Reproductive Medicine Associates of New Jersey, Morristown, New Jersey 07960, USA.
Fertil Steril. 2012 Apr;97(4):870-5. doi: 10.1016/j.fertnstert.2012.01.104. Epub 2012 Feb 2.
To determine both the negative and positive predictive values of comprehensive chromosome screening (CCS) results for clinical outcome.
Data obtained from two prospective, double-blinded, nonselection studies.
Academic center for reproductive medicine.
PATIENT(S): One hundred forty-six couples with a mean maternal age of 34.0 ± 4.4 years and a mean paternal age of 37.3 ± 5.8 years.
INTERVENTION(S): Embryo biopsy for DNA fingerprinting and aneuploidy assessment.
MAIN OUTCOME MEASURE(S): Failure rate of embryos predicted aneuploid by CCS (negative predictive value) and success rate of embryos predicted euploid by CCS (positive predictive value).
RESULT(S): A total of 255 IVF-derived human embryos were cultured and selected for transfer without influence from CCS analysis. Embryos were biopsied before transfer, including 113 blastomeres at the cleavage stage and 142 trophectoderm biopsies at the blastocyst stage. Comprehensive chromosome screening was highly predictive of clinical outcome, with 96% of aneuploid predicted embryos failing to sustain implantation and 41% sustained implantation from embryos predicted to be euploid.
CONCLUSION(S): These nonselection data provide the first prospective, blinded, clinical study directly measuring the predictive value of aneuploidy screening for clinical outcome. The clinical error rate of an aneuploidy designation is very low (4%), whereas implantation and delivery rates of euploid embryos are increased relative to the entire cohort of transferred embryos.
确定综合染色体筛查（CCS）结果对临床结局的阴性和阳性预测值。
来自两项前瞻性、双盲、非选择研究的数据。
生殖医学学术中心。
146 对夫妇，平均母体年龄为 34.0±4.4 岁，平均父体年龄为 37.3±5.8 岁。
胚胎 DNA 指纹分析和非整倍体评估活检。
CCS 预测非整倍体的胚胎失败率（阴性预测值）和 CCS 预测整倍体的胚胎成功率（阳性预测值）。
共培养和选择了 255 个 IVF 衍生的人类胚胎进行转移，不受 CCS 分析的影响。胚胎在转移前进行活检，包括 113 个卵裂期的卵裂球和 142 个囊胚期的滋养外胚层活检。综合染色体筛查对临床结局具有高度预测性，96%的非整倍体预测胚胎未能维持着床，而 41%的整倍体预测胚胎持续着床。
这些非选择数据提供了首例直接测量非整倍体筛查对临床结局预测价值的前瞻性、盲法、临床研究。非整倍体指定的临床错误率非常低（4%），而整倍体胚胎的着床和分娩率相对于转移胚胎的整个队列都有所增加。
