Cao Mingzhu, Zhang Qian, Zhou Wei, Zhu Yueting, Li Hongchang, Yan Junhao
Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.
Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China.
Front Med (Lausanne). 2022 Mar 31;9:803988. doi: 10.3389/fmed.2022.803988. eCollection 2022.
The study aims to investigate whether chromosomal polymorphism affects embryo development and pregnancy outcomes of unexplained recurrent pregnancy loss (uRPL) couples undergoing PGT-A.
A total of 585 couples with uRPL history who performed PGT-A were included in the retrospective study from January 2016 to December 2020. We included 415 couples with normal karyotype and 170 couples with chromosomal polymorphism. Furthermore, the polymorphism group was divided into two subgroups: 113 couples in the male group and 57 couples in the female group. The embryo development and pregnancy outcomes were analyzed in different groups.
The blastocyst rate and aneuploidy rate are statistically different in the normal group, male polymorphism group, and female polymorphism group. Compared with normal and female groups, the male group has a lower blastocyst rate, which is statistically different (48.3 vs. 53.9%, = 0.003; 48.3 vs. 54.1%, = 0.043). Moreover, the aneuploidy rate of the male polymorphism group is significantly higher than female carriers (29.5 vs. 18.6%, = 0.003). However, there were no statistically significant differences in clinical pregnancy rate, early miscarriage rate, and live birth rate after PGT-A ( > 0.05).
Male with chromosome polymorphism (CPM) have a lower blastocyst rate and a higher aneuploidy rate than female carriers in uRPL couples undergoing PGT-A. However, when a euploid blastocyst was first transferred, no difference in pregnancy outcomes was found between the male and female polymorphism carriers. It indicated that CPM may have an adverse effect on the embryos of male carriers with uRPL history, and the occurrence of uRPL may be decreased in male polymorphism carriers after PGT-A.
本研究旨在调查染色体多态性是否会影响接受植入前遗传学检测非整倍体（PGT-A）的不明原因复发性流产（uRPL）夫妇的胚胎发育和妊娠结局。
本回顾性研究纳入了2016年1月至2020年12月期间共585例行PGT-A的有uRPL病史的夫妇。我们纳入了415例核型正常的夫妇和170例有染色体多态性的夫妇。此外，多态性组又分为两个亚组：男性组113对夫妇和女性组57对夫妇。分析不同组别的胚胎发育和妊娠结局。
正常组、男性多态性组和女性多态性组的囊胚率和非整倍体率存在统计学差异。与正常组和女性组相比，男性组的囊胚率较低，具有统计学差异（48.3%对53.9%，P = 0.003；48.3%对54.1%，P = 0.043）。此外，男性多态性组的非整倍体率显著高于女性携带者（29.5%对18.6%，P = 0.003）。然而，PGT-A后的临床妊娠率、早期流产率和活产率没有统计学显著差异（P>0.05）。
在接受PGT-A的uRPL夫妇中，具有染色体多态性的男性（CPM）比女性携带者的囊胚率更低，非整倍体率更高。然而，当首次移植整倍体囊胚时，男性和女性多态性携带者之间的妊娠结局没有差异。这表明CPM可能对有uRPL病史的男性携带者的胚胎有不良影响，PGT-A后男性多态性携带者的uRPL发生率可能会降低。
