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在单个整倍体胚胎移植后,临床因素和胚胎学因素与妊娠丢失之间是否存在关联?

Are there associations between clinical and embryological factors with pregnancy loss following transfer of a single euploid embryo?

作者信息

Yuksel Beril, Ozer Gonul, Duzguner Ipek Nur Balin, Akca Aysu, Bio Yesim Kumtepe, Bio Hakan Yelke, Kahraman Semra, Liperis George, Serdarogullari Munevver

机构信息

B Yuksel, Department of ART and Reproductive Genetics, Istanbul Sisli Memorial Hospital, Istanbul, Turkey.

G Ozer, Memorial Sisli Hospital, Istanbul, 34384, Turkey.

出版信息

Reprod Fertil. 2024 Jun 1;5(3). doi: 10.1530/RAF-24-0002.

Abstract

First trimester pregnancy losses are commonly attributed to chromosomal abnormalities. The causes of pregnancy loss following transfer of a euploid embryo are not fully elucidated. The aim of this study was to evaluate clinical and embryological parameters for pregnancy failure following the transfer of a single euploid embryo. Pregnancy outcomes of single euploid embryo transfers from a single centre between January 2017 and March 2020 were retrospectively evaluated. Several clinical and embryological parameters were evaluated in consideration to pregnancy outcomes; total pregnancy loss and live birth. Endometrial preparation type, number of previous frozen embryo transfer cycles, history of recurrent pregnancy loss, higher body mass index, presence of endometriosis and/or adenomyosis and embryo quality were found to be significantly different between two groups. Morphokinetic parameter analysis of 523 euploid embryos using time-lapse imaging did not show any statistical differences between the two groups, however a significantly higher rate of uneven blastomeres in the cleavage stage was observed in the total preganncy loss group. Evaluation of clinical and embryological data can reveal possible factors associated with pregnancy loss that can facilitate improved patient consultation. Feasible interventions can potentially increase the chance of achieving a live birth.

摘要

孕早期流产通常归因于染色体异常。整倍体胚胎移植后流产的原因尚未完全阐明。本研究的目的是评估单个整倍体胚胎移植后妊娠失败的临床和胚胎学参数。回顾性评估了2017年1月至2020年3月期间来自单一中心的单个整倍体胚胎移植的妊娠结局。考虑到妊娠结局,评估了几个临床和胚胎学参数;包括总流产率和活产率。发现两组之间的子宫内膜准备类型、既往冷冻胚胎移植周期数、复发性流产史、较高的体重指数、子宫内膜异位症和/或子宫腺肌病的存在以及胚胎质量存在显著差异。使用延时成像对523个整倍体胚胎进行的形态动力学参数分析在两组之间未显示任何统计学差异,然而在总流产组中观察到卵裂期不均等卵裂球的发生率显著更高。对临床和胚胎学数据的评估可以揭示与流产相关的可能因素,这有助于改善患者咨询。可行的干预措施可能会增加实现活产的机会。

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本文引用的文献

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Can embryo morphokinetic parameters predict euploid pregnancy loss?
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