供精精液行辅助生殖技术出生子代安全性评估

目的:本研究调查应用供精者精液实施辅助生殖技术(ART),包括供精人工授精(AID)、供精体外受精(IVF-D、ICSI-D)与应用丈夫精液经ART(AIH、IVF、ICSI)出生子代缺陷的发生率,从而评价应用供精者精子实施ART出生子代的安全性。方法:2005年1月至2009年10月,上海市人类精子库向全国11家医疗机构供精,实施供精ART出生子代904例。对照组为4家生殖医学中心,同期对不育夫妇实施丈夫精液ART出生子代4 195例。统计两类精液实施ART出生子代的数量与出生缺陷的例数及病种分类,比较两种精液来源获得子代出生缺陷的发生率。结果:应用供精者精液实施ART获得子代出生缺陷7例(0.77%),使用丈夫精液出生缺陷42例(1.00%),其差异无显著性(P>0.05)。结论:应用供精者精子实施ART出生子代同夫精ICSI出生的子代相比,出生缺陷的种类没有明显差异,但前者的出生缺陷率明显低于后者,就目前结果而言,供精辅助生殖技术更具安全性。

Safety evaluation of the offspring conceived by assisted reproductive technology with donor's semen

Objective：To investigate and compare the incidences of birth defects in the offspring conceived by assisted reproductive technology（ART）,including artificial insemination with the donor＇s semen（AID）,in vitro fertilization with donor＇s semen（IVF-D） and intracytoplasmic sperm injection with the donor＇s semen（ICSI-D）,and in those conceived through ART with the husband＇s semen,including AIH,IVF and ICSI,in order to further evaluate the safety of ART with the donor＇s semen.Methods：From January 2005 to October 2009,Shanghai Human Sperm Bank provided sperm copies to 11 medical institutions,which resulted in a total of 904 offspring born by ART.We followed up all these cases and investigated the status of the offspring.The control group included 4195 offspring of infertile couples from 4 Reproductive Medical Centers approved by health management administrations,which were conceived by ART in the same period.After investigating the number of offspring and cases of birth defects caused by various methods of assisted reproductive technology,we compared the incidence of birth defects resulting from the donor＇s semen and that from the husband＇s.Results：There were 7 cases of birth defects（0.77%） in the offspring born by ART with the donor＇s semen,and 42 cases（1.00%） in those born by ART with the husband＇s semen,with no significant differences between the two groups（P0.05）.Conclusion：There were no significant differences in the category of birth defects between ART with the donor＇s semen and that with the husband＇s,while the incidence of birth defects resulting from ART with the donor＇s semen was significantly lower than that from ICSI in infertile couples.The present findings indicate a higher safety of ART with the donor＇s semen.