Li Xiaolan, Li Qian, Chang Yajie, He Shujing, Wang Yanfang, Liang Xiaoyan, Zhang Zhiqiang
Reproductive Medicine Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, People's Republic of China.
Guangdong Engineering Technology Research Center of Fertility Preservation, Guangzhou, 510655, China.
Sci Rep. 2025 Jul 10;15(1):24904. doi: 10.1038/s41598-025-10300-x.
While extensive research has compared ICSI and c-IVF in general ART outcomes, limited evidence exists regarding their relative efficacy and safety in PGT-A cycles. Therefore, we conducted a large retrospective cohort study to evaluate the effect of conventional in vitro fertilization (c-IVF) on the outcomes of preimplantation genetic testing for aneuploidy (PGT-A) in couples with non-male factor infertility. We conducted a large retrospective cohort study including 578 PGT-A cycles with c-IVF performed on couples with non-male factor infertility at our center between January 2019 and October 2024. To control for confounding factors, 578 PGT-A cycles with ICSI during the same period were selected as a control group. Matching was based on maternal age (± 2 years), number of oocytes retrieved (± 3), and progressive motile sperm count (± 3 × 10). The primary outcome was PGT-A results, while secondary outcomes included the 2PN fertilization rate, blastocyst available for biopsy per 2PN zygote and blastocyst available for biopsy per oocyte retrieved. Baseline characteristics, including parental age, AMH, antral follicle count (AFC), BMI, progressive motile sperm count, and PGT indications, were comparable between groups. Although the 2PN fertilization rate was significantly higher in the ICSI-PGT-A group (65.88% vs. 78.46%, P < 0.001), the 2 PN fertilization rate per retrieved oocyte (65.88% vs. 60.48%, P < 0.001), transferable embryo rate on day 3 (76.67% vs. 74.38%, P = 0.029), blastocyst formation rate per 2PN zygote (51.54% vs. 48.32%, P = 0.008), blastocyst available for biopsy per 2PN zygote (35.60% vs. 29.46%, P < 0.001), and blastocyst available for biopsy per oocyte retrieved (23.45% vs. 17.82%, P < 0.001) were significantly lower in the ICSI-PGT-A group. PGT-A results from 1,268 biopsy samples in the c-IVF group and 936 samples in the ICSI group revealed no significant differences in chromosomal euploidy, aneuploidy, mosaicism, or "No-call" rates. However, after controlling the potential confounders, c-IVF demonstrated significantly higher euploid embryo rate compared to ICSI (adjusted RR = 1.611, 95% CI 1.228-2.114, P = 0.001). Patterns of chromosomal aberrations were similar between groups, with chromosomes 15, 16, 21, and 22 showing the highest frequencies of abnormalities. Notably, no parental contamination was detected in the c-IVF group, while one case of maternal contamination was reported in the ICSI group. Our data suggested c-IVF could improve PGT-A outcomes in couples with non-male factor infertility and exhibited a low risk of parental contamination. c-IVF-PGT-A represents a safe, effective, and cost-efficient strategy for these couples.
虽然广泛的研究比较了ICSI和常规体外受精（c-IVF）在一般辅助生殖技术（ART）中的结局，但关于它们在植入前非整倍体基因检测（PGT-A）周期中的相对疗效和安全性的证据有限。因此，我们进行了一项大型回顾性队列研究，以评估常规体外受精（c-IVF）对非男性因素不孕夫妇植入前非整倍体基因检测（PGT-A）结局的影响。我们进行了一项大型回顾性队列研究，纳入了2019年1月至2024年10月在我们中心对非男性因素不孕夫妇进行的578个c-IVF的PGT-A周期。为了控制混杂因素，选择同期578个ICSI的PGT-A周期作为对照组。匹配基于产妇年龄（±2岁）、取卵数（±3个）和进行性活动精子计数（±3×10）。主要结局是PGT-A结果，次要结局包括2PN受精率、每2PN受精卵可用于活检的囊胚以及每取卵数可用于活检的囊胚。两组间的基线特征，包括父母年龄、抗苗勒管激素（AMH）、窦卵泡计数（AFC）、体重指数（BMI）、进行性活动精子计数和PGT指征，具有可比性。虽然ICSI-PGT-A组的2PN受精率显著更高（65.88%对78.46%，P<0.001），但每取卵数的2PN受精率（65.88%对60.48%，P<0.001）、第3天可移植胚胎率（76.67%对74.38%，P=0.029）、每2PN受精卵的囊胚形成率（51.54%对48.32%，P=0.008）、每2PN受精卵可用于活检的囊胚（35.60%对29.46%，P<0.001）以及每取卵数可用于活检的囊胚（23.
