Yang Han, Yang Dandan, Zhu Qi, Wang Kaijuan, Zhang Chao, Chen Beili, Zou Weiwei, Hao Yan, Ding Ding, Yu Zhaojuan, Ji Dongmei, Chen Dawei, Cao Yunxia, Zou Huijuan, Zhang Zhiguo
Department of Biomedical Engineering, Anhui Medical University, Hefei, China.
Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Front Endocrinol (Lausanne). 2022 Mar 4;13:852620. doi: 10.3389/fendo.2022.852620. eCollection 2022.
Blastocyst biopsy has become the most mainstream biopsy method. Currently, there are two blastocyst biopsy strategies. Many studies have compared the advantages and disadvantages between blastomere and blastocyst biopsy, but fewer articles have compared the two blastocyst biopsy strategies. For the moment, no published studies have explored the entire set of information on embryo development, next-generation sequencing results, and clinical outcomes, including the baby's health status with the two blastocyst biopsy strategies.
A total of 323 preimplantation genetic testing cycles from April 2018 to May 2020, including 178 cycles with Strategy A and 145 cycles with Strategy B. Strategy A was to create a laser-assisted zona pellucid opening for cleavage embryo on the third day after insemination, but Strategy B was not. Strategy A performed a biopsy for artificially assisted hatching blastocysts, while Strategy B performed a biopsy for expanded blastocysts on day 5 or 6. In this study, embryo development, next-generation sequencing results, pregnancy outcomes, and offspring health of the two strategies were compared and analyzed.
There were no statistical differences between the two groups in the rate of fertilization, blastocyst and abortion. The rate of cleavage from Strategy A was slightly higher than Strategy B, and the rate of high-quality cleavage embryo was lower than Strategy B, while the rate of high-quality blastocyst was higher than Strategy B. The rate of no-results blastocyst was significantly lower than Strategy B. In particular, the rate of biochemical pregnancy, clinical pregnancy, and live birth of Strategy A were significantly lower than those of Strategy B. The average Apgar scores of newborns were ≥8 in both groups, and there was no significant difference in average height and weight. In Strategy A, a baby was born with thumb syndactyly, and Strategy B had no congenital disabilities.
Blastocyst biopsy strategy without laser-assisted zona pellucid drilling on day 3 achieves better clinical treatment effects. Therefore, Strategy B is an optimal treatment regime for PGT.
囊胚活检已成为最主流的活检方法。目前，有两种囊胚活检策略。许多研究比较了卵裂球活检和囊胚活检的优缺点，但比较两种囊胚活检策略的文章较少。目前，尚无已发表的研究探讨两种囊胚活检策略关于胚胎发育、下一代测序结果和临床结局的全套信息，包括婴儿的健康状况。
共纳入2018年4月至2020年5月的323个植入前基因检测周期，其中策略A组178个周期，策略B组145个周期。策略A是在授精后第三天为卵裂期胚胎创建激光辅助透明带开口，而策略B不进行此操作。策略A对人工辅助孵化的囊胚进行活检，而策略B在第5天或第6天对扩张期囊胚进行活检。本研究对两种策略的胚胎发育、下一代测序结果、妊娠结局和子代健康进行了比较分析。
两组在受精率、囊胚率和流产率方面无统计学差异。策略A的卵裂率略高于策略B，优质卵裂期胚胎率低于策略B，而优质囊胚率高于策略B。无结果囊胚率显著低于策略B。特别是，策略A的生化妊娠率、临床妊娠率和活产率显著低于策略B。两组新生儿的平均阿氏评分均≥8分，平均身高和体重无显著差异。在策略A中，有一名婴儿出生时患有拇指并指畸形，而策略B没有先天性残疾。
第3天不进行激光辅助透明带钻孔的囊胚活检策略可取得更好的临床治疗效果。因此，策略B是PGT的最佳治疗方案。
