Objective:To evaluate the incidence of birth defects in offspring using frozen semen from sperm banks by meta-analysis, to provide scientific evidence for the safety and reliability of frozen semen in assisted reproductive technology (ART).Methods:China National Knowledge Infrastructure (CNKI), Wanfang Digital Database (Wanfang), VIP Citation Database (VIP), CBMDisc and PubMed were searched about birth defects using frozen semen in ART since the establishment to October 1, 2019. Literatures were screened according to the predefined inclusion and exclusion criteria and evaluated based on the STROBE statement.Results:Thirteen studies with 33 398 cases were included, the rate of birth defects using frozen semen was 1.09% (95% CI=0.85%-1.32%), lower than that published by the Chinese Ministry of Health (1.53%, P<0.001). The rate was 1.06% (95% CI=0.78%-1.35%) in artificial insemination by donor (AID), 0.60% (95% CI=0.03%-1.22%) in in vitro fertilization (IVF) and 1.35% (95% CI=0.06%-2.75% ) in intracytoplasmic sperm injection (ICSI), the difference was not statistically significant ( P=0.785). Among the birth defects, the cardiovascular system had the highest rate, followed by the central nervous system and musculoskeletal system and congenital urogenital system and so on. Conclusion:ART with cryopreserved donor sperm does not increase the risk of birth defects. However, more studies with large sample sizes are needed to confirm this conclusion because some papers with low study quality were included in this study.

Objective:To evaluate the incidence of birth defects in offspring using frozen semen from sperm banks by meta-analysis, to provide scientific evidence for the safety and reliability of frozen semen in assisted reproductive technology (ART).Methods:China National Knowledge Infrastructure (CNKI), Wanfang Digital Database (Wanfang), VIP Citation Database (VIP), CBMDisc and PubMed were searched about birth defects using frozen semen in ART since the establishment to October 1, 2019. Literatures were screened according to the predefined inclusion and exclusion criteria and evaluated based on the STROBE statement.Results:Thirteen studies with 33 398 cases were included, the rate of birth defects using frozen semen was 1.09% (95% CI=0.85%-1.32%), lower than that published by the Chinese Ministry of Health (1.53%, P<0.001). The rate was 1.06% (95% CI=0.78%-1.35%) in artificial insemination by donor (AID), 0.60% (95% CI=0.03%-1.22%) in in vitro fertilization (IVF) and 1.35% (95% CI=0.06%-2.75% ) in intracytoplasmic sperm injection (ICSI), the difference was not statistically significant ( P=0.785). Among the birth defects, the cardiovascular system had the highest rate, followed by the central nervous system and musculoskeletal system and congenital urogenital system and so on. Conclusion:ART with cryopreserved donor sperm does not increase the risk of birth defects. However, more studies with large sample sizes are needed to confirm this conclusion because some papers with low study quality were included in this study.