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Pre-implantation genetic testing alters the sex ratio: an analysis of 91,805 embryo transfer cycles

  • Assisted Reproduction Technologies
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Abstract

Purpose

To determine if pre-implantation genetic testing (PGT) shifts the sex ratio (SER), the ratio of male to female births in a population normalized to 100 and typically stable at 105, following in vitro fertilization (IVF).

Methods

Data from 2014 to 2016 was requested from the Society for Assisted Reproductive Technologies (SART) database including fresh and frozen transfer cycles. Women with a singleton live birth following a fresh or frozen autologous embryo transfer of a PGT blastocyst, non-PGT blastocyst, or non-PGT cleavage stage embryo were included. The SER between groups was compared using chi-square tests. Modified Poisson regression modeled the relative risk (RR) of having a male compared to a female among PGT blastocyst transfers versus non-PGT cleavage and blastocyst transfers adjusting for age, BMI, smoking status, race, parity, number of oocytes retrieved, and clinic region.

Results

The SER was 110 among PGT blastocyst offspring, 107 among non-PGT blastocyst offspring (p = 0.005), and 99 among non-PGT cleavage offspring (p < 0.001). The risk of having a male infant was 2% higher among PGT blastocyst transfers compared to non-PGT blastocyst transfers (RR 1.02; 95% CI: 1.01, 1.04). The risk was 5% higher among PGT blastocyst transfers compared to non-PGT cleavage transfers (RR 1.05; 95% CI: 1.02, 1.07). The association between PGT and infant gender did not significantly differ by region (p = 0.57) or parity (p = 0.59).

Conclusion

Utilizing PGT shifts the SER in the IVF population from the standard of 105 to 110, increasing the probability of a male offspring.

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Acknowledgments

The authors would like to thank the Society for Assisted Reproductive Technology for providing the data to complete this analysis.

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Authors and Affiliations

  1. Division of Reproductive Endocrinology and Infertility, Duke Fertility Center, 5704 Fayetteville Road, Durham, NC, 27713, USA

    Kathryn Shaia & Anne Steiner

  2. Department of Biostatistics & Bioinformatics, Duke University Medical Center, 2424 Erwin Rd, Durham, NC, 27705, USA

    Tracy Truong & Carl Pieper

Authors
  1. Kathryn Shaia
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  2. Tracy Truong
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  3. Carl Pieper
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  4. Anne Steiner
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Contributions

All authors contributed to the study conception and design. Material preparation was performed by all of the authors, and data collection and analysis were performed by Tracy Truong and Carl Pieper. The first draft of the manuscript was written by Kathryn Shaia, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Kathryn Shaia.

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The authors’ declare that they have no conflict of interest.

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Shaia, K., Truong, T., Pieper, C. et al. Pre-implantation genetic testing alters the sex ratio: an analysis of 91,805 embryo transfer cycles. J Assist Reprod Genet 37, 1117–1122 (2020). https://doi.org/10.1007/s10815-020-01746-1

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  • DOI: https://doi.org/10.1007/s10815-020-01746-1

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