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辅助生殖技术后早期自然流产的染色体异常风险：一项荟萃分析。

Risk of chromosomal abnormalities in early spontaneous abortion after assisted reproductive technology: a meta-analysis.

机构信息

Department of Obstetrics and Gynecology, First Affiliated Hospital of Guangxi Medical University, Nanning, China.

出版信息

PLoS One. 2013 Oct 10;8(10):e75953. doi: 10.1371/journal.pone.0075953. eCollection 2013.

DOI:10.1371/journal.pone.0075953
PMID:24130752
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3795086/
Abstract

BACKGROUND

Studies on the risk of chromosomal abnormalities in early spontaneous abortion after assisted reproductive technology (ART) are relatively controversial and insufficient. Thus, to obtain a more precise evaluation of the risk of embryonic chromosomal abnormalities in first-trimester miscarriage after ART, we performed a meta-analysis of all available case-control studies relating to the cytogenetic analysis of chromosomal abnormalities in first-trimester miscarriage after ART.

METHODS

Literature search in the electronic databases MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) based on the established strategy. Meta-regression, subgroup analysis, and Galbraith plots were conducted to explore the sources of heterogeneity.

RESULTS

A total of 15 studies with 1,896 cases and 1,186 controls relevant to the risk of chromosomal abnormalities in first- trimester miscarriage after ART, and 8 studies with 601 cases and 602 controls evaluating frequency of chromosome anomaly for maternal age≥35 versus <35 were eligible for the meta-analysis. No statistical difference was found in risk of chromosomally abnormal miscarriage compared to natural conception and the different types of ART utilized, whereas the risk of fetal aneuploidy significantly increased with maternal age≥35 (OR 2.88, 95% CI: 1.74-4.77).

CONCLUSIONS

ART treatment does not present an increased risk for chromosomal abnormalities occurring in a first trimester miscarriage, but incidence of fetal aneuploidy could increase significantly with advancing maternal age.

摘要

背景

关于辅助生殖技术（ART）后早期自然流产胚胎染色体异常风险的研究尚存在争议且不充分。因此，为了更准确地评估 ART 后早期流产中胚胎染色体异常的风险，我们对所有与 ART 后早期流产的细胞遗传学分析相关的病例对照研究进行了荟萃分析。

方法

根据既定策略，在电子数据库 MEDLINE、EMBASE 和 Cochrane 对照试验中心注册库（CENTRAL）中进行文献检索。采用Meta 回归、亚组分析和 Galbraith 图来探索异质性的来源。

结果

共有 15 项研究（1896 例病例和 1186 例对照）符合纳入标准，评估了 ART 后早期流产中染色体异常的风险，其中 8 项研究（601 例病例和 602 例对照）评估了年龄≥35 岁与<35 岁的产妇发生染色体异常的频率。与自然受孕和不同类型的 ART 相比，染色体异常流产的风险没有统计学差异，而随着产妇年龄≥35 岁，胎儿非整倍体的风险显著增加（OR 2.88，95% CI：1.74-4.77）。

结论

ART 治疗不会增加早期流产中染色体异常的风险，但产妇年龄的增加会显著增加胎儿非整倍体的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e680/3795086/e2c0ae8e9e07/pone.0075953.g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e680/3795086/bc0d556998d6/pone.0075953.g001.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e680/3795086/1f6388265179/pone.0075953.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e680/3795086/49716bfc09d1/pone.0075953.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e680/3795086/050ceaea0ccd/pone.0075953.g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e680/3795086/1db3ebf0630d/pone.0075953.g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e680/3795086/1352313840c0/pone.0075953.g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e680/3795086/d53239931746/pone.0075953.g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e680/3795086/e2c0ae8e9e07/pone.0075953.g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e680/3795086/bc0d556998d6/pone.0075953.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e680/3795086/76f304cec649/pone.0075953.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e680/3795086/1f6388265179/pone.0075953.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e680/3795086/49716bfc09d1/pone.0075953.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e680/3795086/050ceaea0ccd/pone.0075953.g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e680/3795086/1db3ebf0630d/pone.0075953.g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e680/3795086/1352313840c0/pone.0075953.g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e680/3795086/d53239931746/pone.0075953.g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e680/3795086/e2c0ae8e9e07/pone.0075953.g009.jpg

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