Does assisted reproductive technology has effect on human secondary sex ratio?

Abstract

assisted reproduction technology (ART) is up-trending, therefore number of babies born by ART is increasing. ART may influence the secondary sex ratio (SSR) compared to natural conception. to evaluate the effect of ART on SSR. a pilot retrospective medical records review study was conducted on 201 live-birth babies born to couples attended Albayda Fertility Centre. 97 babies were born by ART procedures [intrauterine insemination (IUI) and intracytoplasmic sperm injection (ICSI)] and the remaining were born by non-ART (medical treatment or post-hysteroscopy). The overall SSR was 46%, SSR for non-ART babies was (54.8%) higher than that for the ART offspring (47.4%), however, the difference was non-significant. More girls were born as a result of ICSI (SSR= 43.7%). In contrast, more males were born following IUI (SSR=47.7%) but the difference was insignificant. Regarding the stage of embryo transfer (ET) in babies born by ICSI, a higher but a non-significant difference (Fisher’s Exact test = 0.9) was found in blastocyst stage than the cleavage stage. ART might cause a bias in sex ratio at birth and this change in SSR was found to be affected by the ART procedure applied. The mechanism of these effects is still controversial, larger and multi-centric studies are still warranted.