评估囊胚形态学分级的非整倍体植入前基因检测对新鲜和冷冻供体卵母细胞冷冻胚胎移植活产率的影响。
Assessing the impact of both preimplantation genetic testing for aneuploidy with blastocyst morphologic grade on live birth rates in frozen embryo transfers from fresh and frozen donor oocytes.
作者信息
Dennis Alyson, Jain Nirali, Clarke Emily Auran, Blakemore Jennifer K
机构信息
New York University Grossman School of Medicine, 500 1st Avenue, New York, NY, 10016, USA.
New York University Langone Fertility Center, 159 E 53rd Street, 3rd Floor, New York, NY, 10022, USA.
出版信息
Arch Gynecol Obstet. 2025 Mar;311(3):819-826. doi: 10.1007/s00404-024-07876-6. Epub 2025 Feb 13.
PURPOSE
To evaluate the live birth rate (LBR) following donor frozen embryo transfer (dFET) of preimplantation genetic testing for aneuploidy (PGT-A) versus untested donor embryos, stratified by blastocyst morphologic grade (MG).
METHODS
This was a retrospective cohort study of 146 patients undergoing dFET of a single euploid blastocyst from fresh or frozen oocytes using PGT-A compared to age-matched controls (1:1 ratio) who did not use PGT-A. Primary outcome was LBR. LBR was compared among cohorts, with further stratification by (1) high/low MG and (2) fresh/frozen oocyte status. Secondary outcomes included perinatal outcomes.
RESULT(S): Median age in both groups was 44.5 years (p = 0.98). LBR was similar among the two cohorts (PGT-A: 57.5% vs. untested: 50.0%, p = 0.20). There was similar LBR in fresh (PGT-A: 59.2% vs. untested: 50.0%, p = 0.20) and frozen (PGT-A: 47.6% vs. untested: 50.0%, p = 0.85) oocyte subgroups. When stratified by MG, we appreciated similar LBR among high-quality blastocysts (PGT-A-high: 56.5% vs. untested-high: 52.3%, p = 0.49) among the whole cohort, as well as in fresh (fresh-PGT-A-high: 58.3% vs. fresh-untested-high: 52.9%, p = 0.46) and frozen (frozen-PGT-A-high: 44.4% vs. frozen-untested-high: 51.7%, p = 0.59) subgroups. Similarly, we appreciated no difference in LBR among low-quality blastocysts (PGT-A-low: 75.0% vs. untested-low: 31.2%, p = 0.08) among the whole cohort, as well as in the fresh (fresh-PGT-A-low: 80.0% vs. fresh-untested-low: 16.1%, p = 0.08) or frozen (frozen-PGT-A-low: 66.7% vs. frozen-untested-low: 40.0%, p = 0.56) subgroups. Gestational age (37.8 weeks, p = 1.0) and infant birth weight (PGT-A: 3128.0 g vs. untested: 3150.2 g, p = 0.60) were similar.
CONCLUSION(S): Though limited by the small number of MG blastocysts, overall PGT-A did not improve LBR regardless of blastocyst quality from fresh and previously frozen donor oocytes.
CAPSULE
Use of PGT-A did not improve live birth rate regardless of blastocyst quality from both fresh and previously frozen donor oocytes.
目的
评估经非整倍体植入前基因检测（PGT-A）的供体冷冻胚胎移植（dFET）与未经检测的供体胚胎移植后的活产率（LBR），并按囊胚形态学等级（MG）进行分层。
方法
这是一项回顾性队列研究，对146例使用PGT-A从新鲜或冷冻卵母细胞中获取单个整倍体囊胚进行dFET的患者，与未使用PGT-A的年龄匹配对照组（1:1比例）进行比较。主要结局是LBR。对各队列的LBR进行比较，并进一步按以下因素分层：（1）高/低MG；（2）新鲜/冷冻卵母细胞状态。次要结局包括围产期结局。
结果
两组的中位年龄均为44.5岁（p = 0.98）。两个队列的LBR相似（PGT-A组：57.5% vs. 未检测组：50.0%，p = 0.20）。新鲜（PGT-A组：59.2% vs. 未检测组：50.0%，p = 0.20）和冷冻（PGT-A组：47.6% vs. 未检测组：50.0%，p = 0.85）卵母细胞亚组的LBR相似。按MG分层时，我们发现在整个队列中，高质量囊胚的LBR相似（PGT-A-高等级组：56.5% vs. 未检测-高等级组：52.3%，p = 0.49），在新鲜（新鲜-PGT-A-高等级组：58.3% vs. 新鲜-未检测-高等级组：52.9%，p = 0.46）和冷冻（冷冻-PGT-A-高等级组：44.4% vs. 冷冻-未检测-高等级组：51.7%，p = 0.59）亚组中也是如此。同样，我们发现在整个队列中，低质量囊胚的LBR没有差异（PGT-A-低等级组：75.0% vs. 未检测-低等级组：31.2%，p = 0.08），在新鲜（新鲜-PGT-A-低等级组：80.0% vs. 新鲜-未检测-低等级组：16.1%，p = 0.08）或冷冻（冷冻-PGT-A-低等级组：66.7% vs. 冷冻-未检测-低等级组：40.0%，p = 0.56）亚组中也是如此。孕周（37.8周，p = 1.0）和婴儿出生体重（PGT-A组：3128.0 g vs. 未检测组：3150.2 g，p = 0.60）相似。
结论
尽管受MG囊胚数量较少的限制，但总体而言，无论新鲜和先前冷冻供体卵母细胞的囊胚质量如何，PGT-A均未提高LBR。
总结
无论新鲜和先前冷冻供体卵母细胞的囊胚质量如何，使用PGT-A均未提高活产率。
Zotero 插件