Center for Reproductive Medicine, Shandong University, 157 Jingliu Road, Jinan, 250001, China.
National Research Center for Assisted Reproductive Technology and Reproductive Genetics, 157 Jingliu Road, Jinan, 250001, China.
J Assist Reprod Genet. 2020 Mar;37(3):579-588. doi: 10.1007/s10815-020-01722-9. Epub 2020 Feb 26.
To investigate the associations of previous pregnancy failures, including implantation failures (IFs), biochemical pregnancy losses (BPLs), and early (EMs) and late miscarriages (LMs), with blastocyst aneuploidy and pregnancy outcomes after PGT-A.
This study included 792 couples who underwent PGT-A after multiple pregnancy failures. Subgroup analyses were used to compare the blastocyst aneuploidy rate (BAR), implantation rate (IR), early miscarriage rate (EMR), and live birth rate (LBR). Multiple linear and logistic regression models were used to evaluate the associations. The control group comprised couples with ≤ 2 IFs, ≤ 1 BPL, ≤ 1 EM, and no LM.
Notably, a history of ≥ 4 IFs was significantly associated with an increase in aneuploid blastocysts (42.86% vs. 33.05%, P = 0.044, B = 10.23 for 4 IFs; 48.80% vs. 33.05%, P = 0.002, B = 14.43 for ≥ 5 IFs). Women with ≥ 4 prior EMs also harbored more aneuploid blastocysts (41.00% vs. 33.05%, P = 0.048; B = 9.23). Compared with the control group, women with ≥ 4 prior EMs had a significantly higher EMR (6.58% vs. 31.11%, P < 0.001, OR = 6.49) and a lower LBR (53.49% vs. 34.18%, P = 0.007, OR = 0.56) after euploid transfer. Moreover, a history of LM(s) was associated with adverse pregnancy outcomes after PGT-A (OR for EM = 3.16; OR for live birth = 0.48). However, previous BPLs and 2 EMs were not associated significantly with blastocyst aneuploidy and pregnancy outcomes after PGT-A.
A history of high-order IFs or EMs and existence of LM(s) were significantly associated with blastocyst aneuploidy and adverse pregnancy outcomes after PGT-A, whereas no such associations were observed with BPLs or 2 EMs.
研究既往妊娠失败（包括着床失败[IF]、生化妊娠丢失[BPL]、早期[EM]和晚期[LM]流产）与 PGT-A 后胚胎整倍体率和妊娠结局的关系。
本研究纳入了 792 对因多次妊娠失败而接受 PGT-A 的夫妇。采用亚组分析比较胚胎非整倍体率（BAR）、着床率（IR）、早期流产率（EMR）和活产率（LBR）。采用多元线性和逻辑回归模型评估相关性。对照组为 IF 次数≤2、BPL 次数≤1、EM 次数≤1 且无 LM 的夫妇。
值得注意的是，≥4 次 IF 与胚胎非整倍体率增加显著相关（42.86%比 33.05%，P=0.044，B=10.23；48.80%比 33.05%，P=0.002，B=14.43）。≥4 次既往 EM 的女性胚胎非整倍体率也更高（41.00%比 33.05%，P=0.048，B=9.23）。与对照组相比，≥4 次既往 EM 的女性 EMR 显著升高（6.58%比 31.11%，P<0.001，OR=6.49），活产率显著降低（53.49%比 34.18%，P=0.007，OR=0.56），且胚胎整倍体转移后。此外，LM 病史与 PGT-A 后妊娠结局不良相关（EM 的 OR=3.16；活产的 OR=0.48）。然而，既往 BPL 和 2 次 EM 与 PGT-A 后胚胎非整倍体率和妊娠结局无显著相关性。
既往高 IF 或 EM 史和 LM 存在与 PGT-A 后胚胎非整倍体率和妊娠结局不良显著相关，而 BPL 或 2 次 EM 则无显著相关性。
