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将精子通过微流控或密度梯度离心处理后的精子注入同卵姐妹卵母细胞所产生的胚胎中,比较胚胎整倍体率的一项双盲前瞻性随机临床试验的原理和研究设计。

Rationale and study design of a double-blinded prospective randomized clinical trial comparing euploidy rates among embryos created from sibling oocytes injected with sperm processed by microfluidics or by density gradient centrifugation.

机构信息

The Center for Advanced Reproductive Services, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, Farmington, CT 06032, United States of America.

The Center for Advanced Reproductive Services, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, Farmington, CT 06032, United States of America.

出版信息

Contemp Clin Trials. 2022 Sep;120:106893. doi: 10.1016/j.cct.2022.106893. Epub 2022 Aug 22.

Abstract

BACKGROUND

During the in vitro fertilization (IVF) process, sperm must be processed prior to insemination. While the most common method, density gradient centrifugation, can potentially damage sperm during centrifugation, a recent advancement in sperm processing uses a microfluidics system which selects for the most highly motile sperm. In selecting for these sperm which may be of higher quality, the euploidy rates of embryos created as a result may also be improved. The primary aim of this study is to compare the euploidy rates per mature oocyte between embryos created from sibling oocytes injected with sperm processed by microfluidics sorting or by density gradient centrifugation.

METHODS

This is a double-blinded prospective randomized sibling oocyte study including patients undergoing treatment with IVF with intracytoplasmic sperm injection (ICSI) and preimplantation genetic testing (PGT). After controlled ovarian hyperstimulation, oocytes from each patient will be separated into two groups. Each group will be randomized to sperm processed using either microfluidics or density gradient centrifugation and embryos biopsied for PGT to assess euploidy rates. A sample size of 686 oocytes in each group for a total of 1372 oocytes will provide 80% power to detect a significant difference in the euploidy rates per mature oocyte between the two groups. An ancillary study examining the relationship between sperm processing method and sperm DNA fragmentation will be assessed.

CONCLUSION

This study will offer insight into the sperm's contribution to embryo euploidy, and has the potential to provide an alternative method of improving euploidy rates in clinical practice.

摘要

背景

在体外受精(IVF)过程中,精子在授精前必须经过处理。虽然最常见的方法——密度梯度离心法——在离心过程中可能会损伤精子,但最近的精子处理技术进步使用了微流控系统,该系统可选择最具活力的精子。通过选择这些可能质量更高的精子,由此产生的胚胎的非整倍体率也可能得到改善。这项研究的主要目的是比较通过微流控分选或密度梯度离心处理的精子处理的同胞卵母细胞所产生的胚胎的每个成熟卵母细胞的非整倍体率。

方法

这是一项双盲前瞻性随机同胞卵母细胞研究,包括接受体外受精-胞浆内单精子注射(ICSI)和植入前遗传学检测(PGT)治疗的患者。在控制性卵巢过度刺激后,将从每位患者中分离出的卵母细胞分为两组。每组将随机分为使用微流控或密度梯度离心处理精子的两组,并对胚胎进行活检以进行 PGT,以评估非整倍体率。每组 686 个卵母细胞的样本量(共 1372 个卵母细胞)将提供 80%的功效来检测两组之间每个成熟卵母细胞的非整倍体率的显著差异。还将评估一项辅助研究,该研究检查精子处理方法与精子 DNA 碎片化之间的关系。

结论

这项研究将深入了解精子对胚胎非整倍体的贡献,并有可能为提高临床实践中的非整倍体率提供一种替代方法。

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