난자 세포질내 정자 주입술시 정자 기원에 따른 산과적 결과와 선천성 기형에 관한 연구 = Obstetric Outcomes and Congenital Malformations of Children born after Intracytoplasmic Sperm Injection According to the Origin of Sperm

국문 초록 (Abstract)

목적: 본 연구는 난자 세포질내 정자 주입술 (intracytoplasmic sperm injection, ICSI) 후 임신된 예 및 태어난 신생아들을 대상으로 하여 정자의 기원별로 산과적 결과, 선천성 기형 및 염색체 이상의 빈도를 비교 분석하고자 하였다. 연구 방법: 1995년 1월부터 2004년 1월까지 ICSI 시술 후 임신된 예는 105예이었으며, 출생한 신생아는 103명이었고 정자의 기원에 따라 사정 정자군 (n=77), 부고환 정자군 (n=15), 고환 정자군 (n=13)으로 나누었다. 정자 기원에 따른 임신율, 조산율, 유산율, 다태아 임신율, 출생 시 임신주수, 출생 시 체중, 저체중아의 빈도 등 산과적 결과에 대하여 분석하였으며, 정자 기원에 따른 기형 및 염색체 이상의 빈도에 대하여 분석하였다. 결과: 임신율, 조산율, 유산율, 다태 임신율, 출생 시 임신 주수, 출생 체중은 세 군 간에 유의한 차이가 없었다. 저체중아의 출생률, 극저체중아의 출생률도 세 군 간에 유의한 차이가 없었다. 주 기형은 사정 정자군에서 2예 (2.7%), 고환 정자군에서 1예 (7.7%)이었고 2예는 소화기기형이었고, 1예는 구순열이었다. 부 기형은 사정 정자군에서 3예 (4.1%), 고환 정자군에서 1예 (7.7%)이었다. 염색체 이상은 105 임신 중 6예 (5.7%)에서 관찰되었고 모두 사정 정자군이었다. 상염색체수의 이상이 2예, 구조적 이상이 4예이었으며 성염색체 이상은 없었다. 결론: ICSI 시술 후 임신한 경우 정자 기원에 따른 산과적 결과의 차이는 없었으며, 선천성 기형아의 발생률, 염색체 이상의 빈도도 정자 기원에 따른 차이가 없었다. 선천성 기형과 염색체 이상에 대한 보다 정확한 연구 결과를 얻기 위해서는 향후 장기간의 대규모 추적조사 연구가 필요할 것으로 사료된다.

다국어 초록 (Multilingual Abstract)

Objective: To analyze the obstetric outcomes, the incidence of congenital malformations and chromosomal anomalies of neonates born after intracytoplasmic sperm injection (ICSI) according to the origin of sperm. Methods: A total of 103 neonates born from ICSI between January 1995 and January 2004 was included. They were divided into three groups: ejaculated (n=73), epididymal (n=17) and testicular (n=13) groups. We compared obstetric outcomes such as pregnancy rates, preterm birth rates, abortion rates, multiple pregnancy rates, gestational age at birth, birth-weight, and the incidence of congenital malformations and chromosomal anomalies. Results: There were no differences among the three groups in terms of pregnancy rates, preterm birth rates, abortion rates, multiple pregnancy rates, gestational age at birth and birth-weight. There were no differences in the incidence of low birth-weight babies and very low birth-weight babies. Major malformations were observed in two cases of ejaculatory group (2.7%) and one of testicular group (7.7%). Major malformations included two gastrointestinal malformations and one cleft lip. Minor malformations were observed in three cases of ejaculatory group (4.1%) and one of testicular group (7.7%). Chromosomal anomalies were observed in 6 cases of 105 pregnancies (5.7%), and all of them were from the ejaculatory group. Two cases had autosomal numerical anomalies and 4 cases autosomal structural anomalies. However, sex chromosomal anomalies were not detected in this study. Conclusion: The obstetric outcomes, the incidence of congenital malformations and chromosomal anomalies in ICSI babies were not different according to the origin of sperm. These findings should be further investigated in larger long-term studies.

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