en شیوع ناهنجاری های تناسلی در نوزادان پسر حاصل از سیکل های تزریق داخل سیتوپلاسمی اسپرم: یک مطالعه مقطعی Assisted Reproductive Technologies Original Article Original Article <div style="text-align: justify;"><span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مقدمه: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مطالعات متعددی در سراسر جهان برای ارزیابی شیوع و خطرات نسبی ناهنجاری‌های مادرزادی مرتبط با سیکل&shy;های درمان کمک&shy;باروری انجام شده است. اما اطلاعات محدودی در ایران وجود دارد.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">هدف: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">بررسی ناهنجاری&shy;های دستگاه تناسلی مردانه در نوزادان زنده حاصل از سیکل&shy;های درمان کمک&shy;باروری</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">در پژوهشگاه رویان.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مواد و روش&shy;ها: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">این مطالعه مقطعی بر روی کودکان متولد&shy;شده پس از سیکل&shy;های درمانی تزریق داخل سیتوپلاسمی اسپرم (</span></span><span dir="LTR" style="font-size:10.0pt">ICSI</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) از فروردین 1392 تا آذر 1394 انجام شد. شیوع اختلالات دستگاه تناسلی مردانه شامل هیپوسپادیاس، اپی&shy;اسپادیاس، کریپتورکیدیسم، میکروپنیس، و سندرم غیاب بیضه به صورت درصد گزارش شد و ارتباط بین علت ناباروری و نوع انتقال جنین (تازه یا منجمد)، سن حاملگی در بدو تولد (ترم یا نارس) و وزن هنگام تولد با این ناهنجاری‌های دستگاه تناسلی مردانه با استفاده از آزمون کای اسکوئر بررسی گردید.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتایج: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">در مجموع، 4409 زن باردار پس از سیکل </span></span><span dir="LTR" style="font-size:10.0pt">ICSI</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">برای بررسی ناهنجاری‌های دستگاه تناسلی در فرزندانشان پیگیری شدند. از 5608 تولد زنده، 2614 نوزاد (61/46%) پسر بودند و از 2614 نوزاد پسر، 14 مورد (54/0%) دارای ناهنجاری تناسلی بودند. شیوع ناهنجاری&shy;های مختلف کریپتورکیدیسم (34/0%)، هیپوسپادیاس (038/0%)، میکروپنیس (038/0%)، سندرم غیاب بیضه (038/0%) و اپیسپادیاس (077/0%) بود. هیچ ارتباطی بین علت ناباروری، نوع انتقال جنین (تازه یا منجمد)، سن حاملگی در بدو تولد (ترم یا نارس) و ناهنجاری تناسلی مردانه (به ترتیب 33/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، 66/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، و 62/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) یافت نشد.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتیجه&shy;گیری:</span></span></b> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">شیوع هر یک از ناهنجاری‌های تناسلی مردانه پس از سیکل </span></span><span dir="LTR" style="font-size:10.0pt">ICSI</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نادر و کمتر از 5/0% بود و هیچ عامل مرتبط با ناباروری در این ناهنجاری‌ها مشاهده نشد.</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif""></span></span></span></span></span></span></span><br> &nbsp;</div> <div style="text-align: justify;"><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Background:</span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> Several studies have been conducted worldwide to evaluate the prevalence and relative risks of congenital anomalies associated with assisted reproductive technology cycles; however, there is limited data in Iran. </span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Objective:</span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> To investigate male </span></span><span style="font-size:12.0pt"><span style="background:white"><span new="" roman="" style="font-family:" times="">genital</span></span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> anomalies among live births from assisted reproductive technology.</span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Materials and Methods:</span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> This </span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">cross-sectional</span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> study was conducted on children born after intracytoplasmic sperm injection (ICSI) at Royan Institute, Tehran, Iran from April 2013-December 2015. The prevalence of male genitalia disorders that included hypospadias, epispadias, cryptorchidism, micropenis, and vanishing testis were reported. The relationship between the cause of infertility and type of embryo transfer (fresh or frozen), gestational age at birth (term or preterm), and birth weight with these male genitalia anomalies were evaluated. </span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Results:</span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> In total, 4409 pregnant women were followed after their ICSI cycles to evaluate genitalia anomalies in their children.</span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> Out of 5608 live births, 2614 (46.61%) newborns were male, of which</span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> 14 cases (0.54%) had genital anomalies. The prevalence of various anomalies were cryptorchidism (0.34%), hypospadias (0.038%), micropenis (0.038%), vanishing testis (0.038%), and epispadias (0.077%).</span></span><span lang="EN" style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> No relationship was found between the cause of infertility, type of embryo transfer (fresh or frozen), gestational age at birth (term or preterm), and male genital malformation (p = 0.33, p = 0.66, and p = 0.62, respectively).</span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif""></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Conclusion:</span></span></b> <span lang="EN" style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">The prevalence of each </span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">male </span></span><span style="font-size:12.0pt"><span style="background:white"><span new="" roman="" style="font-family:" times="">genital</span></span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> anomaly </span></span><span lang="EN" style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">after the ICSI cycle was rare and less than 0.5%; however, no significant infertility</span></span><span dir="RTL" lang="AR-SA" style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">-</span></span><span lang="EN" style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">related factor was observed with these anomalies. </span></span></span></span></span></div> شیوع, هیپوسپادیاس, کریپتورکیدیسم, تزریق اسپرم, داخل سیتوپلاسمی, ناهنجاری‌های دستگاه ادراری تناسلی. Cryptorchidism, Hypospadias, Microinjections, Prevalence, Reproductive techniques, Urogenital abnormalities. 53 60 http://ijrm.ir/browse.php?a_code=A-10-222-2&slc_lang=en&sid=1 Fatemeh Aliani aliyani.fatemeh@gmail.com 0000-0003-1650-1574 No Department of Pediatrics, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Zahra Haghshenas haghshenas@tums.ac.ir 0000-0002-7592-9426 No Department of Pediatrics, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Ahmad Vosough Dizaj vosough@royaninstitute.org 0000-0001-7567-1122 No Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran. Arezoo Arabipoor arezoo.arabipoor@gmail.com 0000-0002-8535-7898 No Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran. Samira Vesali samiravesali@yahoo.com 0000-0003-0005-8045 No Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran. Mahnaz Ashrafi dr.mahnaz.ashrafi@gmail.com 0000-0002-8193-3755 Yes Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran. Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), Iran University of Medical Science (IUMS), Tehran, Iran.