Ferraretti A P, Magli M C, Kopcow L, Gianaroli L
SISMeR, Reproductive Medicine Unit, Via Mazzini 12, 40138 Bologna, Italy.
Hum Reprod. 2004 Mar;19(3):694-9. doi: 10.1093/humrep/deh121. Epub 2004 Jan 29.
Preimplantation genetic diagnosis (PGD) for aneuploidy is recommended to couples at risk of generating chromosomally abnormal embryos. The aim of this study was to demonstrate that PGD for aneuploidy has an important role in the prognosis of subsequent treatments.
A total of 389 couples underwent their first PGD for aneuploidy due to either female age >or=38 years (n = 266) or >or=3 previous unsuccessful cycles (n = 123). After the first PGD followed by an unsuccessful treatment cycle, 141 couples underwent 175 subsequent PGD cycles. These patients were divided into three groups depending on the number of euploid embryos available for transfer in their first PGD cycle: group A included patients where no euploid embryos were diagnosed; group B included patients who had only one euploid embryo; and group C included patients with at least two normal embryos resulting from chromosomal analysis.
In subsequent cycles, group A patients underwent significantly fewer transfers (45%) compared with group B (69%, P < 0.05) and group C patients (85%, P < 0.001). The pregnancy rate per transfer was significantly decreased in group A (15%) compared with group B (36%; P < 0.02) and group C (30%; P < 0.03). Accordingly, the live birth rate per patient was significantly lower in group A compared with group C (8.5% versus 30%; P < 0.005).
The outcome of the first PGD for aneuploidy may have a predictive role for subsequent attempts.
对于有产生染色体异常胚胎风险的夫妇，推荐进行胚胎植入前非整倍体遗传学诊断（PGD）。本研究的目的是证明PGD在后续治疗预后中具有重要作用。
共有389对夫妇因女性年龄≥38岁（n = 266）或既往≥3个周期治疗失败（n = 123）首次接受非整倍体PGD。在首次PGD后紧接着一个治疗周期失败后，141对夫妇进行了175次后续PGD周期。根据首次PGD周期中可用于移植的整倍体胚胎数量，将这些患者分为三组：A组包括未诊断出整倍体胚胎的患者；B组包括仅有一个整倍体胚胎的患者；C组包括染色体分析产生至少两个正常胚胎的患者。
在后续周期中，A组患者的移植次数（45%）显著少于B组（69%，P < 0.05）和C组患者（85%，P < 0.001）。A组每次移植的妊娠率（15%）显著低于B组（36%；P < 0.02）和C组（30%；P < 0.03）。因此，A组患者的每例活产率显著低于C组（8.5%对30%；P < 0.005）。
首次非整倍体PGD的结果可能对后续尝试具有预测作用。
