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对体外受精/卵胞浆内单精子注射(IVF/ICSI)中着床不佳患者进行的PGS前瞻性随机对照试验。

Prospectively randomized controlled trial of PGS in IVF/ICSI patients with poor implantation.

作者信息

Blockeel Christophe, Schutyser Valerie, De Vos Anick, Verpoest Willem, De Vos Michel, Staessen Catherine, Haentjens Patrick, Van der Elst Josiane, Devroey Paul

机构信息

Centre for Reproductive Medicine, UZ Brussel, Laarbeeklaan 101, 1090 Brussel, Belgium.

出版信息

Reprod Biomed Online. 2008 Dec;17(6):848-54. doi: 10.1016/s1472-6483(10)60414-2.

Abstract

This randomized, controlled trial verifies whether patients with recurrent failed implantation benefit from preimplantation genetic diagnosis for aneuploidy, as compared with conventional assisted reproduction treatment procedures. Two hundred patients with recurrent failed implantation were randomized into two groups. A total of 139 patients underwent ovarian stimulation, and preimplantation genetic screening was performed in 72 patients. Analysis of chromosomes X, Y, 13, 16, 18, 21 and 22 was carried out using fluorescence in-situ hybridization in blastomeres of day-3 cleavage-stage embryos in the study group. The primary endpoint was implantation rate. Secondary endpoints were embryonic morphology and chromosomal status, number of transferred embryos and clinical pregnancy rate. With regard to the implantation rate, there was no significant difference between the study group (21.4%) and the control group (25.3%). The number of embryos transferred was significantly lower in the study group, namely 1.4 (SD 1.0) versus 2.1 (SD 1.0) in the control group (P < 0.05). The clinical pregnancy rate was not significantly different between the groups (25.0% in the study group versus 40.3% in the control group). It can be concluded that preimplantation genetic screening does not increase the implantation rates after IVF-intracytoplasmic sperm injection in women with repeated implantation failure.

摘要

这项随机对照试验验证了与传统辅助生殖治疗程序相比,反复种植失败的患者进行非整倍体植入前基因诊断是否有益。200例反复种植失败的患者被随机分为两组。共有139例患者接受了卵巢刺激,72例患者进行了植入前基因筛查。研究组使用荧光原位杂交技术对第3天卵裂期胚胎的卵裂球进行X、Y、13、16、18、21和22号染色体分析。主要终点是种植率。次要终点是胚胎形态和染色体状态、移植胚胎数量和临床妊娠率。关于种植率,研究组(21.4%)与对照组(25.3%)之间无显著差异。研究组移植的胚胎数量显著低于对照组,分别为1.4(标准差1.0)和2.1(标准差1.0)(P<0.05)。两组的临床妊娠率无显著差异(研究组为25.0%,对照组为40.3%)。可以得出结论,对于反复种植失败的女性,植入前基因筛查并不能提高体外受精-卵胞浆内单精子注射后的种植率。

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