对无遗传疾病的夫妇进行体外受精/卵胞浆内单精子注射，伴或不伴非整倍体植入前基因筛查：一项系统评价和荟萃分析。
IVF/ICSI with or without preimplantation genetic screening for aneuploidy in couples without genetic disorders: a systematic review and meta-analysis.
作者信息
Checa Miguel A, Alonso-Coello Pablo, Solà Ivan, Robles Ana, Carreras Ramón, Balasch Juan
机构信息
Department of Obstetrics and Gynecology, Hospital Universitari del Mar, Autonomous University of Barcelona, Passeig Marítim 25-29, Barcelona 08003, Spain.
出版信息
J Assist Reprod Genet. 2009 May;26(5):273-83. doi: 10.1007/s10815-009-9328-4. Epub 2009 Jul 24.
Abstract
PURPOSE
To assess the efficacy of preimplantation genetic screening to increase ongoing pregnancy rates in couples without known genetic disorders.
METHODS
Systematic review and meta-analysis of randomized controlled trials. Two reviewers independently determined study eligibility and extracted data.
RESULTS
Ten randomized trials (1,512 women) were included. The quality of evidence was moderate. Meta-analyses using a random-effects model suggest that PGS has a lower rate of ongoing pregnancies (risk ratio=0.73, 95% confidence interval 0.62-0.87) and a lower rate of live births (risk ratio=0.76, 95% confidence interval 0.64-0.91) than standard in vitro fertilization/intracytoplasmic sperm injection.
CONCLUSIONS
In women with poor prognosis or in general in vitro fertilization program, in vitro fertilization/intracytoplasmic sperm injection with preimplantation genetic screening for aneuploidy does not increase but instead was associated with lower rates of ongoing pregnancies and live births. The use of preimplantation genetic screening in daily practice does not appear to be justified.
摘要
目的
评估植入前基因筛查对提高无已知遗传疾病夫妇持续妊娠率的疗效。
方法
对随机对照试验进行系统评价和荟萃分析。两名评价者独立确定研究的纳入标准并提取数据。
结果
纳入了10项随机试验（1512名女性）。证据质量为中等。采用随机效应模型的荟萃分析表明，与标准体外受精/卵胞浆内单精子注射相比，植入前基因筛查的持续妊娠率较低（风险比=0.73，95%置信区间0.62-0.87），活产率也较低（风险比=0.76，95%置信区间0.64-0.91）。
结论
在预后不良的女性或一般体外受精方案中，进行非整倍体植入前基因筛查的体外受精/卵胞浆内单精子注射不会提高反而会降低持续妊娠率和活产率。在日常实践中使用植入前基因筛查似乎没有道理。
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