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对于只有一个优质囊胚的患者,建议进行 PGT-A 检测吗?2064 个周期的结果。

What to advise to patients with only one good quality blastocyst, PGT-A or not? Outcomes of 2064 cycles.

机构信息

ART and Reproductive Genetics Center, Istanbul Memorial Hospital, Piyalepasa Bulvari, Sisli, 34384, Istanbul, Turkey.

Faculty of Medicine, Department of Histology and Embryology, Biruni University, Istanbul, Turkey.

出版信息

J Assist Reprod Genet. 2022 Nov;39(11):2555-2562. doi: 10.1007/s10815-022-02617-7. Epub 2022 Sep 20.

Abstract

PURPOSE

To evaluate whether preimplantation genetic testing for aneuploidy (PGT-A) is beneficial for patients who have only one blastocyst available for biopsy or transfer.

METHODS

This retrospective study was based on 1126 single blastocyst PGT-A and 938 non-PGT-A cycles, a total of 2064 ART cycles which resulted in a single good quality blastocyst in women between 20 and 45 years old. The PGT-A group had 225 single euploid embryo transfer cycles and the non-PGT-A group had 938 single blastocyst embryo transfer cycles.

RESULTS

In the generalized linear mixed model (GLMM), female age and PGT-A variables were found to be significant variables on pregnancy outcomes. In the PGT-A cases, regardless of the effect of other variables, the probabilities of clinical pregnancy and live birth were found to be 3.907 and 3.448 fold higher respectively than in the non-PGT-A cases (p < 0.001). In non PGT-A cases, the probability of a total pregnancy loss was found to be 1.943 fold higher (p = 0.013).

CONCLUSION

PGT-A in the presence of a single blastocyst significantly increases clinical pregnancy and live birth rates and decreases total pregnancy losses regardless of age. In addition, aneuploid embryo transfer cancelations prevent ineffective and potentially risky transfers.

摘要

目的

评估对于仅获得一个可用于活检或移植的囊胚的患者,进行胚胎植入前遗传学检测(PGT-A)是否有益。

方法

本回顾性研究基于 1126 个单囊胚 PGT-A 和 938 个非 PGT-A 周期,共有 2064 个接受辅助生殖技术(ART)的周期,这些周期使 20-45 岁的女性获得了一个优质的单囊胚。PGT-A 组有 225 个单倍体胚胎移植周期,非 PGT-A 组有 938 个单囊胚胚胎移植周期。

结果

在广义线性混合模型(GLMM)中,女性年龄和 PGT-A 变量被发现是妊娠结局的显著变量。在 PGT-A 病例中,无论其他变量的影响如何,临床妊娠和活产的概率分别比非 PGT-A 病例高 3.907 倍和 3.448 倍(p<0.001)。在非 PGT-A 病例中,总妊娠丢失的概率高 1.943 倍(p=0.013)。

结论

无论年龄如何,单囊胚存在 PGT-A 可显著提高临床妊娠和活产率,降低总妊娠丢失率。此外,非整倍体胚胎移植取消可防止无效和潜在危险的移植。

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