Objective: To investigate the effect of embryo quality at different developmental stages on the secondary sex ratio (SSR) of single live birth neonates. Methods: Data for patients with singleton live births after embryo transferred between January 2016 and January 2022 were retrospectively analyzed. The effect of embryo quality at different development stages on the SSR of 11 713 singleton live births were investigated. The association of SSR and embryo quality at different development stages was examined in univariate analysis and in a multivariate logistic regression model, after adjustment for confounders, using two models (Ⅰ and Ⅱ). Results: The age of both male and female, body mass index of both male and female, basal follicle stimulating hormone and estradiol, smoking of male, methods of insemination, methods of sperm extraction, types of transfer cycle and the number of embryo transferred were not related with SSR (all P>0.05). After adjustment for confounders, the probability of a male live birth was higher after transfer of good-quality blastula than after transfer of poorer-quality blastula (model Ⅰ: aOR=0.73, 95%CI: 0.65-0.82, P<0.001; model Ⅱ: aOR=0.73, 95%CI: 0.65-0.82, P<0.001). The quality of cleavage stage embryo was not associated with SSR (model Ⅰ: aOR=0.99, 95%CI: 0.87-1.13, P=0.937; model Ⅱ: aOR=0.99, 95%CI: 0.87-1.13, P=0.899). Conclusions: The SSR of singleton live births after embryo transfer is not correlated with the quality of cleavage stage embryo, but is correlated with the quality of blastula. Good-quality blastula transfer is more likely to result in a male live birth.
目的： 探讨不同发育阶段胚胎的质量对单胎活产第二性别比的影响。 方法： 回顾性分析2016年1月至2022年1月在河南省人民医院生殖中心进行胚胎移植后单胎活产的不孕症患者。分别分析卵裂期胚胎和囊胚的质量对单胎活产第二性别比的影响。本研究共纳入11 713例单胎活产患者，通过单因素分析和调整混杂因素后的多元logistic回归分析不同发育阶段胚胎的质量对单胎活产第二性别比的影响。 结果： 男女双方年龄、男女双方体重指数、基础卵泡刺激素和雌二醇、男方吸烟、受精方式、取精方式、周期类型和移植胚胎个数与单胎活产第二性别比不相关（P均>0.05）。多元logistic回归分析显示，调整混杂因素后，非优质囊胚出生的男性比例明显低于优质囊胚（调整混杂因素Ⅰ：aOR=0.73，95%CI为0.65~0.82，P<0.001；调整混杂因素Ⅱ：aOR=0.73，95%CI为0.65~0.82，P<0.001），卵裂期胚胎质量与单胎活产第二性别比不相关（调整混杂因素Ⅰ：aOR=0.99，95%CI为0.87~1.13，P=0.937；调整混杂因素Ⅱ：aOR=0.99，95%CI为0.87~1.13，P=0.899）。 结论： 胚胎移植后单胎活产第二性别比与卵裂期胚胎质量不相关，与囊胚质量相关；优质囊胚出生的新生儿男性比例更高。.