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不同年龄段中预后良好的 IVF 人群中,胚胎植入前遗传学检测非整倍体的作用。

The role of preimplantation genetic testing for aneuploidy in a good prognosis IVF population across different age groups.

机构信息

Division of Reproductive Endocrinology and Infertility, University of South Florida, Tampa, FL, USA.

Division of Reproductive Endocrinology and Infertility, Albert Einstein College of Medicine, Bronx, NY, USA.

出版信息

Syst Biol Reprod Med. 2021 Oct;67(5):366-373. doi: 10.1080/19396368.2021.1954725. Epub 2021 Aug 6.

Abstract

Preimplantation genetic testing for aneuploidy is associated with increased pregnancy success and reduced miscarriage in women 35 years and older when embryos are available for transfer. In this retrospective cohort study our objective was to evaluate if this holds true in good prognosis patients and across all age groups. Data were obtained from the Society for Assisted Reproductive Technology between 2014-2015. We included only the first single frozen embryo transfer where indication for corresponding 'stimulation/freeze-all cycle' was for reducing risk of ovarian hyperstimulation syndrome and performance of PGT-A for selecting euploid embryos. Our main outcomes were live birth and miscarriage rates. Among <35 age group, no difference in LBR was observed between cycles who underwent single embryo FET using non-PGT-A tested vs. tested embryos (51.7% vs. 50.9%, aOR 1.03, 95% CI 0.87-1.21). Additionally, the miscarriage rates (8.7% vs. 8.8%, aOR 0.97, 95% CI 0.72-1.30) were not different. Among 35-37 years old, no difference was observed between non-PGT-A tested and tested groups in LBR (50.4% vs. 54.7%, aOR 1.26, 95% CI 0.96-1.67) or miscarriage rates (8.3% vs. 10%; aOR 1.11, 95% CI 0.68-1.82). Similarly, among > 37 year old, no difference was observed between non-PGT-A tested and tested groups in LBR (48.1% vs. 53.2%, aOR 1.27, 95% CI 0.8-2.02) and miscarriage rates (6.2% vs. 8.5%, aOR1.34, 95% CI 0.52-3.43). To conclude, PGT-A tested embryos did not improve LBR and miscarriage rates in a good prognosis IVF population across all age groups. PGT-A: preimplantation genetic testing for aneuploidy; FET: frozen embryo transfer; LBR: live birth rate; OHSS: ovarian hyperstimulation syndrome; SART: society for assisted reproductive technology.

摘要

胚胎植入前遗传学检测(PGT-A)可提高 35 岁及以上患者胚胎移植时的妊娠成功率并降低流产率。本回顾性队列研究旨在评估该方法在预后良好的患者和所有年龄段患者中是否适用。数据来自 2014-2015 年的辅助生殖技术协会。我们仅纳入了因降低卵巢过度刺激综合征风险而进行“刺激/冻存所有卵子”周期且进行 PGT-A 以选择整倍体胚胎的首次单枚冻融胚胎移植。主要结局为活产率和流产率。<35 岁年龄组中,非 PGT-A 检测组和检测组的单胚胎 FET 活产率(51.7% vs. 50.9%,优势比 1.03,95%置信区间 0.87-1.21)无差异。此外,流产率(8.7% vs. 8.8%,优势比 0.97,95%置信区间 0.72-1.30)也无差异。35-37 岁年龄组中,非 PGT-A 检测组和检测组的活产率(50.4% vs. 54.7%,优势比 1.26,95%置信区间 0.96-1.67)或流产率(8.3% vs. 10%,优势比 1.11,95%置信区间 0.68-1.82)也无差异。同样,>37 岁年龄组中,非 PGT-A 检测组和检测组的活产率(48.1% vs. 53.2%,优势比 1.27,95%置信区间 0.8-2.02)和流产率(6.2% vs. 8.5%,优势比 1.34,95%置信区间 0.52-3.43)也无差异。总之,PGT-A 检测并未改善各年龄段预后良好的 IVF 人群的活产率和流产率。PGT-A:胚胎植入前遗传学检测(aneuploidy);FET:冻融胚胎移植;LBR:活产率;OHSS:卵巢过度刺激综合征;SART:辅助生殖技术协会。

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