Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, Shandong, China.
Medical Integration and Practice Center, Shandong University, Jinan, Shandong, China.
Front Endocrinol (Lausanne). 2024 Nov 6;15:1453083. doi: 10.3389/fendo.2024.1453083. eCollection 2024.
The safety and clinical effectiveness of preimplantation genetic testing for aneuploidy (PGT-A) in improving pregnancy outcomes for sub-fertile patients remains controversial. Potential sex-based differences in the relationship between PGT-A and pregnancy complications have not been investigated, which could guide the appropriate clinical application of PGT-A. In this secondary analysis of data from a multicenter, randomized, controlled, non-inferiority trial (NCT03118141), 940 women who achieved singleton live birth during the trial were included to estimate the between-group differences in pregnancy complications following PGT-A versus conventional fertilization (IVF) vary with fetal sex. Logistic regression analysis was used to adjust for possible confounders, and subgroup analysis was also performed. Among male fetuses, the risk of maternal preeclampsia was significantly lower after PGT-A compared to conventional IVF treatment (3.37% vs. 7.88%; adjusted OR, 0.40; 95% CI, 0.17-0.92; = 0.032). However, this protective effect was not observed in pregnancies with female fetuses (3.63% vs. 3.38%; adjusted OR, 1.04; 95% CI, 0.36-3.00; = 0.937). In addition, no significant sex-dependent differences in the risks of other pregnancy complications or neonatal outcomes were detected between PGT-A and conventional IVF groups ( > 0.05). In summary, PGT-A was associated with a decreased risk of maternal preeclampsia in singleton pregnancies with male fetuses, highlighting its potential utility in preeclampsia prevention in addition to spontaneous abortion rate reduction.
胚胎植入前遗传学检测非整倍体（PGT-A）在提高不孕患者妊娠结局方面的安全性和临床有效性仍存在争议。尚未研究 PGT-A 与妊娠并发症之间的潜在性别差异，这可能有助于指导 PGT-A 的临床应用。在这项多中心、随机、对照、非劣效性试验（NCT03118141）的二次分析中，纳入了 940 名在试验中实现单胎活产的女性，以估计 PGT-A 与传统体外受精（IVF）相比，妊娠并发症的组间差异是否随胎儿性别而变化。使用逻辑回归分析调整可能的混杂因素，并进行亚组分析。在男性胎儿中，PGT-A 后子痫前期的风险明显低于传统 IVF 治疗（3.37% vs. 7.88%；调整后的 OR，0.40；95%CI，0.17-0.92； = 0.032）。然而，在女性胎儿妊娠中未观察到这种保护作用（3.63% vs. 3.38%；调整后的 OR，1.04；95%CI，0.36-3.00； = 0.937）。此外，在 PGT-A 与传统 IVF 组之间，未检测到其他妊娠并发症或新生儿结局的风险存在显著的性别依赖性差异（ > 0.05）。总之，PGT-A 与男性胎儿单胎妊娠中子痫前期的风险降低相关，这突出了其在降低自发流产率之外预防子痫前期的潜在效用。
