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    袁牧, 张荣荣, 宋雪梅, 袁振亚, 朱彤, 李玉雯, 蔡迁, 黄晓洁, 柏明珠, 张箴波, 丰有吉. PGT-A技术在反复妊娠丢失和高龄人群辅助生殖治疗中的应用[J]. 徐州医科大学学报, 2022, 42(11): 833-838. DOI: 10.3969/j.issn.2096-3882.2022.11.010
    引用本文: 袁牧, 张荣荣, 宋雪梅, 袁振亚, 朱彤, 李玉雯, 蔡迁, 黄晓洁, 柏明珠, 张箴波, 丰有吉. PGT-A技术在反复妊娠丢失和高龄人群辅助生殖治疗中的应用[J]. 徐州医科大学学报, 2022, 42(11): 833-838. DOI: 10.3969/j.issn.2096-3882.2022.11.010
    shu
    Application of PGT-A in assisted reproductive therapy for patients with recurrent pregnancy loss or advanced maternal age[J]. Journal of Xuzhou Medical University, 2022, 42(11): 833-838. DOI: 10.3969/j.issn.2096-3882.2022.11.010
    Citation: Application of PGT-A in assisted reproductive therapy for patients with recurrent pregnancy loss or advanced maternal age[J]. Journal of Xuzhou Medical University, 2022, 42(11): 833-838. DOI: 10.3969/j.issn.2096-3882.2022.11.010
    shu

    PGT-A技术在反复妊娠丢失和高龄人群辅助生殖治疗中的应用

    Application of PGT-A in assisted reproductive therapy for patients with recurrent pregnancy loss or advanced maternal age

      摘要
    • 摘要: 目的：探讨胚胎植入前遗传学非整倍体检测(PGT-A)技术是否能改善反复妊娠丢失(RPL)或高龄患者的IVF妊娠结局。方法： 回顾性分析2019年1月至2021年1月在徐州妇幼保健院辅助生殖中心行PGT-A检测的RPL和高龄（≥35岁）患者。通过PGT-A技术检测RPL和高龄患者囊胚染色体非整倍体情况，选择单个整倍体囊胚进行解冻移植后比较各组人群的妊娠结局。结果： RPL和高龄患者囊胚非整倍体率分别为42.5%和62.8%。本研究共纳入RPL PGT-A单囊胚移植周期52个，RPL对照组23个；高龄PGT-A单囊胚移植周期50个及高龄对照组381个。分析后发现RPL PGT-A组与对照组相比，胚胎种植率、生化妊娠率、临床妊娠率、持续妊娠率及临床流产率均无统计学差异(P>0.05)，但RPL PGT-A组的持续妊娠率有降低趋势。以35岁为分界行年龄分层后两组妊娠结局仍无统计学差异。高龄PGT-A组与对照组相比，胚胎种植率（66.0% vs. 44.6%）、生化妊娠率（66.0% vs. 48.8%）、临床妊娠率（66.0% vs. 44.6%）、持续妊娠率（58.0% vs. 34.9%）均明显升高 (P＜0.05)。以40岁为分界进行年龄分层后发现随着年龄增加，PGT-A技术对IVF妊娠率的改善作用更为明显，且PGT-A技术在一定程度上能降低高龄患者的流产率（12.1% vs. 22.9% ）。结论： PGT-A技术可避免染色体非整倍体的囊胚植入，改善高龄患者IVF妊娠结局，但对RPL患者IVF妊娠结局无改善。

       

      Abstract: obective: To investigate whether preimplantation genetic testing for aneuploidy ( PGT-A) improves IVF pregnancy outcomes for patients with recurrent pregnancy loss (RPL) or advanced maternal age. Methods: This study retrospectively analyzed patients with RPL or advanced maternal age ( ≥ 35 years old) who underwent PGT-A in the assisted reproduction center of Xuzhou maternal and child health hospital from January 2019 to January 2021. The pregnancy outcomes of each group were compared after single euploid blastocyst transfer. Results: The rates of blastocyst aneuploidy in patients with RPL or advanced maternal age were 42.5% and 62.8%, respectively. This study included PGT-A cycles in IVF patients with RPL ( n=52), those with advanced maternal age ( n=50), non-PGT-A cycles in patients with RPL (n=23 ) and those with advanced maternal age ( n=381) as control group. It was found that there was no statistical difference in embryo implantation rate, biochemical pregnancy rate, clinical pregnancy rate, ongoing pregnancy rate , and clinical abortion rate between RPL PGT-A group and the control group (P> 0.05). However, the ongoing pregnancy rate of RPL PGT-A group tended to be lower. There was no significant difference in pregnancy outcomes between the two groups after age stratification with the age of 35 as the dividing point. Compared with the control group, the embryo implantation rate (66.0% vs. 44.6%), biochemical pregnancy rate (66.0% vs. 48.8%), clinical pregnancy rate (66.0% vs. 44.6%) and ongoing pregnancy rate (58.0% vs. 34.9%) in the PGT-A group of patients with advanced maternal age were significantly higher (P < 0.05). Moreover, PGT-A had a more obvious effect on the improvement of IVF pregnancy rate with the increase of age and reduce d the abortion rate of patients with advanced maternal age to a certain extent (12.1% vs. 22.9%). Conclusion: PGT-A avoids the aneuploid blastocyst implantation and improves IVF pregnancy outcome in patients with advanced maternal age , with no good effect on that of patients with RPL.

       

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