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24 染色体单体型 SNP 基因芯片技术用于胚胎植入前遗传学筛查的 1800 多次体外受精周期的妊娠结局。

Pregnancy outcomes from more than 1,800 in vitro fertilization cycles with the use of 24-chromosome single-nucleotide polymorphism-based preimplantation genetic testing for aneuploidy.

机构信息

Natera, San Carlos, California.

Pacific Fertility Center, San Francisco, California.

出版信息

Fertil Steril. 2018 Jul 1;110(1):113-121. doi: 10.1016/j.fertnstert.2018.03.026. Epub 2018 Jun 13.

Abstract

OBJECTIVE

To measure in vitro fertilization (IVF) outcomes following 24-chromosome single‒nucleotide-polymorphism (SNP)-based preimplantation genetic testing for aneuploidy (PGT-A) and euploid embryo transfer.

DESIGN

Retrospective.

SETTING

Fertility clinics and laboratory.

PATIENT(S): Women 20-46 years of age undergoing IVF treatment.

INTERVENTION(S): Twenty-four-chromosome SNP-based PGT-A of day 5/6 embryo biopsies.

MAIN OUTCOME MEASURE(S): Maternal age-stratified implantation, clinical pregnancy, and live birth rates per embryo transfer; miscarriage rates; and number of embryo transfers per patient needed to achieve a live birth.

RESULT(S): An implantation rate of 69.9%, clinical pregnancy rate per transfer of 70.6%, and live birth rate per transfer of 64.5% were observed in 1,621 nondonor frozen cycles with the use of SNP-based PGT-A. In addition, SNP-based PGT-A outcomes, when measured per cycle with transfer, remained relatively constant across all maternal ages; when measured per cycle initiated, they decreased as maternal age increased. Miscarriage rates were ∼5% in women ≤40 years old. No statistically significant differences in pregnancy outcomes were found for single-embryo transfers (SET) versus double-embryo transfers with SNP-based PGT-A. On average, 1.38 embryo transfers per patient were needed to achieve a live birth in nondonor cycles.

CONCLUSION(S): Our findings that SNP-based PGT-A can mitigate the negative effects of maternal age on IVF outcomes in cycles with transfer, and that pregnancy outcomes from SET cycles are not significantly different from those of double-embryo transfer cycles, support the use of SET when transfers are combined with SNP-based PGT-A.

摘要

目的

测量基于 24 染色体单核苷酸多态性(SNP)的胚胎植入前遗传学检测非整倍体(PGT-A)和整倍体胚胎移植后体外受精(IVF)的结果。

设计

回顾性。

设置

生育诊所和实验室。

患者

年龄在 20-46 岁之间接受 IVF 治疗的女性。

干预措施

第 5/6 天胚胎活检的 24 染色体 SNP 检测。

主要观察指标

每个胚胎移植的母体年龄分层着床率、临床妊娠率和活产率;流产率;以及每个患者需要进行多少次胚胎移植才能获得活产。

结果

在 1621 个非捐赠冷冻周期中使用 SNP 检测,观察到着床率为 69.9%,每次移植的临床妊娠率为 70.6%,每次移植的活产率为 64.5%。此外,当按周期测量时,SNP 检测的结果在所有母亲年龄中相对稳定;当按周期开始测量时,随着母亲年龄的增加而降低。≤40 岁的女性流产率约为 5%。在 SNP 检测的单胚胎移植(SET)与双胚胎移植之间,妊娠结局没有统计学上的显著差异。在非捐赠周期中,平均需要 1.38 次胚胎移植才能获得活产。

结论

我们的研究结果表明,基于 SNP 的 PGT-A 可以减轻母亲年龄对转移周期中 IVF 结果的负面影响,并且 SET 周期的妊娠结局与双胚胎转移周期没有显著差异,这支持在转移周期中结合 SNP 检测时使用 SET。

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