目的:非整倍性胚胎植入前基因检测(PGT-A)后接受冷冻胚胎移植(FET)的患者选择性别的频率和在成功分娩第一个婴儿前后的性别选择率是否不同?
结论:当男性和女性胚胎之间有选择时,与第一个孩子(32.4%)相比,尝试怀孕第二个孩子(62%)时,患者选择性别的频率更高,并且最常选择第一个孩子的异性。
背景:性别选择在美国生育诊所中广泛使用。然而,PGT-A后接受FET的患者的性别选择率未知.
方法:这是一项2013年1月至2021年2月期间585例患者的回顾性队列研究。
方法:这项研究是在一个单一的,美国城市学术生育中心。如果患者在单个整倍体FET后有活产,并返回至少一个随后的整倍体FET,则将其包括在内。主要结果是第一个婴儿与第二个婴儿的性别选择比率。次要结果是第一次活产的同性和异性的选择率,以及男性和女性的总体选择率。
结果:五百八十五名患者接受了总共1560个单倍体FET,导致一个或两个活产。919个FET可在男性和女性整倍体胚胎之间进行选择(第一个孩子:67.5%(519/769),第二个孩子:50.6%(400/791),P<0.01)。当有选择时,患者在尝试怀孕第二个孩子时更频繁地选择性别(第一个孩子:32.4%(168/519)与第二个孩子:62.0%(248/400),P<0.01)。当第一次活产后选择性别时,81.8%(203/248FET)的第一个孩子的异性被选中.涉及性别选择的转移,第一个孩子的男性和女性选择率相似,但是第二个孩子对女性的选择更大(第一个孩子:51.2%(86/168)男性对48.9%(82/168)女性,第二个孩子:41.1%(102/248)男性与58.9%(146/248)女性,P<0.04)。
结论:这项研究是在美国东北部的一个城市学术医疗中心进行的,这可能会限制PGT-A可能不太频繁执行的其他设置的通用性,或性别选择可能受到限制或不允许。此外,我们无法可靠地解释患者或其伴侣是否有先前的孩子,如果有,什么性别。
结论:接受男性和女性整倍体胚胎PGT-A的患者在尝试第二个孩子时更有可能选择性别,并且通常选择第一个孩子的异性。这些发现强调了在允许性别选择的环境中接受PGT-A的患者家庭平衡的潜力。
背景:这项研究没有获得资助。作者没有利益冲突要声明。
背景:不适用。
How often do patients undergoing frozen embryo transfer (FET) after preimplantation genetic testing for aneuploidy (PGT-A) choose to select for sex and do sex selection rates differ before and after successful delivery of a first baby?
When a choice was available between male and female embryos, patients selected the sex more frequently when trying to conceive the second child (62%) as compared to the first child (32.4%) and most commonly selected for the opposite sex of the first child.
Sex selection is widely available in US fertility clinics. However, the rate of sex selection for patients undergoing FET after PGT-A is unknown.
This is a retrospective cohort study of 585 patients that took place between January 2013 and February 2021.
The study took place at a single, urban academic fertility center in the USA. Patients were included if they had a live birth after single euploid FET and returned for at least one subsequent euploid FET. The primary outcomes were the rates of sex selection for first versus second baby. Secondary outcomes were rate of selection for same versus opposite sex as first live birth and overall rate of selection for males versus females.
Five hundred and eighty-five patients underwent a total of 1560 single euploid FETs resulting in either one or two live births. A choice between male and female euploid embryos was available for 919 FETs (first child: 67.5% (519/769) versus second child: 50.6% (400/791), P < 0.01). When a choice was available, patients selected the sex more frequently when trying to conceive the second child (first child: 32.4% (168/519) versus second child: 62.0% (248/400), P < 0.01). When sex was selected after first live birth, the opposite sex of the first child was selected 81.8% (203/248 FETs) of the time. Of transfers that involved sex selection, rates of male and female selection were similar for the first child, but selection for females was greater for the second child (first child: 51.2% (86/168) male versus 48.9% (82/168) female, second child: 41.1% (102/248) male versus 58.9% (146/248) female, P < 0.04).
The study was performed at one urban academic medical center in the Northeastern US, which may limit generalizability to other settings where PGT-A may be performed less frequently, or sex selection may be limited or not permitted. In addition, we could not reliably account for whether patients or their partners had prior children and if so, of what sex.
Patients undergoing PGT-A with both male and female euploid embryos were more likely to select for sex when attempting a second child and usually selected for the opposite sex of their first child. These findings highlight the potential for family balancing for patients who undergo PGT-A in settings where sex selection is permitted.
This study received no funding. The authors have no conflicts of interest to declare.
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