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单冻融胚胎移植周期中胚胎植入前遗传学检测后单胎活产儿的围产结局:一项倾向评分匹配研究。

Perinatal outcomes of singleton live births after preimplantation genetic testing during single frozen-thawed blastocyst transfer cycles: a propensity score-matched study.

机构信息

Center for Reproductive Medicine, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China.

Clinical Laboratory, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China.

出版信息

Fertil Steril. 2022 Mar;117(3):562-570. doi: 10.1016/j.fertnstert.2021.12.020. Epub 2022 Feb 1.

Abstract

OBJECTIVE

To determine whether singleton pregnancy achieved after preimplantation genetic testing (PGT) is associated with a higher risk of adverse perinatal outcomes than in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) singleton pregnancy.

DESIGN

A retrospective cohort study.

SETTING

A university-affiliated fertility center.

PATIENT(S): This cohort study included singleton live births resulting from PGT (n = 232) and IVF/ICSI singleton pregnancies (n = 2,829) with single frozen-thawed blastocyst transfer. Multiple baseline covariates were used for propensity score matching, yielding 214 PGT singleton pregnancies matched to 617 IVF/ICSI singleton pregnancies.

INTERVENTION(S): Trophectoderm biopsy.

MAIN OUTCOME MEASURE(S): The primary outcome was gestational hypertension, and various clinical perinatal secondary outcomes related to maternal and neonatal health were measured.

RESULT(S): Compared with IVF/ICSI singleton pregnancy, PGT singleton pregnancy was associated with a significantly higher risk of gestational hypertension (adjusted odds ratio, 2.58; 95% confidence interval, 1.32, 5.05). In the matched sample, the risk of gestational hypertension remained higher with PGT singleton pregnancy (odds ratio, 2.33; 95% confidence interval, 1.04, 5.22) than with IVF/ICSI singleton pregnancy. No statistical differences were noted in any other measured outcomes between the groups.

CONCLUSION(S): The perinatal outcomes of PGT and IVF/ICSI singleton pregnancies were similar except for the observed potentially higher risk of gestational hypertension with PGT singleton pregnancy. However, because the data on PGT singleton pregnancies are limited, this conclusion warrants further investigation.

摘要

目的

确定与体外受精(IVF)/卵胞浆内单精子注射(ICSI)单胎妊娠相比,经胚胎植入前遗传学检测(PGT)后获得的单胎妊娠是否与不良围产期结局风险增加相关。

设计

回顾性队列研究。

地点

一家大学附属生育中心。

患者

本队列研究纳入了 232 例经 PGT 获得的单胎活产和 2829 例接受单个冷冻解冻囊胚移植的 IVF/ICSI 单胎妊娠,这些患者均有多个基线协变量用于倾向评分匹配,最终匹配出 214 例 PGT 单胎妊娠和 617 例 IVF/ICSI 单胎妊娠。

干预措施

滋养外胚层活检。

主要观察指标

主要结局为妊娠期高血压,同时还测量了与母婴健康相关的各种临床围产期次要结局。

结果

与 IVF/ICSI 单胎妊娠相比,PGT 单胎妊娠发生妊娠期高血压的风险显著更高(校正优势比,2.58;95%置信区间,1.325.05)。在匹配样本中,PGT 单胎妊娠发生妊娠期高血压的风险仍高于 IVF/ICSI 单胎妊娠(比值比,2.33;95%置信区间,1.045.22)。两组在其他任何测量结果方面均无统计学差异。

结论

PGT 和 IVF/ICSI 单胎妊娠的围产期结局相似,除了 PGT 单胎妊娠妊娠期高血压的风险可能更高外。然而,由于关于 PGT 单胎妊娠的数据有限,这一结论需要进一步研究。

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