Chamayou Sandrine, Sicali Maria, Alecci Carmelita, Ragolia Carmen, Liprino Annalisa, Nibali Daniela, Storaci Giorgia, Cardea Antonietta, Guglielmino Antonino
Unità di Medicina della Riproduzione-Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy.
J Assist Reprod Genet. 2017 Apr;34(4):479-486. doi: 10.1007/s10815-016-0868-0. Epub 2017 Jan 9.
In a preimplantation genetic diagnosis for aneuploidy (PGD-A) program, the more embryos available for biopsy, consequently increases the chances of obtaining euploid embryos to transfer. The aim was to increase the number of viable euploid blastocysts in patients undergoing PGD-A using fresh oocytes together with previously accumulated vitrified oocytes.
Sixty-nine patients with normal ovarian reserve underwent PGD-A for repeated implantation failure or recurrent pregnancy loss indication. After several cycles of ovarian stimulation, 591 accumulated vitrified oocytes and 463 fresh oocytes were micro-injected with the same partner's semen sample. PGD-A was completed on 134 blastocysts from vitrified/warmed oocytes and 130 blastocysts from fresh oocytes.
A mean of 9.6% euploid blastocyst per micro-injected vitrified/warmed oocytes and 11.4% euploid blastocyst per micro-injected fresh oocyte were obtained (p > 0.05). The euploidy and aneuploidy rates were comparable in blastocysts obtained from micro-injected vitrified/warmed oocytes and fresh oocytes (42.5 versus 40.8% and 57.5 versus 59.2%, p > 0.05). Implantation rates of euploid blastocysts were comparable between the two sources of oocytes (56.0% from vitrified/warmed oocytes versus 60.9% from fresh oocytes, p > 0.05).
Oocyte vitrification and warming do not generate aneuploidy in blastocysts. The number of viable euploid embryos for transfer can be increased by using accumulated vitrified oocytes together with fresh oocytes in ICSI.
NCT02820415 ClinicalTrials.gov.
在植入前非整倍体遗传学诊断(PGD-A)程序中,可供活检的胚胎越多,获得可移植的整倍体胚胎的机会就越大。目的是使用新鲜卵母细胞和先前积累的玻璃化卵母细胞,增加接受PGD-A治疗患者中存活的整倍体囊胚数量。
69例卵巢储备功能正常的患者因反复种植失败或复发性流产指征接受PGD-A治疗。经过几个周期的卵巢刺激后,用同一伴侣的精液样本对591个积累的玻璃化卵母细胞和463个新鲜卵母细胞进行显微注射。对来自玻璃化/解冻卵母细胞的134个囊胚和来自新鲜卵母细胞的130个囊胚完成了PGD-A。
每个显微注射的玻璃化/解冻卵母细胞平均获得9.6%的整倍体囊胚,每个显微注射的新鲜卵母细胞平均获得11.4%的整倍体囊胚(p>0.05)。从显微注射的玻璃化/解冻卵母细胞和新鲜卵母细胞获得的囊胚中,整倍体和非整倍体率相当(分别为42.5%对40.8%和57.5%对59.2%,p>0.05)。两种卵母细胞来源的整倍体囊胚植入率相当(玻璃化/解冻卵母细胞来源为56.0%,新鲜卵母细胞来源为60.9%,p>0.05)。
卵母细胞玻璃化和解冻不会在囊胚中产生非整倍体。在卵胞浆内单精子注射(ICSI)中,使用积累的玻璃化卵母细胞和新鲜卵母细胞可以增加可移植的存活整倍体胚胎数量。
NCT02820415 美国国立医学图书馆临床试验注册库。