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Multicenter Study
. 2014 Nov 20;9(11):e113522.
doi: 10.1371/journal.pone.0113522. eCollection 2014.

Live birth sex ratio after in vitro fertilization and embryo transfer in China--an analysis of 121,247 babies from 18 centers

Zhiqin Bu  1 , Zi-Jiang Chen  2 , Guoning Huang  3 , Hanwang Zhang  4 , Qiongfang Wu  5 , Yanping Ma  6 , Juanzi Shi  7 , Yanwen Xu  8 , Songying Zhang  9 , Cuilian Zhang  10 , Xiaoming Zhao  11 , Bo Zhang  12 , Yuanhua Huang  13 , Zhengyi Sun  14 , Yuefan Kang  15 , Riran Wu  16 , Xueqing Wu  17 , Haixiang Sun  18 , Yingpu Sun  1
Affiliations
Multicenter Study

Live birth sex ratio after in vitro fertilization and embryo transfer in China--an analysis of 121,247 babies from 18 centers

Zhiqin Bu et al. PLoS One. .

Abstract

In order to study the impact of procedures of IVF/ICSI technology on sex ratio in China, we conducted this multi-center retrospective study including 121,247 babies born to 93,895 women in China. There were 62,700 male babies and 58,477 female babies, making the sex ratio being 51.8% (Male: Female = 107:100). In univariate logistic regression analysis, sex ratio was imbalance toward females of 50.3% when ICSI was preformed compared to 47.7% when IVF was used (P<0.01). The sex ratio in IVF/ICSI babies was significantly higher toward males in transfers of blastocyst (54.9%) and thawed embryo (52.4%) when compared with transfers of cleavage stage embryo (51.4%) and fresh embryo (51.5%), respectively. Multiple delivery was not associated with sex ratio. However, in multivariable logistic regression analysis after controlling for related factors, only ICSI (adjusted OR = .90, 95%CI: 0.88-0.93; P<0.01) and blastocyst transfer (adjusted OR = 1.14, 95% CI: 1.09-1.20; P<0.01) were associated with sex ratio in IVF/ICSI babies. In conclusion, the live birth sex ratio in IVF/ICSI babies was influenced by the use of ICSI, which may decrease the percentage of male offspring, or the use of blastocyst transfer, which may increase the percentage of male offspring.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Effect of insemination method (IVF/ICSI) on SSR.
SSR =  secondary sex ratio; IVF =  in vitro fertilization; ICSI =  intracytoplasmic sperm injection; CE =  cleavage stage embryo; BE =  blastocyst embryo.
Figure 2
Figure 2. Effect of stage of embryo transferred (CE/BE) on SSR.
SSR =  secondary sex ratio; IVF =  in vitro fertilization; ICSI =  intracytoplasmic sperm injection; CE =  cleavage stage embryo; BE =  blastocyst embryo.
Figure 3
Figure 3. Effect of type of embryo transferred (fresh/thawed) on SSR.
SSR =  secondary sex ratio; IVF =  in vitro fertilization; ICSI =  intracytoplasmic sperm injection; CE =  cleavage stage embryo; BE =  blastocyst embryo.
Figure 4
Figure 4. Effect of type of birth (singleton/multiple delivery) on SSR.
SSR =  secondary sex ratio; IVF =  in vitro fertilization; ICSI =  intracytoplasmic sperm injection; CE =  cleavage stage embryo; BE =  blastocyst embryo.
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