He Tingting, Shi Wenhao, Xue Xia, Shi Juanzi
Assisted Reproduction Center, Northwest Women's and Children's Hospital, No. 73 Houzai Gate, Xincheng District, Xi'an, 710003, Shaanxi province, People's Republic of China.
BMC Pregnancy Childbirth. 2025 Jan 27;25(1):74. doi: 10.1186/s12884-024-07107-5.
Up to now, a number of studies have explored the influence of blastocyst biopsy on maternal and neonatal outcomes, and the results have been somewhat inconsistent. Therefore, the aim of this study was to investigate whether blastocyst biopsy is associated with an elevated risk of hypertensive disorders of pregnancy (HDP) and other adverse perinatal outcomes during frozen embryo transfer (FET) cycles in singleton live births resulting from intracytoplasmic sperm injection (ICSI) in women aged ≤ 35 years.
A total of 1,008 women were involved in this study from January 2020 to June 2022, who underwent ICSI cycles and received single FET, leading to the birth of a live singleton newborn. The study population were categorized into two groups: the preimplantation genetic testing (PGT) group, comprising 269 women whose blastocysts underwent trophectoderm biopsy, and the control group, consisting of 739 women whose blastocysts did not undergo biopsy. The primary outcome assessed in this study was HDP. Additionally, various relevant perinatal outcomes related to both maternal and neonatal health were also evaluated.
In comparison to the control group, notable disparities were observed between the groups in relation to infertility duration, EMT, infertility type, infertility cause and endometrial preparation protocol (P < 0.05, for all). The percentage of female gender significantly increased in the PGT group in comparison with the control group (P < 0.05). However, the risk of HDP, other maternal and neonatal outcomes exhibited comparable results between the two groups (P > 0.05, for all). Moreover, univariate regression analyses further revealed that PGT had no influence on maternal and neonatal outcomes, except for gender (aOR 1.44; 95% CI, 1.03-2.01; P = 0.031).
In the short-term perspective, it could be inferred that blastocyst biopsy may not increase the risks associated with HDP or other unfavorable maternal and neonatal outcomes. However, despite the limited sample size, our findings may not be applicable to those aged 35 or over; therefore, larger cohort studies are imperative for the validation of our results.
到目前为止，许多研究探讨了囊胚活检对孕产妇和新生儿结局的影响，结果有些不一致。因此，本研究的目的是调查在年龄≤35岁的女性中，通过胞浆内单精子注射（ICSI）进行单胎活产的冷冻胚胎移植（FET）周期中，囊胚活检是否与妊娠高血压疾病（HDP）风险升高及其他不良围产期结局相关。
2020年1月至2022年6月，共有1008名女性参与本研究，她们接受了ICSI周期并进行了单胎FET，最终分娩出单胎活产新生儿。研究人群分为两组：植入前基因检测（PGT）组，包括269名其囊胚接受了滋养外胚层活检的女性；对照组，由739名其囊胚未接受活检的女性组成。本研究评估的主要结局是HDP。此外，还评估了与孕产妇和新生儿健康相关的各种围产期结局。
与对照组相比，两组在不孕持续时间、子宫内膜厚度（EMT）、不孕类型、不孕原因和子宫内膜准备方案方面存在显著差异（均P<0.05）。与对照组相比，PGT组女性性别比例显著增加（P<0.05）。然而，两组在HDP风险、其他孕产妇和新生儿结局方面结果相当（均P>0.05）。此外，单因素回归分析进一步显示，PGT除了对性别有影响外（调整后比值比[aOR]为1.44；95%置信区间[CI]为1.03-2.01；P=0.031），对孕产妇和新生儿结局没有影响。
从短期来看，可以推断囊胚活检可能不会增加HDP或其他不良孕产妇和新生儿结局的风险。然而，尽管样本量有限，我们的研究结果可能不适用于35岁及以上人群；因此，需要更大规模的队列研究来验证我们的结果。
