes. The association between PGT and a higher risk of IUGR requires further investigation.
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Affiliation(s)
- Wenhui Hou
- Reproductive Medical Center, Henan Province Key Laboratory for Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Gaohui Shi
- Reproductive Medicine Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Yuanlin Ma
- Reproductive Medicine Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Yongxiang Liu
- Reproductive Medicine Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Manman Lu
- Reproductive Medical Center, Henan Province Key Laboratory for Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Xiuli Fan
- Obstetric Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Yingpu Sun
- Reproductive Medical Center, Henan Province Key Laboratory for Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China.
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Perlman BE, Minis E, Greenberg P, Krishnamoorthy K, Morelli SS, Jindal SK, McGovern PG. Increased male live-birth rates after blastocyst-stage frozen-thawed embryo transfers compared with cleavage-stage frozen-thawed embryo transfers: a SART registry study. F S Rep 2021; 2:161-165. [PMID: 34278348 PMCID: PMC8267381 DOI: 10.1016/j.xfre.2021.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/09/2021] [Accepted: 02/18/2021] [Indexed: 11/30/2022] Open
Abstract
Objective To investigate whether there is a difference in live-birth gender rates in blastocyst-stage frozen-thawed embryo transfers (FETs) compared with those in cleavage-stage FETs. Design Retrospective cohort study. Setting Academic medical center. Patient(s) All women with recorded live births who underwent FET at either the blastocyst or cleavage stage, reported to the Society for Assisted Reproductive Technology during 2004–2013. Intervention(s) None. Main Outcome Measure(s) The primary outcome was live-birth gender rates. Demographic criteria were also collected. The chi-square analyses were used for bivariate associations, and multiple logistic regression models were used for adjusted associations, with all two-sided P<.05 considered statistically significant. Result(s) A statistically significant increase was noted in the number of live male births after blastocyst-stage FET compared with that after cleavage-stage FET (51.9% vs. 50.5%). After controlling for potential confounders including age (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.03, 1.08), body mass index (OR, 1.08; 95% CI, 1.04, 1.12), and male factor infertility (OR, 1.06; 95% CI, 1.03, 1.08), the increase in male live births after blastocyst-stage FET remained statistically significant. Conclusion(s) In patients undergoing FETs, blastocyst-stage transfers are associated with higher male gender live-birth rates compared with cleavage-stage transfers.
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Affiliation(s)
- Barry E Perlman
- Obstetrics, Gynecology and Reproductive Health, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Evelyn Minis
- Obstetrics, Gynecology and Reproductive Health, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Patricia Greenberg
- Department of Biostatistics & Epidemiology, Rutgers School of Public Health, New Brunswick School of Public Health, Piscataway, New Jersey
| | - Kavitha Krishnamoorthy
- Obstetrics, Gynecology and Reproductive Health, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Sara S Morelli
- Obstetrics, Gynecology and Reproductive Health, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Sangita K Jindal
- Montefiore's Institute for Reproductive Medicine and Health, Hartsdale, New York
| | - Peter G McGovern
- University Reproductive Associates, Hasbrouck Heights, New Jersey
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Garcia-Dominguez X, Juarez JD, Vicente JS, Marco-Jiménez F. Impact of embryo technologies on secondary sex ratio in rabbit. Cryobiology 2020; 97:60-65. [PMID: 33053364 DOI: 10.1016/j.cryobiol.2020.10.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 10/01/2020] [Accepted: 10/09/2020] [Indexed: 01/20/2023]
Abstract
Increasing evidence indicates that assisted reproductive technologies (ARTs) disturb skewed sex-ratio and induce sex-dimorphic postnatal effects. Undoubtedly, the combination of multiple ovulation and embryo transfer (MOET) together with the use of vitrification technique (MOVET) is currently being used in breeding programs. However, since the first case of sex skewing reported in 1991, the accumulative and long-term transmission of skewed sex-ratio to future generations has not been thoroughly evaluated. Here we test as MOVET program induce a skewed sex ratio, and we consider skewed sex ratio transmission to future generations. To this end, we first evaluated the F1 generation, demonstrating that a MOVET program causes a severe imbalance skewed secondary sex ratio (SSR) towards male by 12%. This imbalanced persist after a second MOVET program (F2 generation), with an accumulative skewed SSR towards male by 25%. Finally, using a crossbred generation derived from crossing F1 males derived from a MOVET program with naturally-conceived (NC) females, we show that the imbalance skewed SRR persist. Bodyweight comparison between MOVET animals and NC counterparts revealed significant changes at birth, weaning and adulthood. However, there was a significant interaction between F2 MOVET animals and sex, demonstrating an apparent accumulative sex-dimorphic effect. At adulthood, MOVET derived males presented a lower body weight. In conclusion, we show that the MOVET program causes a direct, accumulative and long-term transmission of skewed SSR.
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Affiliation(s)
- Ximo Garcia-Dominguez
- Laboratory of Biotechnology of Reproduction, Institute for Animal Science and Technology (ICTA), Universitat Politècnica de València, 46022, Valencia, Spain
| | - Jorge D Juarez
- Laboratory of Biotechnology of Reproduction, Institute for Animal Science and Technology (ICTA), Universitat Politècnica de València, 46022, Valencia, Spain
| | - José S Vicente
- Laboratory of Biotechnology of Reproduction, Institute for Animal Science and Technology (ICTA), Universitat Politècnica de València, 46022, Valencia, Spain
| | - Francisco Marco-Jiménez
- Laboratory of Biotechnology of Reproduction, Institute for Animal Science and Technology (ICTA), Universitat Politècnica de València, 46022, Valencia, Spain.
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Shaia K, Truong T, Pieper C, Steiner A. Pre-implantation genetic testing alters the sex ratio: an analysis of 91,805 embryo transfer cycles. J Assist Reprod Genet 2020; 37:1117-1122. [PMID: 32215822 DOI: 10.1007/s10815-020-01746-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 03/12/2020] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To determine if pre-implantation genetic testing (PGT) shifts the sex ratio (SER), the ratio of male to female births in a population normalized to 100 and typically stable at 105, following in vitro fertilization (IVF). METHODS Data from 2014 to 2016 was requested from the Society for Assisted Reproductive Technologies (SART) database including fresh and frozen transfer cycles. Women with a singleton live birth following a fresh or frozen autologous embryo transfer of a PGT blastocyst, non-PGT blastocyst, or non-PGT cleavage stage embryo were included. The SER between groups was compared using chi-square tests. Modified Poisson regression modeled the relative risk (RR) of having a male compared to a female among PGT blastocyst transfers versus non-PGT cleavage and blastocyst transfers adjusting for age, BMI, smoking status, race, parity, number of oocytes retrieved, and clinic region. RESULTS The SER was 110 among PGT blastocyst offspring, 107 among non-PGT blastocyst offspring (p = 0.005), and 99 among non-PGT cleavage offspring (p < 0.001). The risk of having a male infant was 2% higher among PGT blastocyst transfers compared to non-PGT blastocyst transfers (RR 1.02; 95% CI: 1.01, 1.04). The risk was 5% higher among PGT blastocyst transfers compared to non-PGT cleavage transfers (RR 1.05; 95% CI: 1.02, 1.07). The association between PGT and infant gender did not significantly differ by region (p = 0.57) or parity (p = 0.59). CONCLUSION Utilizing PGT shifts the SER in the IVF population from the standard of 105 to 110, increasing the probability of a male offspring.
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Affiliation(s)
- Kathryn Shaia
- Division of Reproductive Endocrinology and Infertility, Duke Fertility Center, 5704 Fayetteville Road, Durham, NC, 27713, USA.
| | - Tracy Truong
- Department of Biostatistics & Bioinformatics, Duke University Medical Center, 2424 Erwin Rd, Durham, NC, 27705, USA
| | - Carl Pieper
- Department of Biostatistics & Bioinformatics, Duke University Medical Center, 2424 Erwin Rd, Durham, NC, 27705, USA
| | - Anne Steiner
- Division of Reproductive Endocrinology and Infertility, Duke Fertility Center, 5704 Fayetteville Road, Durham, NC, 27713, USA
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Unraveling the biologic and social predictors of infant sex among assisted reproductive technology cycles in the United States. Fertil Steril 2019; 112:237-238. [PMID: 31230838 DOI: 10.1016/j.fertnstert.2019.04.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 04/23/2019] [Indexed: 11/20/2022]
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