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在 7847 个单囊胚移植周期中,滋养外胚层活检对妊娠早期不同胚胎滋养外胚层评分的血清β-人绒毛膜促性腺激素水平有不同影响。

Trophectoderm Biopsy Differentially Influences the Level of Serum β-Human Chorionic Gonadotropin With Different Embryonic Trophectoderm Scores in Early Pregnancy From 7847 Single-Blastocyst Transfer Cycles.

机构信息

Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China.

Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China.

出版信息

Front Endocrinol (Lausanne). 2022 Feb 18;13:794720. doi: 10.3389/fendo.2022.794720. eCollection 2022.

Abstract

OBJECTIVE

To evaluate whether trophectoderm (TE) biopsy differentially influence the level of serum β-human chorionic gonadotropin (β-hCG) with different TE-scored blastocysts transferred in early pregnancy.

METHODS

This retrospective cohort study contained 7847 single-blastocyst transfer cycles executed between January 2019 and June 2020, including 2657 preimplantation genetic testing (PGT) cycles and 5190 fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycles. All cycles were classified into biopsy and control groups, and further stratified based on the TE morphological scores into three subgroups: grades A, B, and C for TE scores, respectively. Intra-group and inter-group analyses were performed on serum β-hCG levels on the 12th day after blastocyst transfer (HCG), and obstetric and neonatal outcomes.

RESULTS

For cycles with a live birth, in grade A TE score subgroups, the HCG level did not exhibit statistical significance between the control and biopsy groups after adjustment (769 mIU/mL vs. 753 mIU/mL, P=0.631). In contrast, in grade B and C TE score subgroups, the control group showed a significantly higher level of HCG relative to the biopsy group (690 mIU/mL vs. 649 mIU/mL, P=0.001; 586 mIU/mL vs. 509 mIU/mL, P<0.001, respectively). We observed no statistically significant differences in obvious adverse obstetric and neonatal outcomes between the same TE-score subgroups of the biopsy group and control group.

CONCLUSIONS

While blastocysts with higher TE grades produced higher serum β-hCG levels in early pregnancy, TE biopsy might exert a negative impact on serum β-hCG levels by blastocysts with a grade-B TE score and below. TE biopsy did not increase the risk for adverse obstetric and neonatal outcomes.

摘要

目的

评估滋养外胚层(TE)活检是否会对不同 TE 评分的囊胚在早孕时的血清β-人绒毛膜促性腺激素(β-hCG)水平产生影响。

方法

本回顾性队列研究纳入了 2019 年 1 月至 2020 年 6 月期间执行的 7847 个单囊胚移植周期,包括 2657 个植入前遗传学检测(PGT)周期和 5190 个体外受精(IVF)或卵胞浆内单精子注射(ICSI)周期。所有周期分为活检组和对照组,并根据 TE 形态学评分进一步分为 3 个亚组:TE 评分分别为 A、B 和 C 级。对囊胚移植后 12 天(HCG)血清β-hCG 水平、产科和新生儿结局进行组内和组间分析。

结果

对于有活产的周期,在 TE 评分 A 级亚组中,调整后对照组和活检组的 HCG 水平无统计学差异(769 mIU/mL 比 753 mIU/mL,P=0.631)。相比之下,在 TE 评分 B 级和 C 级亚组中,对照组的 HCG 水平明显高于活检组(690 mIU/mL 比 649 mIU/mL,P=0.001;586 mIU/mL 比 509 mIU/mL,P<0.001)。我们观察到,在相同的 TE 评分亚组中,活检组和对照组之间的明显不良产科和新生儿结局没有统计学差异。

结论

虽然高 TE 级别的囊胚在早孕时产生更高的血清β-hCG 水平,但 TE 活检可能会对 TE 评分 B 级及以下的囊胚的血清β-hCG 水平产生负面影响。TE 活检不会增加不良产科和新生儿结局的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4993/8894721/3ab819fe3ea7/fendo-13-794720-g001.jpg

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