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Down syndrome live births following assisted reproductive technology in Japan: a nationwide survey between 2007 and 2016

  • Assisted Reproduction Technologies
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Abstract

Purpose

The use of assisted reproductive technology (ART) and prenatal genetic testing have become more widespread in line with an increase in maternal age. However, the effect of the introduction of non-invasive prenatal testing (NIPT) in April 2013 on pregnancy outcomes in Japan, including the prevalence of Down syndrome live births following ART, has not been investigated. This study aimed to evaluate the trends in the prevalence of Down syndrome live births following ART in Japan.

Methods

This population-based retrospective study used the Japanese nationwide ART registry. All clinical pregnancies resulting in live births, stillbirths, and termination of pregnancy (TOP) following ART from 2007 to 2016 were included. Pregnancy outcomes involving infants with Down syndrome were evaluated.

Results

Among 351,808 pregnancies, the proportion of mothers with advanced age increased significantly from 2007 to 2016 (from 49.5 to 62.4% and 8.9 to 17.8% for mothers aged ≥ 35 and ≥ 40 years, respectively). The proportion of live births with Down syndrome was 77.3% in 2007, which remained consistent until 2012, but then decreased significantly to 45.1% after 2013 (P < 0.001). The prevalence of Down syndrome live births increased up to 2012 (19.5/10,000 live births), decreased significantly in 2013 (12.1/10,000 live births), and then remained almost stable (11.1–14.7/10,000 live births).

Conclusion

The introduction of NIPT balanced the prevalence of Down syndrome live births following ART with recent increasing maternal age in Japan.

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Acknowledgements

We thank all the registered facilities for their cooperation in providing cycle-specific information to the ART registry. We thank Charles Allan, PhD, and Susan Furness, PhD, from Edanz (https://jp.edanz.com/ac) for editing drafts of this manuscript.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Saitama Medical University, 38, Morohongo, Moroyama, Saitama, 350-0495, Japan

    Seung Chik Jwa, Akira Namba, Shunsuke Tamaru, Osamu Ishihara & Yoshimasa Kamei

  2. Department of Obstetrics and Gynecology, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15, Kuramoto-cho, Tokushima, 770-8503, Japan

    Akira Kuwahara

  3. Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan

    Haruhiko Sago

Authors
  1. Seung Chik Jwa
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  2. Akira Namba
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  3. Shunsuke Tamaru
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  4. Akira Kuwahara
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  5. Haruhiko Sago
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  6. Osamu Ishihara
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  7. Yoshimasa Kamei
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Corresponding author

Correspondence to Seung Chik Jwa.

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Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the institutional review board at the Saitama Medical University (Approval number 875; February 2018) and the ethics committee of the JSOG (Approval number 78; September 2018).

Competing interests

The authors declare no competing interests.

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Jwa, S.C., Namba, A., Tamaru, S. et al. Down syndrome live births following assisted reproductive technology in Japan: a nationwide survey between 2007 and 2016. J Assist Reprod Genet 39, 1625–1631 (2022). https://doi.org/10.1007/s10815-022-02501-4

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  • DOI: https://doi.org/10.1007/s10815-022-02501-4

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