染色体多态性对受精/胚胎移植辅助生殖临床结局的影响。
The effects of chromosome polymorphism on the clinical outcomes of fertilization/embryo transfer-assisted reproduction.
机构信息
Center of Reproductive Medicine, Children's Hospital of Shanxi and Women Health Center of Shanxi, Taiyuan City, Shanxi Province, China.
Tianjin Central Hospital of Gynecology Obstetrics, Tianjin Key Laboratory of human development and Reproductive Regulation, Tianjin, China.
出版信息
J Matern Fetal Neonatal Med. 2023 Dec;36(2):2238863. doi: 10.1080/14767058.2023.2238863.
OBJECTIVE
To investigate the effects of chromosome polymorphism on the clinical outcomes of fertilization/embryo transfer (IVF/ET)-assisted reproductive technology.
METHODS
The case data of 2740 patients treated between January 2018 and January 2019 were retrospectively analyzed. The patients were organized into two groups: a case group and a control group. In the case group ( = 81), one or both parents were characterized by chromosomal polymorphism; in the control group ( = 2659), both parents had normal chromosome karyotyping. The primary outcomes included clinical pregnancy rate (clinical pregnancy rate of fresh transfer cycles = number of clinical pregnancy cycles/number of fresh embryo transfer cycles × 100%) and live birth rate (live birth rate per fresh transfer cycles = number of live births/numbers of fresh embryo transfer cycles × 100%). The propensity score matching (PSM) method was used for statistical analysis.
RESULTS
After PSM 1:2 matching for the patients in the two groups, 72 patients were successfully matched. The clinical pregnancy rate and live birth rate in the case group were lower than in the control group before PSM (clinical pregnancy rate: 33.30% case group vs. 46.60% control group, = .020; live birth rate: 30.90% case group vs. 47.90% control group, = .03). The differences were statistically significant ( < .05). The live birth rate in the case group was also significantly lower than in the control group after PSM (34.98% case group vs. 74.52% control group; = .028). The correlation coefficient between clinical pregnancy and grouping (i.e. if there was a characteristic chromosome polymorphism) was -.045 ( = .02), while the correlation coefficient between live birth and grouping was -.046.
CONCLUSION
Chromosome polymorphism is weakly negatively correlated with live birth in IVF/ET-assisted reproduction and can significantly reduce the live birth rate of patients.
目的
探讨染色体多态性对体外受精/胚胎移植（IVF/ET）辅助生殖技术临床结局的影响。
方法
回顾性分析 2018 年 1 月至 2019 年 1 月间收治的 2740 例患者的临床资料。将患者分为病例组（81 例，父母一方或双方存在染色体多态性）和对照组（2659 例，父母染色体核型正常）。主要结局包括临床妊娠率（新鲜移植周期临床妊娠率=临床妊娠周期数/新鲜胚胎移植周期数×100%）和活产率（每新鲜移植周期活产率=活产数/新鲜胚胎移植周期数×100%）。采用倾向性评分匹配（PSM）法进行统计学分析。
结果
对两组患者进行 PSM1：2 匹配后，72 例患者成功匹配。匹配前，病例组的临床妊娠率和活产率均低于对照组（临床妊娠率：病例组 33.30%vs.对照组 46.60%， = .020；活产率：病例组 30.90%vs.对照组 47.90%， = .03），差异有统计学意义（ < .05）。匹配后，病例组的活产率仍明显低于对照组（病例组 34.98%vs.对照组 74.52%， = .028）。临床妊娠与分组（即是否存在特征性染色体多态性）的相关系数为-0.045（ = .02），活产与分组的相关系数为-0.046。
结论
染色体多态性与 IVF/ET 辅助生殖中的活产呈弱负相关，可显著降低患者的活产率。
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