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高龄产妇、反复种植失败和不明原因复发性流产患者体外受精周期中非整倍体植入前基因检测的性能。

Performance of preimplantation genetic testing for aneuploidy in IVF cycles for patients with advanced maternal age, repeat implantation failure, and idiopathic recurrent miscarriage.

作者信息

Lee Chun-I, Wu Cheng-Hsuan, Pai Yi-Ping, Chang Yu-Jun, Chen Chung-I, Lee Tsung-Hsien, Lee Maw-Sheng

机构信息

Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan; Lee Womens' Hospital, Taichung, Taiwan.

Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan; School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

出版信息

Taiwan J Obstet Gynecol. 2019 Mar;58(2):239-243. doi: 10.1016/j.tjog.2019.01.013.

Abstract

OBJECTIVE

The primary objective of this study was to investigate whether preimplantation genetic testing for aneuploidy (PGT-A) of blastocysts through array comparative genomic hybridization (aCGH) improves live birth rates (LBR) in IVF cycles for patients with high prevalence of aneuploidy.

MATERIALS AND METHODS

This study included 1389 blastocysts with aCGH results derived from 296 PGT-A cycles in IVF patients with advanced maternal age (AMA) (n = 87, group A), those with repeated implantation failure (RIF) (n = 82, group B), those with recurrent miscarriage (RM) (n = 82, group C), and oocyte donors (OD) (n = 45, young age, as a control group). Another 61 AMA patients without PGT-A procedures were used as a control group for group A. Vitrification was performed after blastocyst biopsy, and thawed euploid embryos were transferred in a nonstimulated cycle.

RESULTS

For the AMA group, a significant increase in LBRs was found in the PGT-A group compared with the non-PGT-A group (54.1% vs. 32.8%, p = 0.018). Consistent LBRs (54.1%, 51.6%, 55.9%, and 57.1%, respectively, in group A, B, C, and young age group) were obtained for all the indications.

CONCLUSIONS

LBRs can be improved using PGT-A of blastocysts with aCGH in IVF cycles for patients with a high rate of aneuploidy, especially for patients with AMA.

摘要

目的

本研究的主要目的是调查通过阵列比较基因组杂交(aCGH)对囊胚进行非整倍体植入前基因检测(PGT-A)是否能提高非整倍体高发生率患者体外受精(IVF)周期的活产率(LBR)。

材料与方法

本研究纳入了1389个有aCGH结果的囊胚,这些囊胚来自296个IVF患者的PGT-A周期,其中高龄产妇(AMA)患者87例(A组)、反复种植失败(RIF)患者82例(B组)、反复流产(RM)患者82例(C组)以及卵母细胞捐赠者(OD)45例(年轻,作为对照组)。另外61例未进行PGT-A操作的AMA患者作为A组的对照组。囊胚活检后进行玻璃化冷冻,解冻后的整倍体胚胎在非刺激周期进行移植。

结果

对于AMA组,与非PGT-A组相比,PGT-A组的LBR显著增加(54.1%对32.8%,p = 0.018)。所有适应证的LBR一致(A组、B组、C组和年轻组分别为54.1%、51.6%、55.9%和57.1%)。

结论

对于非整倍体发生率高的患者,尤其是AMA患者,在IVF周期中使用aCGH对囊胚进行PGT-A可提高LBR。

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