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比较胚胎植入前遗传学检测非整倍体筛选的卵胞浆内单精子注射和体外受精-胚胎移植的结局:美国生殖医学学会临床结局报告系统数据分析。

Comparison of outcomes between intracytoplasmic sperm injection and in vitro fertilization inseminations with preimplantation genetic testing for aneuploidy, analysis of Society for Assisted Reproductive Technology Clinic Outcome Reporting System data.

机构信息

Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Philadelphia.

NYU Langone Reproductive Specialists of New York, NYU Langone Long Island School of Medicine, Mineola, New York.

出版信息

Fertil Steril. 2024 May;121(5):799-805. doi: 10.1016/j.fertnstert.2023.12.041. Epub 2024 Jan 5.

Abstract

OBJECTIVE

To evaluate whether insemination via intracytoplasmic sperm injection (ICSI) provides any benefit over in vitro fertilization (IVF) insemination for nonmale factor infertility with respect to preimplantation genetic testing (PGT) results and pregnancy outcome.

DESIGN

Retrospective cohort study of the Society for Assisted Reproductive Technology database.

SETTINGS

US-based fertility clinics reporting to the Society for Assisted Reprodcutive Technology.

PATIENTS

Patients undergoing IVF or ICSI inseminations in nonmale factor PGT for aneuploidy cycles.

INTERVENTION

In vitro fertilization vs. ICSI inseminations.

MAIN OUTCOME MEASURES

Primary outcomes were the percentage of embryos suitable for transfer and live birth rates (LBRs). Secondary outcomes included subgroup analysis for embryos suitable for transfer on cycles from patients ≥35-year-old vs. <35-year-old, ≤6 oocytes retrieved vs. >6 oocytes retrieved, and unexplained infertility. Additionally, gestational age at delivery and birth weight between IVF and ICSI inseminations were evaluated.

RESULTS

A total of 30,446 nonmale factor PGT diagnoses for aneuploidy cycles were evaluated, of which 4,867 were IVF inseminations and 25,579 were ICSI inseminations. Following exclusion criteria and adjustment for any necessary confounding variables, no significant differences existed in embryos suitable for transfer between IVF and ICSI treatment cycles, 41.6% (40.6%, 42.6%) vs. 42.5% (42.0%, 42.9%), respectively, or in LBRs, 50.1% (37.8, 62.4%) vs. 50.8% (38.5%, 62.9%), respectively.

CONCLUSION

There were no significant differences in the rates of embryos suitable for transfer and LBRs between IVF and ICSI inseminations in nonmale factor cycles undergoing PGT for aneuploidy.

摘要

目的

评估对于非男性因素不孕患者,在进行胚胎植入前遗传学检测(PGT)时,与体外受精(IVF)授精相比,卵胞浆内单精子注射(ICSI)是否在 PGT 结果和妊娠结局方面具有优势。

设计

回顾性队列研究,对美国生殖辅助技术协会数据库进行分析。

地点

向生殖辅助技术协会报告的美国生育诊所。

患者

在非男性因素 PGT 进行胚胎植入前遗传学检测(PGT)的周期中进行 IVF 或 ICSI 授精的患者。

干预措施

IVF 与 ICSI 授精。

主要观察指标

主要观察指标是适合移植胚胎的百分比和活产率(LBR)。次要观察指标包括对≥35 岁与<35 岁患者、获卵数≤6 与>6 个的周期、不明原因不孕患者的亚组分析。此外,还评估了 IVF 和 ICSI 授精之间的分娩时胎龄和出生体重。

结果

共评估了 30446 例非男性因素 PGT 诊断为非整倍体周期,其中 4867 例为 IVF 授精,25579 例为 ICSI 授精。排除标准并调整任何必要的混杂变量后,IVF 和 ICSI 治疗周期中适合移植胚胎的比例没有显著差异,分别为 41.6%(40.6%,42.6%)和 42.5%(42.0%,42.9%),活产率也没有显著差异,分别为 50.1%(37.8%,62.4%)和 50.8%(38.5%,62.9%)。

结论

在进行胚胎植入前遗传学检测(PGT)的非男性因素周期中,与 IVF 授精相比,ICSI 授精在适合移植胚胎的比例和活产率方面没有显著差异。

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