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年轻(<35 岁)和高龄(≥35 岁)疑似健康和不孕患者人群中囊胚的整倍体率和着床率。

Blastocyst euploidy and implantation rates in a young (<35 years) and old (≥35 years) presumed fertile and infertile patient population.

机构信息

Reproductive Endocrinology Associates of Charlotte, Charlotte, North Carolina; University of Kent, School of Biosciences, Canterbury, United Kingdom.

Reproductive Endocrinology Associates of Charlotte, Charlotte, North Carolina.

出版信息

Fertil Steril. 2014 Nov;102(5):1318-23. doi: 10.1016/j.fertnstert.2014.07.1207. Epub 2014 Aug 22.

DOI:10.1016/j.fertnstert.2014.07.1207
PMID:25154676
Abstract

OBJECTIVE

To examine the relationship between blastocyst euploidy and implantation rates in a presumed fertile patient population.

DESIGN

Retrospective analysis.

SETTING

Private IVF clinic.

PATIENT(S): IVF patients undergoing comprehensive chromosome screening (CCS).

INTERVENTION(S): Embryo biopsy at the blastocyst stage with preimplantation genetic screening using CCS.

MAIN OUTCOME MEASURE(S): Euploidy, chemical pregnancy, and implantation rates.

RESULT(S): There was no significant difference in the number of euploid blastocysts between presumed fertile (68/118, 57.6%) and infertile (75/132, 56.8%) patients<35 years old. Likewise, there was no significant difference in the number of euploid blastocysts between presumed fertile (42/86, 48.8%) and infertile (97/206, 47.1%) patients≥35 years old. When those same patients underwent a corresponding frozen embryo transfer cycle, presumed fertile patients demonstrated a significantly higher chemical pregnancy rate when compared with infertile patients, 28/33 (84.8%) and 50/81 (61.7%), respectively. Moreover, presumed fertile patients exhibited significantly higher implantation rates compared with infertile patients, 36/42 (85.7%) and 54/109 (66.7%), respectively.

CONCLUSION(S): When subdivided by maternal age, no significant difference was seen in blastocyst euploidy rates between presumed fertile and infertile patients; however, chemical pregnancy and implantation rates were significantly higher in a presumed fertile patient population even when transferring only euploid blastocysts. This would indicate that infertility, as a disease, may encompass other aspects such as uterine or other unknown embryological factors that can influence outcomes.

摘要

目的

研究假定生育能力患者人群中囊胚整倍体与种植率的关系。

设计

回顾性分析。

地点

私立 IVF 诊所。

患者

进行全面染色体筛查(CCS)的 IVF 患者。

干预措施

囊胚期胚胎活检,采用 CCS 进行植入前遗传学筛查。

主要观察指标

整倍体率、生化妊娠率和种植率。

结果

年龄<35 岁的假定生育能力患者(68/118,57.6%)与不孕患者(75/132,56.8%)的囊胚整倍体数量无显著差异。同样,年龄≥35 岁的假定生育能力患者(42/86,48.8%)与不孕患者(97/206,47.1%)的囊胚整倍体数量也无显著差异。当这些患者进行相应的冷冻胚胎移植周期时,假定生育能力患者的生化妊娠率显著高于不孕患者,分别为 28/33(84.8%)和 50/81(61.7%)。此外,假定生育能力患者的种植率也显著高于不孕患者,分别为 36/42(85.7%)和 54/109(66.7%)。

结论

按母体年龄细分时,假定生育能力患者与不孕患者的囊胚整倍体率无显著差异;然而,即使只移植整倍体囊胚,假定生育能力患者的生化妊娠和种植率仍显著更高。这表明,不孕作为一种疾病,可能包含其他方面,如子宫或其他未知的胚胎学因素,这些因素可能会影响结果。

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