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控制性卵巢超刺激参数与植入前遗传学检测中的染色体异常率和临床妊娠结局无关。

Controlled ovarian hyperstimulation parameters are not associated with chromosomal abnormality rates and clinical pregnancy outcomes in preimplantation genetic testing.

机构信息

The Reproduction Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Office of Scientific Research, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

出版信息

Front Endocrinol (Lausanne). 2023 Jan 12;13:1080843. doi: 10.3389/fendo.2022.1080843. eCollection 2022.

Abstract

OBJECTIVE

This study aimed to determine whether controlled ovarian hyperstimulation (COH) parameters influence the incidence of chromosomal abnormalities (> 4 Mb) in blastocysts and, thus, clinical pregnancy outcomes in preimplantation genetic testing (PGT).

METHODS

Couples who underwent preimplantation genetic testing for structural chromosome rearrangements (PGT-SR) and monogenic disorders (PGT-M) were included in this study. The relationships of maternal age, paternal age, stimulation protocol, exogenous gonadotropin dosage, duration of stimulation, number of oocytes retrieved and estradiol (E) levels on human chorionic gonadotropin (hCG) trigger day with the incidence of chromosomal abnormalities were assessed. Blastocysts were biopsied, and nuclear DNA was sequenced using next-generation sequencing (NGS). Clinical pregnancy outcomes after single euploid blastocyst transfers under different COH parameters were assessed.

RESULTS

A total of 1,710 and 190 blastocysts were biopsied for PGT-SR and PGT-M, respectively. The rate of chromosomal abnormalities was found to increase with maternal age ( 0.001) and paternal age ( = 0.019) in the PGT-SR group. No significant differences in the incidence of chromosomal abnormalities were seen for different maternal or paternal age groups between the PGT-SR and PGT-M groups ( > 0.05). Stratification analysis by gonadotropin dosage, stimulation protocol, duration of stimulation, number of retrieved oocytes and E levels on hCG trigger day revealed that chromosomal abnormalities and clinical pregnancy outcomes were not correlated with COH parameters after adjusting for various confounding factors.

CONCLUSION

The rate of chromosomal abnormalities was found to increase with maternal or paternal age. COH parameters were found to not influence the incidence of chromosomal abnormalities or clinical pregnancy outcomes.

摘要

目的

本研究旨在确定控制性卵巢超刺激(COH)参数是否会影响囊胚中染色体异常(>4Mb)的发生率,并由此影响胚胎植入前遗传学检测(PGT)的临床妊娠结局。

方法

本研究纳入了接受结构染色体重排(PGT-SR)和单基因疾病(PGT-M)胚胎植入前遗传学检测的夫妇。评估了母体年龄、父体年龄、刺激方案、外源性促性腺激素剂量、刺激持续时间、获卵数和人绒毛膜促性腺激素(hCG)扳机日雌二醇(E)水平与染色体异常发生率的关系。对囊胚进行活检,并使用下一代测序(NGS)对核 DNA 进行测序。评估了不同 COH 参数下单一整倍体囊胚移植后的临床妊娠结局。

结果

共对 1710 个和 190 个囊胚进行了 PGT-SR 和 PGT-M 的活检。PGT-SR 组中,染色体异常率随母体年龄(<0.001)和父体年龄(=0.019)的增加而增加。PGT-SR 和 PGT-M 组之间,不同母体或父体年龄组的染色体异常发生率无显著差异(>0.05)。通过促性腺激素剂量、刺激方案、刺激持续时间、获卵数和 hCG 扳机日 E 水平的分层分析,在调整了各种混杂因素后,发现染色体异常和临床妊娠结局与 COH 参数无关。

结论

染色体异常率随母体或父体年龄的增加而增加。COH 参数与染色体异常发生率或临床妊娠结局无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d59/9877337/a0cb1905d094/fendo-13-1080843-g001.jpg

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