Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
Fertil Steril. 2011 Feb;95(2):563-7. doi: 10.1016/j.fertnstert.2010.05.020. Epub 2010 Jun 23.
To investigate whether the incidence of chromosomally abnormal blastomeres is related to the type of pituitary suppression used in ovarian stimulation.
Retrospective study.
Tertiary referral center.
PATIENT(S): The study involved 694 consecutive cycles; 320 belonged to agonist group and 374 to antagonist group, of patients' ≤ 37 years of age who underwent preimplantation genetic screening between October 1, 1992 until December 31, 2006. All of them (and their partners) had normal karyotyping results. Only the data of patients who had at least one embryo biopsy were analyzed.
INTERVENTION(S): Preimplantation genetic screening (PGS).
MAIN OUTCOME MEASURE(S): The primary outcome measure was detection of abnormal blastomeres on the total number of embryos analyzed.
RESULT(S): The total abnormal ratio was statistically similar between the embryos of the two study groups (49.9 ± 28.1 vs. 50.2 ± 26.6). Likewise, a multivariate (linear regression) analysis indicated that the total abnormality ratio was not influenced by the type of stimulation when simultaneously adjusting for age, rank of trials, indication for preimplantation genetic screening, total gonadotropin amount, number of cumulus-oocyte complexes, and number of two pronuclear oocytes embryos. No difference was observed in ongoing pregnancy rates between agonists and antagonists (26.6% vs. 23.3%, respectively).
CONCLUSION(S): Based on our findings there is no difference in the proportion of abnormal blastomeres either when using gonadotropin-releasing hormone (GnRH) agonist, or antagonist protocol.
探讨卵巢刺激中使用的垂体抑制类型与胚胎中染色体异常的发生率是否有关。
回顾性研究。
三级转诊中心。
这项研究共涉及 694 个连续周期;320 个周期属于激动剂组,374 个周期属于拮抗剂组,均为年龄≤37 岁的患者,于 1992 年 10 月 1 日至 2006 年 12 月 31 日期间接受胚胎植入前遗传学筛查。所有患者(及其配偶)均具有正常的核型结果。仅分析了至少有一个胚胎活检的患者的数据。
胚胎植入前遗传学筛查(PGS)。
异常胚胎在分析的总胚胎数中的检出率。
两组研究中的胚胎总异常率无统计学差异(49.9±28.1 对 50.2±26.6)。同样,多元(线性回归)分析表明,当同时调整年龄、试验等级、PGS 指征、总促性腺激素用量、卵丘-卵母细胞复合物数量和二原核卵母细胞数量时,刺激类型对总异常率没有影响。激动剂和拮抗剂的持续妊娠率无差异(分别为 26.6%和 23.3%)。
根据我们的研究结果,使用促性腺激素释放激素(GnRH)激动剂或拮抗剂方案时,胚胎中染色体异常的比例没有差异。