Secondary sex ratio in assisted reproduction: an analysis of 1 376 454 treatment cycles performed in the UK.

Does ART impact the secondary sex ratio (SSR) when compared to natural conception?IVF and ICSI as well as the stage of embryo transfer does impact the overall SSR.The World Health Organization quotes SSR for natural conception to range between 103 and 110 males per 100 female births.

A total of 1 376 454 ART cycles were identified, of which 1 002 698 (72.8%) cycles involved IVF or ICSI. Of these, 863 859 (85.2%) were fresh cycles and 124 654 (12.4%) were frozen cycles.

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Missing data were identified in 14 185 (1.4%) cycles.All cycles recorded in the anonymized UK Human Fertilisation and Embryology Authority (HFEA) registry database between 1991 and 2016 were analysed. All singleton live births were included, and multiple births were excluded to avoid duplication.