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体外受精/卵胞浆内单精子注射后 1496 例胎儿与自然妊娠后 1396 例胎儿的染色体核型新生畸变率相当。

The de novo aberration rate of prenatal karyotype was comparable between 1496 fetuses conceived via IVF/ICSI and 1396 fetuses from natural conception.

机构信息

Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410008, Hunan, China.

Hospital of Hunan Guangxiu, Medical College of Hunan Normal University, Hunan Normal University, Changsha, 410008, Hunan, China.

出版信息

J Assist Reprod Genet. 2022 Jul;39(7):1683-1689. doi: 10.1007/s10815-022-02500-5. Epub 2022 May 26.

Abstract

PURPOSE

To evaluate the cytogenetic risk of assisted reproductive technology (ART) by comparing the incidence of de novo chromosomal abnormalities between fetuses conceived via in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) and natural conception.

MATERIALS AND METHODS

Prenatal invasive diagnostic testing (amniocentesis and cytogenetic analysis) was performed on 1496 fetuses conceived via IVF/ICSI (IVF/ICSI group) and 1396 fetuses from natural conception (NC group). The incidence of de novo chromosomal abnormalities (including aneuploidy and chromosomal structure abnormalities) was used to evaluate the cytogenetic risk of ART. For statistical analysis, χ-test was used for binary dependent variable. The significance level was P < 0.05 and confidence interval was 95%.

RESULT(S): The IVF/ICSI group displayed a modest increase in the overall de novo chromosomal abnormality rate compared with that in the NC group but with no statistical significance (6.75% vs. 6.16%; χ = 0.42, P > 0.05). The incidence of abnormal karyotypes was also not significantly different between the IVF/ICSI and NC groups in different maternal ages, including ≥ 35 years group (7.55% vs. 9.60%, χ = 1.40, P > 0.05) and < 35 years group (6.20% vs. 4.54%, χ = 2.51, P > 0.05). Moreover, there was no difference in the proportion of aneuploid and structural abnormalities in detected karyotypes between the IVF/ICSI and NC groups. Logistic regression analysis showed no significant association between the method of pregnancy and de novo chromosomal abnormalities (odds ratio (OR) 1.03; 95% CI 0.71-1.50; P = 0.86) after adjusting for other confounding factors.

CONCLUSION(S): Fetuses conceived via IVF/ICSI had a slight but not statistically significant increase in de novo abnormal karyotypes compared to those in naturally conceived fetuses. Our findings indicate no significant association between de novo fetal chromosomal abnormalities and the pregnancy method in high-risk pregnancies in the second trimester. For these pregnancies with a high risk but with a normal karyotype, further genetic testing is required for diagnosis.

摘要

目的

通过比较体外受精/卵胞浆内单精子注射(IVF/ICSI)和自然受孕胎儿中新生染色体异常的发生率,评估辅助生殖技术(ART)的细胞遗传学风险。

材料与方法

对 1496 例 IVF/ICSI 受孕胎儿(IVF/ICSI 组)和 1396 例自然受孕胎儿(NC 组)进行产前侵袭性诊断检测(羊膜穿刺术和细胞遗传学分析)。使用新生染色体异常(包括非整倍体和染色体结构异常)的发生率来评估 ART 的细胞遗传学风险。统计分析采用二项相依变量的卡方检验。显著性水平为 P<0.05,置信区间为 95%。

结果

与 NC 组相比,IVF/ICSI 组的整体新生染色体异常发生率略有增加,但无统计学意义(6.75%比 6.16%;χ²=0.42,P>0.05)。不同年龄的 IVF/ICSI 组与 NC 组的异常核型发生率也无显著差异,包括≥35 岁组(7.55%比 9.60%,χ²=1.40,P>0.05)和<35 岁组(6.20%比 4.54%,χ²=2.51,P>0.05)。此外,IVF/ICSI 组与 NC 组检测到的核型中,非整倍体和结构异常的比例也无差异。经多因素校正后,Logistic 回归分析显示,妊娠方式与新生染色体异常无显著相关性(比值比 1.03;95%置信区间 0.71-1.50;P=0.86)。

结论

与自然受孕胎儿相比,IVF/ICSI 受孕胎儿的新生异常核型略有增加,但无统计学意义。我们的研究结果表明,在高危妊娠的中期,新生胎儿染色体异常与妊娠方式之间无显著相关性。对于这些具有高危因素但核型正常的妊娠,需要进一步进行遗传检测以明确诊断。

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