Barad David H, Darmon Sarah K, Kushnir Vitaly A, Albertini David F, Gleicher Norbert
Center for Human Reproduction, New York, NY; Foundation for Reproductive Medicine, New York, NY.
Center for Human Reproduction, New York, NY.
Am J Obstet Gynecol. 2017 Nov;217(5):576.e1-576.e8. doi: 10.1016/j.ajog.2017.07.023. Epub 2017 Jul 20.
Our objective was to estimate the contribution of preimplantation genetic screening to in vitro fertilization pregnancy outcomes in donor oocyte-recipient cycles.
This was a retrospective cross-sectional study of US national data from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System between 2005 and 2013. Society for Assisted Reproductive Technology Clinic Outcome Reporting relies on voluntarily annual reports by more than 90% of US in vitro fertilization centers. We evaluated pregnancy and live birth rates in donor oocyte-recipient cycles after the first embryo transfer with day 5/6 embryos. Statistical models, adjusted for patient and donor ages, number of embryos transferred, race, infertility diagnosis, and cycle year were created to compare live birth rates in 392 preimplantation genetic screening and 20,616 control cycles.
Overall, pregnancy and live birth rates were significantly lower in preimplantation genetic screening cycles than in control cycles. Adjusted odds of live birth for preimplantation genetic screening cycles were reduced by 35% (odds ratio, 0.65, 95% confidence interval, 0.53-0.80; P < .001).
Preimplantation genetic screening, as practiced in donor oocyte-recipient cycles over the past 9 years, has not been associated with improved odds of live birth or reduction in miscarriage rates.
我们的目的是评估植入前基因筛查对供体卵母细胞-受体周期体外受精妊娠结局的贡献。
这是一项对2005年至2013年美国辅助生殖技术协会诊所结局报告系统的美国国家数据进行的回顾性横断面研究。美国辅助生殖技术协会诊所结局报告依赖于美国90%以上的体外受精中心自愿提交的年度报告。我们评估了首次胚胎移植后第5/6天胚胎的供体卵母细胞-受体周期中的妊娠率和活产率。建立了针对患者和供体年龄、移植胚胎数量、种族、不孕诊断和周期年份进行调整的统计模型，以比较392个植入前基因筛查周期和20616个对照周期中的活产率。
总体而言，植入前基因筛查周期的妊娠率和活产率显著低于对照周期。植入前基因筛查周期的活产调整比值降低了35%（比值比，0.65，95%置信区间，0.53 - 0.80；P <.001）。
在过去9年的供体卵母细胞-受体周期中实施的植入前基因筛查，与提高活产几率或降低流产率无关。
