人冷冻胚胎单胚胎卵裂球活检对辅助生殖结局的影响。

TEffect of Single Embryo Blastomere Biopsy from Human Frozen Embryos on Assisted Reproductive Outcomes.

作者信息

Aghajani Shahrzad, Salehzadeh Ali, Ghasemian Fatemeh, Mehrafza Marziyeh, Hosseini Ahmad

机构信息

Department of Biology, Rasht Branch, Islamic Azad University, Rasht, Iran.

Department of Biology, Faculty of Science, University of Guilan, Rasht, Iran.

出版信息

Cell J. 2022 Oct 1;24(10):628-636. doi: 10.22074/cellj.2022.8328.

DOI:10.22074/cellj.2022.8328

PMID:36259481

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9617026/

Abstract

OBJECTIVE

Preimplantation genetic testing for aneuploidies (PGT-A) is used to determine chromosomal normality and achieve a successful live birth in infertile couples. There is a possible correlation between chromosomal aneuploidy, embryo development and pregnancy rate. This study evaluated the influence of single blastomere biopsy (SBB) on embryo development and pregnancy rates during frozen embryo transfer (FET) and fresh cycles.

MATERIALS AND METHODS

This quasi-experimental study evaluated 115 intracytoplasmic sperm injection (ICSI) cycles, including 443 embryos (6-8 cells) with a grade A on day three, following PGT-A in the fresh or FET cycles from February 2018 to June 2020. In addition, the fresh cycles without PGT were included as a control group (n=166 embryos). SBB was done on day three and was grouped as FET-PGT (n=149) and the fresh-PGT (n=128).

RESULTS

There is a more aneuploidy rate in the FET-PGT group compared to the fresh-PGT cycle (36.60% vs. 20.38%, P<0.001). There is a rate of higher development and blastocyst in the control group. While the embryos of PGT groups showed higher degrees of expansion (expansion 5) on day five. 8.6, 8.59, and 9.37% of expansion 3, 4, and 5 in the fresh-PGT embryos, 12.58, 2.78, and 14.84% of expansion 3, 4, and 5 in the FET-PGD embryos compared to 10.84and 33.73% of expansion 3 and 4 in the control group (without expansion 5; P<0.001). There was no significant relationship between 13, 18, and 21 chromosome aneuploidies with blastocyst development competence among the groups (P<0.1). Following embryo transfer (n=97), the spontaneous abortion rate was higher in the FET-PGT cycles compared to the fresh-PGT and control groups (50 vs. 22 and 11%, respectively; P<0.04).

CONCLUSION

The process of SBB following vitrification significantly decreased embryo development and pregnancy outcomes. Therefore, a morphological analysis could not be reliable in selecting chromosomally normal embryos.

摘要

目的

植入前非整倍体基因检测（PGT-A）用于确定染色体正常性，并帮助不孕夫妇成功实现活产。染色体非整倍体、胚胎发育和妊娠率之间可能存在关联。本研究评估了单卵裂球活检（SBB）对冷冻胚胎移植（FET）和新鲜周期中胚胎发育及妊娠率的影响。

材料与方法

这项准实验研究评估了115个卵胞浆内单精子注射（ICSI）周期，包括2018年2月至2020年6月在新鲜周期或FET周期中进行PGT-A后第三天评级为A级的443个胚胎（6-8细胞）。此外，将未进行PGT的新鲜周期作为对照组（n = 166个胚胎）。第三天进行SBB，并分为FET-PGT组（n = 149）和新鲜-PGT组（n = 128）。

结果

与新鲜-PGT周期相比，FET-PGT组的非整倍体率更高（36.60%对20.38%，P<0.001）。对照组的发育率和囊胚率更高。而PGT组的胚胎在第五天显示出更高程度的扩张（扩张5级）。新鲜-PGT胚胎中扩张3级、4级和5级分别为8.6%、8.59%和9.37%，FET-PGD胚胎中扩张3级、4级和5级分别为12.58%、2.78%和14.84%，相比之下对照组中扩张3级和4级分别为10.84%和33.73%（无扩张5级；P<0.001）。各组中13、18和21号染色体非整倍体与囊胚发育能力之间无显著关系（P<0.1）。胚胎移植后（n = 97），FET-PGT周期的自然流产率高于新鲜-PGT组和对照组（分别为50%对22%和11%；P<0.04）。