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胚胎植入前遗传学筛查(PGS)结合比较基因组杂交技术(CGH),对第 3 天的单个细胞卵裂球活检进行检测,可显著提高体外受精(IVF)的成功率,同时降低多胎妊娠和流产的风险。

Preimplantation genetic screening (PGS) with Comparative genomic hybridization (CGH) following day 3 single cell blastomere biopsy markedly improves IVF outcomes while lowering multiple pregnancies and miscarriages.

机构信息

Continuum Reproductive Center, Department of Obstetrics and Gynecology, St. Luke's-Roosevelt Hospital Center, Columbia University, College of Physicians and Surgeons, New York, NY, USA,

出版信息

J Assist Reprod Genet. 2013 Oct;30(10):1333-9. doi: 10.1007/s10815-013-0070-6. Epub 2013 Aug 16.

Abstract

PURPOSE

To determine benefits of cleavage-stage preimplantation genetic screening (PGS) by array comparative genomic hybridization (CGH).

METHODS

A retrospective case-control study was performed at a tertiary care university-affiliated medical center. Implantation rate was looked at as a primary outcome. Secondary outcomes included clinical and ongoing pregnancy rates, as well as multiple pregnancy and miscarriage rates. Thirty five patients underwent 39 fresh cycles with PGS by aCGH and 311 similar patients underwent 394 invitro fertilization cycles.

RESULT(S): The implantation rate in the CGH group doubled when compared to the control group (52.63 % vs. 19.15 %, p = < 0.001), clinical pregnancy rate was higher (69.23 % vs. 43.91 %, p = 0.0002), ongoing pregnancy rate almost doubled (61.54 % vs. 32.49 %, p = < 0.0001), multiple pregnancy rate decreased (8.33 % vs. 34.38 %, p = 0.0082) and miscarriage rate trended lower (11.11 % vs. 26.01 %, p = 0.13).

CONCLUSION

Cleavage stage PGS with CGH is a feasible and safe option for aneuploidy screening that shows excellent outcomes when used in fresh cycles. This is the first report of cleavage stage PGS by CGH showing improved ongoing pregnancy rates.

摘要

目的

通过比较基因组杂交(CGH)的芯片技术,来确定卵裂期胚胎植入前遗传学筛查(PGS)的益处。

方法

在一所三级保健大学附属医院进行了回顾性病例对照研究。将着床率作为主要观察结果。次要结果包括临床妊娠率和持续妊娠率,以及多胎妊娠和流产率。35 名患者接受了 39 个新鲜周期的 CGH PGS,311 名类似患者接受了 394 个体外受精周期。

结果

与对照组相比,CGH 组的着床率提高了一倍(52.63%比 19.15%,p<0.001),临床妊娠率更高(69.23%比 43.91%,p=0.0002),持续妊娠率几乎翻了一番(61.54%比 32.49%,p<0.0001),多胎妊娠率下降(8.33%比 34.38%,p=0.0082),流产率呈下降趋势(11.11%比 26.01%,p=0.13)。

结论

CGH 卵裂期 PGS 是一种可行且安全的非整倍体筛查方法,在新鲜周期中应用时可获得良好的效果。这是首次报道 CGH 卵裂期 PGS 可提高持续妊娠率。

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