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100 个胚胎植入前遗传学诊断周期的临床分析

[Clinical analysis of 100 preimplantation genetic diagnosis cycles].

作者信息

Xu Yan-wen, Zhou Can-quan, Zeng Yan-hong, Liu Ying, Gao Ling, Zhuang Guang-lun

机构信息

Reproductive Medical Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2011 Apr;46(4):255-9.

Abstract

OBJECTIVE

To investigate influence of chromosomal translocations on early embryo development and to evaluate the efficacy and feasibility of preimplantation genetic diagnosis (PGD) techniques through clinical analysis on PGD cycles.

METHODS

Embryo development, efficacy of PGD and clinical outcome of 100 cycles were studied retrospectively, including 23 cycles with Robertsonian translocations, 19 cycles with reciprocal translocations, and 58 cycles for α-Thalassaemia.

RESULTS

Among 354 embryos biopsied by PGD for translocations, 321 (90.7%) presented fluorescence in situ hybridization (FISH) results. The rate of normal/balanced embryos in the Robertsonian translocation was 38.3% (64/167), which was significantly higher than 20.8% (32/154) in the reciprocal translocation group. Amplification was achieved in 443 blastomeres from 537 embryos in Thalassaemia group, which given to an amplification efficiency rate of 82.5% (443/537). Totally, 140 normal homozygous, 112 heterozygotes and 155 affected homozygous embryos were identified, while 36 embryos had uncertain result. The successful diagnostic rate was 75.8% (407/537). After 3 days in the translocation groups, the rate of normal and/or balanced translocations in biopsed embryos with ≥7 cells was 34.4% (77/224), which was significantly higher than 19.6% (19/97) of biopsed embryos with <7 cells. After 4 days, the compaction rate in normal/balanced embryos was 59.4% (57/96), which was significantly higher than 34.2% (77/225) in imbalanced embryos significantly. Seventy-five embryos transferred in 37 cycles with translocations group led to clinical pregnancy rate of 27.0% (10/37), and 170 embryos transferred in 58 cycles with Thalassaemia got a clinical pregnancy rate of 43.1% (25/58).

CONCLUSIONS

PGD can provide management efficiently for both chromosome translocations and Thalassaemia. Translocations might have slightly negative impact on embryo development before implantation.

摘要

目的

通过对植入前基因诊断(PGD)周期的临床分析,探讨染色体易位对早期胚胎发育的影响,并评估PGD技术的有效性和可行性。

方法

回顾性研究100个周期的胚胎发育、PGD效果及临床结局,其中罗伯逊易位23个周期,相互易位19个周期,α地中海贫血58个周期。

结果

在因易位接受PGD活检的354个胚胎中,321个(90.7%)获得荧光原位杂交(FISH)结果。罗伯逊易位中正常/平衡胚胎率为38.3%(64/167),显著高于相互易位组的20.8%(32/154)。地中海贫血组537个胚胎的443个卵裂球实现扩增,扩增效率为82.5%(443/537)。共鉴定出140个正常纯合子、112个杂合子和155个受累纯合子胚胎,36个胚胎结果不确定。成功诊断率为75.8%(407/537)。易位组3天后,活检时细胞数≥7个的胚胎中正常和/或平衡易位率为34.4%(77/224),显著高于细胞数<7个的活检胚胎的19.6%(19/97)。4天后,正常/平衡胚胎的致密化率为59.4%(57/96),显著高于不平衡胚胎的34.2%(77/225)。易位组37个周期移植75个胚胎,临床妊娠率为27.0%(10/37),地中海贫血组中58个周期移植170个胚胎,临床妊娠率为43.1%(25/58)。

结论

PGD能有效处理染色体易位和地中海贫血。易位可能对植入前胚胎发育有轻微负面影响。

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