Felipe Dieamant, Claudia G Petersen, Laura D Vagnini, Adriana Renzi, Bruna Petersen, Fabiana Massaro, Camila Zamara, Andreia Nicoletti, Juliana Ricci, Antonio H Oliani, João Batista A Oliveira, José G Franco
{"title":"胞浆内形态学选择精子注射(IMSI)对出生缺陷的影响:系统回顾和荟萃分析。","authors":"Felipe Dieamant, Claudia G Petersen, Laura D Vagnini, Adriana Renzi, Bruna Petersen, Fabiana Massaro, Camila Zamara, Andreia Nicoletti, Juliana Ricci, Antonio H Oliani, João Batista A Oliveira, José G Franco","doi":"10.5935/1518-0557.20210030","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>It is generally accepted that the incidence of birth defects in spontaneously conceived children ranges between 2.0-4.0%. However, several studies have shown that babies born after assisted reproductive technology (ART) procedures tend to present more congenital malformations than naturally conceived children, with 6.5% of the children born after intracytoplasmic sperm injection (ICSI) presenting birth defects. The use of high magnification sperm selection before ICSI was introduced in the early 2000s to allow the identification of spermatozoa with low risk of sperm DNA damage. Intracytoplasmic morphologically selected sperm injection (IMSI) is expected to change the incidence of congenital malformations, although data on the incidence of birth defects in children conceived after IMSI are still scarce.</p><p><strong>Methods: </strong>A systematic review based on searches performed in electronic databases (PubMed, EMBASE, Web of Science, SCOPUS, and Cochrane Central Register of Controlled Trials) including articles published by February 2021 was conducted to identify trials comparing the neonatal outcomes of ICSI and IMSI. The outcome measured was the rate of birth defects in children born after ICSI or IMSI. Three trials were included as targets for data extraction and meta-analysis.</p><p><strong>Results: </strong>Our meta-analysis included 3907 children conceived after IMSI (1280) or ICSI (2627). The incidence of birth defects was statistically different, with 2.5% (32/1280) in IMSI and 4.5% (119/2627) in ICSI (RR=0.59; 95% CI=0.40-0.87; p=0.007). The results demonstrated that IMSI decreased the incidence of structural defects compared to ICSI - 2.2% (18/830) vs. 3.8% (78/2049) - in a statistically significant manner (RR=0.58; 95%CI=0.35-0.96; p=0.04). No significant difference was observed in chromosomal abnormalities (Trisomy 13; 18; 21 and Triple X) between children conceived after IMSI (8/830) or ICSI (19/2049) (RR=1.07; 95%CI=0.47-2.43; p=0.87).</p><p><strong>Conclusions: </strong>IMSI seems to be an effective tool at reducing the incidence of structural defects compared to ICSI. However, IMSI does not change the incidence of chromosomal abnormalities.</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":" ","pages":"466-472"},"PeriodicalIF":1.9000,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2a/1c/jbra-25-03-0466.PMC8312289.pdf","citationCount":"3","resultStr":"{\"title\":\"Impact of Intracytoplasmic Morphologically Selected Sperm Injection (IMSI) on Birth Defects: A Systematic Review and Meta-Analysis.\",\"authors\":\"Felipe Dieamant, Claudia G Petersen, Laura D Vagnini, Adriana Renzi, Bruna Petersen, Fabiana Massaro, Camila Zamara, Andreia Nicoletti, Juliana Ricci, Antonio H Oliani, João Batista A Oliveira, José G Franco\",\"doi\":\"10.5935/1518-0557.20210030\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>It is generally accepted that the incidence of birth defects in spontaneously conceived children ranges between 2.0-4.0%. However, several studies have shown that babies born after assisted reproductive technology (ART) procedures tend to present more congenital malformations than naturally conceived children, with 6.5% of the children born after intracytoplasmic sperm injection (ICSI) presenting birth defects. The use of high magnification sperm selection before ICSI was introduced in the early 2000s to allow the identification of spermatozoa with low risk of sperm DNA damage. Intracytoplasmic morphologically selected sperm injection (IMSI) is expected to change the incidence of congenital malformations, although data on the incidence of birth defects in children conceived after IMSI are still scarce.</p><p><strong>Methods: </strong>A systematic review based on searches performed in electronic databases (PubMed, EMBASE, Web of Science, SCOPUS, and Cochrane Central Register of Controlled Trials) including articles published by February 2021 was conducted to identify trials comparing the neonatal outcomes of ICSI and IMSI. The outcome measured was the rate of birth defects in children born after ICSI or IMSI. Three trials were included as targets for data extraction and meta-analysis.</p><p><strong>Results: </strong>Our meta-analysis included 3907 children conceived after IMSI (1280) or ICSI (2627). The incidence of birth defects was statistically different, with 2.5% (32/1280) in IMSI and 4.5% (119/2627) in ICSI (RR=0.59; 95% CI=0.40-0.87; p=0.007). The results demonstrated that IMSI decreased the incidence of structural defects compared to ICSI - 2.2% (18/830) vs. 3.8% (78/2049) - in a statistically significant manner (RR=0.58; 95%CI=0.35-0.96; p=0.04). No significant difference was observed in chromosomal abnormalities (Trisomy 13; 18; 21 and Triple X) between children conceived after IMSI (8/830) or ICSI (19/2049) (RR=1.07; 95%CI=0.47-2.43; p=0.87).</p><p><strong>Conclusions: </strong>IMSI seems to be an effective tool at reducing the incidence of structural defects compared to ICSI. However, IMSI does not change the incidence of chromosomal abnormalities.</p>\",\"PeriodicalId\":520656,\"journal\":{\"name\":\"JBRA assisted reproduction\",\"volume\":\" \",\"pages\":\"466-472\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2021-07-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2a/1c/jbra-25-03-0466.PMC8312289.pdf\",\"citationCount\":\"3\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JBRA assisted reproduction\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5935/1518-0557.20210030\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JBRA assisted reproduction","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5935/1518-0557.20210030","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 3
摘要
目的:一般认为自然妊娠儿出生缺陷的发生率在2.0-4.0%之间。然而，一些研究表明，在辅助生殖技术(ART)手术后出生的婴儿比自然受孕的婴儿更容易出现先天性畸形，6.5%的卵胞浆内单精子注射(ICSI)后出生的婴儿出现出生缺陷。在21世纪初引入ICSI之前，使用高倍率精子选择可以识别精子DNA损伤风险低的精子。细胞质内形态学选择精子注射(IMSI)有望改变先天性畸形的发生率，尽管关于IMSI后婴儿出生缺陷发生率的数据仍然很少。方法:基于电子数据库(PubMed, EMBASE, Web of Science, SCOPUS和Cochrane Central Register of Controlled Trials)的搜索进行系统综述，包括2021年2月发表的文章，以确定比较ICSI和IMSI新生儿结局的试验。测量的结果是在ICSI或IMSI后出生的儿童的出生缺陷率。纳入三个试验作为数据提取和荟萃分析的目标。结果:我们的荟萃分析包括3907名IMSI(1280名)或ICSI(2627名)后怀孕的儿童。两组出生缺陷发生率有统计学差异，IMSI组为2.5% (32/1280)，ICSI组为4.5% (119/2627)(RR=0.59;95%可信区间= 0.40 - -0.87;p = 0.007)。结果表明，与ICSI相比，IMSI降低了结构缺陷的发生率，分别为2.2%(18/830)和3.8%(78/2049)，具有统计学意义(RR=0.58;95%可信区间= 0.35 - -0.96;p = 0.04)。在染色体异常方面无显著差异(13三体;18;在IMSI(8/830)或ICSI(19/2049)后怀孕的孩子之间(RR=1.07;95%可信区间= 0.47 - -2.43;p = 0.87)。结论:与ICSI相比，IMSI似乎是减少结构缺陷发生率的有效工具。然而，IMSI并没有改变染色体异常的发生率。
Impact of Intracytoplasmic Morphologically Selected Sperm Injection (IMSI) on Birth Defects: A Systematic Review and Meta-Analysis.
Objective: It is generally accepted that the incidence of birth defects in spontaneously conceived children ranges between 2.0-4.0%. However, several studies have shown that babies born after assisted reproductive technology (ART) procedures tend to present more congenital malformations than naturally conceived children, with 6.5% of the children born after intracytoplasmic sperm injection (ICSI) presenting birth defects. The use of high magnification sperm selection before ICSI was introduced in the early 2000s to allow the identification of spermatozoa with low risk of sperm DNA damage. Intracytoplasmic morphologically selected sperm injection (IMSI) is expected to change the incidence of congenital malformations, although data on the incidence of birth defects in children conceived after IMSI are still scarce.
Methods: A systematic review based on searches performed in electronic databases (PubMed, EMBASE, Web of Science, SCOPUS, and Cochrane Central Register of Controlled Trials) including articles published by February 2021 was conducted to identify trials comparing the neonatal outcomes of ICSI and IMSI. The outcome measured was the rate of birth defects in children born after ICSI or IMSI. Three trials were included as targets for data extraction and meta-analysis.
Results: Our meta-analysis included 3907 children conceived after IMSI (1280) or ICSI (2627). The incidence of birth defects was statistically different, with 2.5% (32/1280) in IMSI and 4.5% (119/2627) in ICSI (RR=0.59; 95% CI=0.40-0.87; p=0.007). The results demonstrated that IMSI decreased the incidence of structural defects compared to ICSI - 2.2% (18/830) vs. 3.8% (78/2049) - in a statistically significant manner (RR=0.58; 95%CI=0.35-0.96; p=0.04). No significant difference was observed in chromosomal abnormalities (Trisomy 13; 18; 21 and Triple X) between children conceived after IMSI (8/830) or ICSI (19/2049) (RR=1.07; 95%CI=0.47-2.43; p=0.87).
Conclusions: IMSI seems to be an effective tool at reducing the incidence of structural defects compared to ICSI. However, IMSI does not change the incidence of chromosomal abnormalities.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
