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一项回顾性研究表明,当植入前基因检测(PGT)允许选择整倍体胚胎时,来自供体或患者卵母细胞的胚胎在体外受精结果方面并无差异。

Embryos derived from donor or patient oocytes are not different for in vitro fertilization outcomes when PGT allows euploid embryo selection: a retrospective study.

作者信息

Schaeffer Elizabeth, Porchia Leonardo M, Neumann Adina, Luna Almena, Rojas Tania, López-Bayghen Esther

机构信息

Laboratorio de Investigación y Diagnóstico Molecular, Instituto de Infertilidad y Genética, Ingenes, México City, Mexico.

Departamento de Toxicología, Centro de Investigación de Estudios Avanzados del Instituto Politécnico Nacional, Av. Instituto Politécnico Nacional 2508, Col. San Pedro Zacatenco, CP 07360, México City, Distrito Federal, Mexico.

出版信息

Clin Transl Med. 2020 Feb 7;9(1):14. doi: 10.1186/s40169-020-0266-1.

Abstract

BACKGROUND

At our facilities, patients that received embryos using donor oocyte during in vitro fertilization (IVF), usually have had at least one failed attempt to produce at least one euploid embryo with their own oocytes; however, the current debate between using donor over patient oocytes remains inconclusive. We examined the aneuploidy rate and IVF clinical outcomes from embryos derived from either donor or patient oocytes.

METHODS

Retrospectively, 973 cycles were examined of patients who underwent a standard IVF protocol. Chromosomal content was determined using Pre-implantation Genetic Testing (PGT) by either microarray-comparative genomic hybridization or Next-generation sequencing from either Day 3 (blastocysts) or Day 5 (trophectoderm) embryo biopsies, respectively. Embryo implantation was confirmed by serum β-hCG (> 10 m IU/mL/Day 14), whereas clinical pregnancy by a fetal heartbeat (Week 6.5-8).

RESULTS

Embryos derived from donor oocytes presented with more monosomies than embryos derived from patient oocytes (41.2% vs. 25.4%, p < 0.05, respectively); however, only Trisomy 7 (0.4% vs. 2.3%, p < 0.05) and Trisomy in X (0.7% vs. 2.3%, p < 0.05) were significantly less present when compared to patient oocyte derived embryos. Interestingly, rates for embryo implantation (46.7% vs. 50.8%, p = 0.35), clinical pregnancy (38.5% vs. 43.1%, p = 0.30), and live birth (30.5% vs. 30.5%, p = 0.99) were similar for embryos derived from donor and patient oocytes. These results did not change when adjusted for the number of embryos implanted.

CONCLUSION

Here, we show no significant differences in achieving pregnancy when using donor oocytes. Taking into consideration that aneuploidy rates are > 30% in embryos, independent of the oocyte origin, PGT should be recommended with donor oocytes as well.

摘要

背景

在我们的机构中,接受体外受精(IVF)时使用供体卵母细胞的患者,通常至少有一次尝试使用自身卵母细胞产生至少一个整倍体胚胎失败;然而,目前关于使用供体卵母细胞还是患者自身卵母细胞的争论尚无定论。我们研究了来自供体或患者卵母细胞的胚胎的非整倍体率和IVF临床结局。

方法

回顾性分析了973例接受标准IVF方案的患者的周期。通过微阵列比较基因组杂交或下一代测序,分别对第3天(囊胚)或第5天(滋养外胚层)胚胎活检样本进行植入前基因检测(PGT),以确定染色体含量。通过血清β-hCG(>10 m IU/mL/第14天)确认胚胎着床,通过检测到胎心(第6.5 - 8周)确认临床妊娠。

结果

与来自患者卵母细胞的胚胎相比,来自供体卵母细胞的胚胎出现更多单体(分别为41.2%对25.4%,p < 0.05);然而,与来自患者卵母细胞的胚胎相比,只有7号三体(0.4%对2.3%,p < 0.05)和X染色体三体(0.7%对2.3%,p < 0.05)的出现率显著降低。有趣的是,来自供体和患者卵母细胞的胚胎的着床率(46.7%对50.8%,p = 0.35)、临床妊娠率(38.5%对43.1%,p = 0.30)和活产率(30.5%对30.5%,p = 0.99)相似。调整植入胚胎数量后,这些结果没有改变。

结论

在此,我们表明使用供体卵母细胞在实现妊娠方面没有显著差异。考虑到无论卵母细胞来源如何,胚胎中的非整倍体率均>30%,使用供体卵母细胞时也应推荐进行植入前基因检测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf6b/7005195/5959150eff4b/40169_2020_266_Fig1_HTML.jpg

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