慢发育囊胚与第 6 天冷冻-解冻周期中无植入前遗传学检测-非整倍体的临床结局比较。

Comparison of Clinical Outcomes in the Slow-Developing Blastocysts With or Without Preimplantation Genetic Testing-Aneuploidy on Day 6 in the Frozen-Thawed Cycle.

机构信息

Fertility Center of CHA Gangnam Medical Center, CHA University of Medicine, Seoul, Korea.

出版信息

J Obstet Gynaecol Can. 2024 Oct;46(10):102644. doi: 10.1016/j.jogc.2024.102644. Epub 2024 Aug 22.

DOI:10.1016/j.jogc.2024.102644

PMID:39179155

Abstract

OBJECTIVES

This study investigated the potential of the slow-developing blastocysts using preimplantation genetic testing-aneuploidy (PGT-A) in patients undergoing frozen-thawed embryo transfer, stratified by age.

METHODS

A retrospective analysis was performed including a total of 743 cycles, the first frozen embryo transfer (FET) cycle with single embryo transfer, who underwent treatment between January 2020 and July 2023 in a single fertility centre, Gangnam CHA Fertility Center. A total of 743 cycles, in which we performed intracellular sperm injection and freeze-all strategy, from 743 patients were included. The patient group was divided into 4 groups as follows: group 1 (G1), 208 FET on day 5; group 2 (G2), 177 FET with PGT-A on day 5; group 3 (G3), 220 FET on day 6; group 4 (G4), 138 FET with PGT-A on day 6. We also divided into 2 groups-under 35 years of age and over 35 years of age-and performed the analysis separately for each group.

RESULTS

In the under 35 years of age group, there were no significant differences in clinical pregnancy and miscarriage rates in G1 and G2 (67.2% vs. 63.8%, not statistically significantly different). Also, G4 had a higher clinical pregnancy rate than G3, but it was not significant (51.8% vs. 54.7%, not statistically significantly different). In the 35 years or older group, G2 had higher pregnancy rates than G1 and lower miscarriage rates (clinical pregnancy rate: 43.3% vs. 67.7%, P = 0.001, miscarriage rate: 22.5% vs. 3.4%, P = 0.001). In addition, G4 had a higher pregnancy rate than G3 and a lower miscarriage rate (clinical pregnancy rate: 31.8% vs. 46.9%, P = 0.003, miscarriage rate: 22.9% vs. 2.2%, P = 0.023).

CONCLUSIONS

In the under-35-year-old group, PGT-A on day 5 and day 6 showed a high pregnancy rate and a low miscarriage rate. Therefore, using PGT-A seems advantageous for patients of an advanced maternal age.

摘要

目的

本研究通过对接受冻融胚胎移植（FET）的患者进行植入前遗传学检测-非整倍体（PGT-A），按年龄分层，探讨发育缓慢的囊胚的潜力。

方法

这是一项回顾性分析，共纳入 743 个周期，均为首次行单胚胎移植的冻融胚胎移植（FET）周期，这些患者于 2020 年 1 月至 2023 年 7 月在一家生育中心——江南 CHA 生育中心接受治疗。共纳入 743 个周期，这些周期均来自 743 名患者，我们对其进行了胞浆内单精子注射和冷冻-全部策略。患者组分为 4 组：第 1 组（G1），5 天的 208 个 FET；第 2 组（G2），5 天的 177 个 PGT-A 的 FET；第 3 组（G3），6 天的 220 个 FET；第 4 组（G4），6 天的 138 个 PGT-A 的 FET。我们还按年龄<35 岁和≥35 岁分为 2 组，并分别对每组进行分析。

结果

在年龄<35 岁的患者中，G1 和 G2 的临床妊娠率和流产率无显著差异（67.2% vs. 63.8%，无统计学差异）。此外，G4 的临床妊娠率高于 G3，但无统计学意义（51.8% vs. 54.7%，无统计学差异）。在年龄≥35 岁的患者中，G2 的妊娠率高于 G1，流产率低于 G1（临床妊娠率：43.3% vs. 67.7%，P=0.001，流产率：22.5% vs. 3.4%，P=0.001）。此外，G4 的妊娠率高于 G3，流产率低于 G3（临床妊娠率：31.8% vs. 46.9%，P=0.003，流产率：22.9% vs. 2.2%，P=0.023）。