Consideration on Birth Sex Ratio in Human IVF-ET Program in Korea

인간의 체외수정 및 배아이식술에서 출생 성비에 대한 고찰

  • Cha, Byung-Hun (Department of Bio-Medical Laboratory Science, College of Health Sciences, Eulji University) ;
  • Jun, Jin-Hyun (Department of Bio-Medical Laboratory Science, College of Health Sciences, Eulji University) ;
  • Lee, Jung-Ryeol (Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital) ;
  • Choi, Young-Min (Department of Obstetrics and Gynecology, Seoul National University College of Medicine)
  • 차병헌 (을지대학교 보건과학대학 임상병리학과) ;
  • 전진현 (을지대학교 보건과학대학 임상병리학과) ;
  • 이정렬 (분당서울대학교병원 산부인과) ;
  • 최영민 (서울대학교 의과대학 산부인과학교실)
  • Published : 2010.03.31

Abstract

Objective: Birth sex ratio (BSR) with human IVF-ET program is an interesting subject of social and scientific issue but very little information is available in Korea. This study was performed to assess the BSR with IVF-ET and to suggest the effective factors on the BSR. Methods: The national data from 1991~2008 were obtained from governmental Statistics Korea and the delivery data of human IVF-ET program on 2007 and 2008 were provided from the Ministry for Health, Welfare and Family Affairs. The BSR were statistically analyzed according to methods of IVF and to transferred embryos from fresh or frozen-thawed cycles. Results: The BSRs of Korean populations were over 1.10 up to 2002, and then it declined and maintained to 1.06 as balance BSR on 2007 and 2008. In human IVF-ET program, the BSRs were 1.07 on 2007 and 1.06 on 2008, respectively. Conventional IVF on 2008 showed the highest BSR as 1.10, and ICSI the lowest on 2008 as 1.01. There was no significant difference of BSRs related to the methods of in vitro fertilization and the feature of transferred embryos. Conclusion: The BSR of Korea showed 1.06~1.07 as normal and balanced state on 2007 and 2008 both general populations and human IVF-ET program. To the best of our knowledge, this is the first study to evaluate the BSR of human IVF-ET in Korea. There is a need to expand the further studies for national statistics and influencing factors on the BSR with IVF-ET.

목 적: 체외수정 및 배아이식술에서의 출생 성비는 사회적으로 과학적으로도 매우 관심이 있는 분야이지만 국내에서는 아직까지 정확하게 조사된 바가 없다. 본 연구에서는 국가 통계에서 출생 성비의 추이를 살펴보고, 국내 체외수정 및 배아이식술에서의 출생 성비에 대해 조사하고자 하였다. 연구방법: 출생 성비 국가 통계 (1991~2008)는 통계청 자료를 통해 확인하였으며, 체외수정의 분만 자료 (2007~2008)는 보건복지가족부의 용역 연구 결과를 제공받아 분석하였다. 체외수정 방법에 따라 일반적인 체외수정과 세포질내 정자주입술 그리고 이식된 배아에 따라 신선 주기 배아이식과 동결-해동 배아이식으로 구분하여 출생 성비를 통계학적인 방법으로 비교하였다. 결 과: 우리나라의 출생 성비는 2002년까지 불균형 상태인 1.10 정도로 유지되었으나, 그 이후 감소되기 시작하여 2007년과 2008년에는 균형 출생 성비인 1.06이 유지되고 있으며, 체외수정에서의 출생 성비도 2007년 1.07, 2008년 1.06을 나타내었다. 체외수정 방법에 따른 출생 성비는 2008년의 일반적인 체외수정에서 1.10로 가장 높았으며, 2008년의 세포질내 정자주입술에서 1.01로 가장 낮게 나타났다. 체외수정 방법과 이식배아에 따른 각 군간의 비교에서 통계적인 유의성은 나타나지 않았다. 결 론: 국내에서 처음으로 조사된 2007년과 2008년 체외수정 및 배아이식술의 출생 성비도 각각 1.07과 1.06으로 우리나라의 전체적인 출생 성비와 매우 유사하였으며, 정상적인 출생 성비를 나타냈다. 향후 국내의 전체적인 체외수정 및 배아이식술에 대한 통계와 다양한 요인들에 따른 보다 전향적인 출생 성비에 대한 연구가 필요할 것으로 생각된다.

Keywords

References

  1. Cunningham FG, Gant NF, Leveno KJ, Gilstrap III LC, Hauth JC, Wenstrom KD. Williams Obstetrics. Fetal Growth and Development: Fetal Gender. 21st ed. United states of America: McGraw-Hill; 2001. p.156.
  2. Cronk L. Boy or girl: gender preferences from a Darwinian point of view. Reprod BioMed Online 2007; 15 (Suppl 2): 2487-94.
  3. Zhou R. Insight into human sex ratio imbalance: the more boys born, the more infertile men. Reprod BioMed Online 2007; 15: 487-94. https://doi.org/10.1016/S1472-6483(10)60378-1
  4. Kuroiwa J, Imamichi T. Growth and reproduction of the chinchilla-age at vaginal opening, oestrous cycle, gestation period, litter size, sex ratio, and diseases frequently encountered. Jikken Dobutsu 1977: 26; 213-22.
  5. Kuroki Y, Toyoda A, Noguchi H, Taylor TD, Itoh T, Kim DS, et al. Comparative analysis of chimpanzee and human Y chromosomes unveils complex evolutionary pathway. Nature Genetics 2006: 38; 158-67. https://doi.org/10.1038/ng1729
  6. 구인모, 고영채, 이희, 최원일, 양기원, 구홍모, 김정욱. 최근 10년간 (1994-2003) 서울성애병원에서 출생한 신생아 출생 성비에 관한 통계보고. 대한산부학회지 2004: 47; 1982-6.
  7. 천희란, 김일호, 강영호. 부모의 사회경제적 위치에 따른 자녀의 출생 성비 추이: 1981년부터 2004년까지. 예방의학회지 2009: 42; 143-50. https://doi.org/10.3961/jpmph.2009.42.2.143
  8. 통계청 사회통계국 인구동향과. 2008년 출생통계 결과 (http://www.nso.go.kr). 2009. 8. 19.
  9. Mittwoch U. Blastocysts prepare for the race to be male. Hum Reprod 1993; 8: 1550-5. https://doi.org/10.1093/oxfordjournals.humrep.a137889
  10. Quintans CJ, Donaldson MJ, Blanco LA, Sergio PR. Deviation in sex ratio after selective transfer of the most developed cocultured blastocysts. J Assist Reprod Genet 1998; 15: 403-4. https://doi.org/10.1023/A:1022593202557
  11. Menezo YJ, Chouteau J, Torello J, Girard A, Veiga A. Birth weight and sex ratio after transfer at the blastocyst stage in humans. Fertil Steril 1999; 72: 221-4. https://doi.org/10.1016/S0015-0282(99)00256-3
  12. Milki AA, Jun SH, Hinckley MD, Westphal LW, Giudice LC, Behr B. Comparison of the sex ratio with blastocyst transfer and cleavage stage transfer. J Assist Reprod Genet 2003; 20: 323-6. https://doi.org/10.1023/A:1024861624805
  13. Luna M, Duke M, Copperman A, Grunfeld L, Sandler B, Barritt J. Blastocyst embryo transfer is associated with a sex-ratio imbalance in favor of male offspring. Fertil Steril 2007; 87: 519-23. https://doi.org/10.1016/j.fertnstert.2006.06.058
  14. Avery B, Madison V, Greve T. Sex and development in bovine in-vitro fertilized embryos. Theriogenology 1991; 35: 953-63. https://doi.org/10.1016/0093-691X(91)90306-X
  15. Valdivia RP, Kunieda T, Azuma S, Toyoda Y. PCR sexing and developmental rate differences in preimplantation mouse embryos fertilized and cultured in vitro. Mol Reprod Dev 1993; 35: 121-6. https://doi.org/10.1002/mrd.1080350204
  16. Pergament E, Fiddler M, Cho N, Johnson D, Holmgren WJ. Sexual differentiation and preimplantation cell growth. Hum Reprod 1994; 9: 1730-2. https://doi.org/10.1093/oxfordjournals.humrep.a138783
  17. Ray PF, Conaghan J, Winston RM, Handyside AH. Increased number of cells and metabolic activity in male human preimplantation embryos following in vitro fertilization. J Reprod Fertil 1995; 104: 165-71. https://doi.org/10.1530/jrf.0.1040165
  18. Kausche A, Jones GM, Trounson AO, Figueiredo F, MacLachlan V, Lolatgis N. Sex ratio and birth weights of infants born as a result of blastocyst transfers compared with early cleavage stage embryo transfers. Fertil Steril 2001; 76: 688-93. https://doi.org/10.1016/S0015-0282(01)02010-6
  19. Richter KS, Anderson M, Osborn BH. Selection for faster development does not bias sex ratios resulting from blastocyst embryo transfer. Reprod Biomed Online 2006; 12: 460-5. https://doi.org/10.1016/S1472-6483(10)61999-2
  20. Weston G, Osianlis T, Catt J, Vollenhoven B. Blastocyst transfer does not cause a sex-ratio imbalance. Fertil Steril 2009; 92: 1302-5. https://doi.org/10.1016/j.fertnstert.2008.07.1784
  21. Hentemann MA, Briskemyr S, Bertheussen K. Blastocyst transfer and gender: IVF versus ICSI. J Assist Reprod Genet 2009; 26: 433-6. https://doi.org/10.1007/s10815-009-9337-3
  22. 김경아, 민우경, 임재우, 전누리, 원혜성, 김정훈 등. 체외수정시술로 출생한 쌍생아의 임상적 경과에 대한 비교 분석. 대한소아과학회지 2003; 46: 224-9.
  23. Ulizzi L, Zonta LA. Sex ratio and natural selection in human: a comparative analysis of two Caucasian populations. Ann Hum Genet 1993; 57: 211-9. https://doi.org/10.1111/j.1469-1809.1993.tb01597.x
  24. Ulizzi L, Zonta LA. Factors affecting the sex ratio in humans: multivariate analysis of the Italian population. Hum Biol 1995; 67: 59-67.
  25. Graffelman J, Hoekstra R. A statistical analysis of the effect of warfare on the human secondary sex ratio. Hum Biol 2000; 72: 433-45.
  26. Zorn B, Sucur V, Stare J, Meden-Vrtovec. Decline in sex ratio at birth after 10-day war in Slovenia. Hum Reprod 2002; 17: 3171-7.
  27. Abu-Musa A, Usta I, Hannoun A, Nassar A. Effect of the Lebanese civil war on sex ratio. Reprod BioMed Online 2008; 17 (Suppl 1): 21-4. https://doi.org/10.1016/S1472-6483(10)60186-1
  28. Mocarelli P, Gerthoux PM, Ferrari E, Patterson Jr DG, Kieszak SM, Brambilla P, et al. Paternal concentrations of dioxin and sex ratio of offspring. Lancet 2000; 355: 1858-63. https://doi.org/10.1016/S0140-6736(00)02290-X
  29. Hertz-Picciotto I, Jusko TA, Willman EJ, Baker RJ, Keller JA, Teplin SW, et al. A cohort study of in utero polychlorinated biphenyl (PCB) exposures in relation to secondary sex ratio. Environ Health 2008; 15: 37.
  30. 김윤수, 최은선, 차경준. 남아 선호 사상에 기반한 출생성비에 관한 확률론적 고찰. 한국수학사학회지 2008; 21: 79-86.
  31. Chang HJ, Lee JR, Jee BC, Suh CS, Kim SH. Impact of blastocyst transfer on offspring sex ratio and the monozygotic twinning rate: a systematic review and meta-analysis. Fertil Steril 2009; 91: 2381-90. https://doi.org/10.1016/j.fertnstert.2008.03.066
  32. Sturmey RG, Bermejo-Alvarez P, Gutierrez-Adan A, Rizos D, Leese HJ, Lonergan P. Amino acid metabolism of bovine blastocysts: a biomarker of sex and viability. Mol Reprod Dev 2010; 77: 285-96.
  33. Guinness FE, Albon SD, Clutton-Brock TH. Factors affecting reproduction in red deer (Cervus elaphus) hinds on Rhum. J Reprod Fertil 1978; 54: 325-34. https://doi.org/10.1530/jrf.0.0540325
  34. Gomendio M, Malo AF, Soler AJ, Fernandez-Santos MR, Esteso MC, Garcia AJ, et al. Male fertility and sex ratio at birth in red deer. Science 2006; 314: 1445-7. https://doi.org/10.1126/science.1133064
  35. Sharpe RM. Hormones and testis development and the possible adverse effects of environmental chemicals. Toxicol Lett 2001; 120: 221-32. https://doi.org/10.1016/S0378-4274(01)00298-3
  36. Carlsen E, Giwercman A, Keiding N, Skakkebaek NE. Evidence for decreasing quality of semen during past 50 years. Br Med J 1992; 305: 609-13. https://doi.org/10.1136/bmj.305.6854.609
  37. Tiido T, Rignell-Hydbom A, Jonsson B, Giwercman YL, Rylander L, Hagmar L, et al. Exposure to persistent organochlorine pollutants associates with human sperm Y:X chromosome ratio. Hum Reprod 2005; 20: 1903-9. https://doi.org/10.1093/humrep/deh855
  38. Robbins WA, Wei F, Elashoff DA, Wu G, Xun L, Jia J. Y:X sperm ratio in boron-exposed men. J Androl 2008; 29: 115-21. https://doi.org/10.2164/jandrol.107.003541