Preimplantation embryos sex ratios in couples with four or more children of same sex, what should be expected from a preimplantation genetic diagnosis cycle?

Abstract

Our aim was to assess the preimplantation embryos’ sex ratios in couples with four or more children of same sex, undergoing sex selection for nonmedical reasons. We conducted a cohort-historical study of all consecutive patients admitted to the IVF-PGD program in a large tertiary center. We reviewed the computerized files of all consecutive women admitted to our IVF for sex selection for nonmedical reasons. Patients and their PGD cycle characteristics were compared according to the desired sex of their embryo and the mode of fertilization. Nine patients underwent a total of 19 PGD cycle attempts during the study period. Of the 77 embryos with complete molecular diagnosis, 41 revealed a male embryo and 36 a female embryo. Thirty-five percent of all the diagnosed embryos were of the desired sex. For couples desiring a boy, IVF cycles achieved a higher ratio of the desired embryonal sex compared to ICSI (52% vs 18.7%, p = .03). For couples desiring a girl, ICSI cycles had a higher percentage of the desired embryonal sex compared to IVF cycles (38% vs 23%). Moreover, 29.7% of ICSI and 40% of IVF embryos achieved the desired sex. In conclusion, PGD for sex selection results in a relatively low percentage (35%) of embryos demonstrating the desired sex. Nonetheless, selecting the mode of fertilization (ICSI/IVF) might improve the success rate. Further studies are required to explore the appropriate and cost-effective method for sex selection for nonmedical reasons.

摘要

我们的目的是评估有4个或更多同性别孩子的夫妇胚胎植入前胚胎的性别比例, 因非医学原因进行性别选择。我们对在一家大型三级中心接受IVF-PGD计划的所有连续患者进行了历史性队列研究。我们回顾了非医学原因进行性别选择而准许IVF的所有连续女性的电脑文件。根据所需的胚胎性别和受精方式比较患者及其PGD周期特征。在研究期间, 9名患者共进行了19次PGD周期尝试。在完整分子诊断的77个胚胎中, 41个显示为雄性胚胎, 36个显示为雌性胚胎。所有被诊断的胚胎中有35％是所需的性别。对于想要男孩的夫妇, IVF周期与ICSI相比, 得到所需性别胚胎的比例更高（52％vs 18.7％, p = 0.03）。对于想要女孩的夫妇, ICSI与IVF周期相比, 获得所需胚胎性别的百分比更高（38％vs. 23％）。此外, 29.7％的ICSI和40％的IVF获得了所需的胚胎性别。总之, PGD用于性别选择导致所需性别胚胎的百分比相对较低（35%）。尽管如此, 选择受精方式（ICSI / IVF）可能会提高成功率。需要进一步的研究来探索非医学原因进行性别选择的适当和划算的方法。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• PGD
• ICSI
• IVF
• sex-selection

Disclosure statement

No potential conflict of interest was reported by the authors.