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囊胚活检后的活产新生儿结局:一项对 1721 名儿童的随访研究。

Neonatal outcomes of live births after blastocyst biopsy in preimplantation genetic testing cycles: a follow-up of 1,721 children.

机构信息

Institute of Reproduction and Stem Cell Engineering, Basic Medical College, Central South University, Changsha, People's Republic of China.

Institute of Reproduction and Stem Cell Engineering, Basic Medical College, Central South University, Changsha, People's Republic of China; Key Laboratory of Stem Cell and Reproductive Engineering, Ministry of Health, Changsha, People's Republic of China; Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, People's Republic of China.

出版信息

Fertil Steril. 2019 Jul;112(1):82-88. doi: 10.1016/j.fertnstert.2019.03.006. Epub 2019 May 2.

Abstract

OBJECTIVE

To investigate whether blastocyst biopsy in preimplantation genetic testing (PGT) increases the risk of adverse neonatal outcomes.

DESIGN

Retrospective cohort study.

SETTING

University-affiliated center.

PATIENTS

Live births after blastocyst biopsy combined with frozen ET (PGT group) and frozen blastocyst transfer after in vitro fertilization or intracytoplasmic sperm injection (control group).

INTERVENTION(S): Blastocyst biopsy.

MAIN OUTCOME MEASURE(S): Gestational age (GA), birth weight (BW), and rates of preterm birth (PB), very preterm birth (VPB), extreme preterm birth (EPB), low birth weight (LBW), very low birth weight (VLBW), and macrosomia.

RESULT(S): No significant differences were observed in the sex ratio, GA, PB, VPB, EPB, BW, or rates of LBW, VLBW, and macrosomia between the PGT and control groups for either singletons or twins. However, the cesarean section rate of the PGT group was significantly higher than that of the control group for twins (adjusted odds ratio, 2.383 [1.079, 5.259]). Regarding fluorescence in situ hybridization-PGT neonates, neonatal outcomes, including GA, BW, and rates of PB, VPB, LBW, and VLBW, did not differ between the different groups of biopsied cells (≥10 group and <10 group) for either the grade B or grade C trophectoderm score subgroups; however, in the grade B trophectoderm score subgroup, the rate of boy babies in the ≥10 group was significantly higher than that in the <10 group (83.3% vs. 40.9%). The association between the number of biopsied cells and GA/BW was not statistically significant.

CONCLUSION(S): Blastocyst biopsy may not add additional risk to neonatal outcomes when compared with a control group.

摘要

目的

研究胚胎植入前遗传学检测(PGT)中的囊胚活检是否会增加不良新生儿结局的风险。

设计

回顾性队列研究。

地点

大学附属医院。

患者

囊胚活检联合冷冻胚胎移植后活产(PGT 组)和体外受精或卵胞浆内单精子注射后冷冻囊胚移植(对照组)。

干预措施

囊胚活检。

主要观察指标

孕龄(GA)、出生体重(BW)、早产率(PB)、极早产率(VPB)、超早产率(EPB)、低出生体重率(LBW)、极低出生体重率(VLBW)和巨大儿率。

结果

PGT 组与对照组在单胎或双胎中,男婴比例、GA、PB、VPB、EPB、BW、LBW、VLBW 和巨大儿率均无显著差异。然而,PGT 组的剖宫产率明显高于对照组(调整后的优势比,2.383[1.079,5.259])。对于荧光原位杂交-PGT 新生儿,不同活检细胞数量组(≥10 个和<10 个)的新生儿结局,包括 GA、BW、PB、VPB、LBW 和 VLBW,在 B 级滋养外胚层评分亚组和 C 级滋养外胚层评分亚组中均无差异;然而,在 B 级滋养外胚层评分亚组中,≥10 个细胞活检组的男婴比例明显高于<10 个细胞活检组(83.3% vs. 40.9%)。活检细胞数量与 GA/BW 的相关性无统计学意义。

结论

与对照组相比,囊胚活检可能不会增加新生儿结局的风险。

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