Wu Tonghua, Yin Biao, Zhu Yuanchang, Li Guangui, Ye Lijun, Chen Chunmei, Zeng Yong, Liang Desheng
Shenzhen Key Laboratory for Reproductive Immunology of Preimplantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, No. 1001 Fuqiang Road, Futian District, Shenzhen, 518045 China.
The State Key Laboratory of Medical Genetics of China, Central South University, No. 110 Xiangya Road, Kaifu District, Changsha, 410013 China.
Mol Cytogenet. 2016 Oct 12;9:79. doi: 10.1186/s13039-016-0284-2. eCollection 2016.
Spontaneous abortion (SA) is the most common complication of pregnancy, and chromosome aberrations are the principal cause of the first trimester abortuses in natural conception (NC) The increasing use of assisted reproductive technology (ART) has raised concern about chromosome abnormalities in ART-initiated pregnancies. Up to date, the literature on the risk of aneuploidy in failed pregnancies among various ART factors remain limited and inconclusive. This study aimed to explore the genetic etiology of pregnancy loss conceived from varying ART procedures.
A total of 560 cases of villus that were successfully collected and performed molecular karyotype analysis were enrolled in present research, including 92 cases of NC, 340 cases of in-vitro fertilization (IVF) and 128 cases of intracytoplasmic sperm injection (ICSI). There was no statistical difference in the distribution of karyotyping results and the aneuploidy rate of each individual chromosome among NC, IVF and ICSI group. Both the total chromosomal abnormality rate and the one chromosome aneuploidy rate were increased with maternal age. Compared with fresh ET abortion group, frozen-thawed embryo transfer (FET) abortion group had elder maternal age (34.68 ± 4.73 years vs. 33.41 ± 4.48 years, = 0.003) but lower chromosomal aberration rate of abortus (58.33 % vs. 67.50 %, = 0.040). A slightly higher incidence of chromosome segmental abnormalities was found in FET than in fresh ET abortion (5.26 % vs. 2.08 %, = 0.066).
Chromosomal abnormality of fetus is the main cause of SA in the first trimester, no matter pregnancies are conceived through NC, IVF or ICSI. ART is a relatively safety treatment, and it does not enhance aneuploidy rate of abortus. The FET is bad for ongonging pregnancy and the aneuploidy rate were increased with maternal age.
自然流产(SA)是妊娠最常见的并发症,染色体畸变是自然受孕(NC)中孕早期流产的主要原因。辅助生殖技术(ART)使用的增加引发了对ART启动妊娠中染色体异常的关注。迄今为止,关于各种ART因素导致妊娠失败中染色体非整倍体风险的文献仍然有限且尚无定论。本研究旨在探讨不同ART程序受孕流产的遗传病因。
本研究共纳入560例成功收集并进行分子核型分析的绒毛样本,包括92例NC、340例体外受精(IVF)和128例卵胞浆内单精子注射(ICSI)。NC、IVF和ICSI组之间核型分析结果分布及各条染色体非整倍体率无统计学差异。总染色体异常率和单条染色体非整倍体率均随母亲年龄增加而升高。与新鲜胚胎移植(ET)流产组相比,冻融胚胎移植(FET)流产组母亲年龄更大(34.68±4.73岁 vs. 33.41±4.48岁,P = 0.003),但流产儿染色体畸变率更低(58.33% vs. 67.50%,P = 0.040)。FET流产中染色体片段异常的发生率略高于新鲜ET流产(5.26% vs. 2.08%,P = 0.066)。
无论妊娠是通过NC、IVF还是ICSI受孕,胎儿染色体异常都是孕早期SA的主要原因。ART是一种相对安全的治疗方法,不会增加流产儿的非整倍体率。FET对持续妊娠不利,且非整倍体率随母亲年龄增加而升高。