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Impact of blastocyst transfer on offspring sex ratio and the monozygotic twinning rate: a systematic review and meta-analysis

Cited 117 time in Web of Science Cited 137 time in Scopus
Authors

Chang, Hye Jin; Lee, Jung Ryeol; Jee, Byung Chul; Suh, Chang Suk; Kim, Seok Hyun

Issue Date
2009-06
Publisher
ELSEVIER SCIENCE INC
Citation
FERTILITY AND STERILITY; Vol.91 6; 2381-2390
Keywords
Blastocystembryo transfermonozygotic twincleavage stagesex ratio
Abstract
Objective: To determine the sex ratio and risk of monozygotic twinning (MZT) after blastocyst transfer compared with cleavage-stage embryo transfer (ET) in fresh IVF cycles. Design: Systematic review and meta-analysis. Setting: University hospital center for reproductive medicine and IVF. Patient(s): Results of all reports from January 1995 to November 2007 with women undergoing nondonor fresh WE The sex ratio of 2,587 offspring and MZT rate in 40,917 cycles were included. Intervention(s): Cleavage or blastocyst stage for embryo transfer. Main Outcome Measure(s): Sex ratio and rate of MZT. Result(s): A meta-analysis was performed using four studies for sex ratio and nine studies for MZT. The results of the meta-analysis using a fixed effect model demonstrated a higher male-female ratio after blastocyst. transfer compared with cleavage-stage ET (odds ratio (OR] 1.29, 95% confidence interval [CI] 1.10-1.51), and this difference was statistically significant. The risk of MZT after blastocyst transfer was significantly higher compared with cleavage-stage ET (OR 3.04, 95% CI 1.54-6.01). Conclusion(s): The combined data presented in this meta-analysis Suggest that blastocyst transfer appears to be associated with a sex ratio skewed in favor of males and an increased risk of MZT. The clinicians should provide this information to their infertility patients awaiting blastocyst transfer. (Fertil Steril (R) 2009;91:2381-90. (C) 2009 by American Society for Reproductive Medicine.)
ISSN
0015-0282
Language
English
URI
https://hdl.handle.net/10371/76766
DOI
https://doi.org/10.1016/j.fertnstert.2008.03.066
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