Retrospective Cohort Study of Preimplantation Genetic Testing for Aneuploidy with Comprehensive Chromosome Screening versus Nonpreimplantation Genetic Testing in Normal Karyotype,Secondary Infertility Patients with Recurrent Pregnancy Loss  

作　　者：Cai-Xia Lei Jiang-Feng Ye Yi-Lun Sui Yue-Ping Zhang Xiao-Xi Sun 

机构地区：[1]Department of Genetics,Shanghai Ji Ai Genetics and IVF Institute,Obstetrics and Gynecology Hospital of Fudan University,Shanghai 200011,China [2]Department of Clinical Epidemiology Research,Obstetrics and Gynecology Hospital of Fudan University,Shanghai 200011,China [3]Key Laboratory of Female Reproductive Endocrine Related Diseases,Obstetrics and Gynecology Hospital of Fudan University,Shanghai 200011,China

出　　处：《Reproductive and Developmental Medicine》2019年第4期205-212,共8页生殖与发育医学（英文版）

基　　金：This study was supported by Shanghai Municipal Commission of Health and Family Planning Project(No.201640365);Shanghai Shen Kang Hospital Development Center Municipal Hospital New Frontier Technology Joint Project(SHDC12017105).

摘　　要：Objective:To evaluate whether preimplantation genetic testing for aneuploidy(PGT-A)with comprehensive chromosome screening increases live birth rate(LBR)in normal karyotype couples with recurrent pregnancy loss(RPL).Methods:A retrospective cohort follow-up study of 506 couples with RPL was conducted between April 2014 and March 2017.Couples were allocated to two groups according to their decision to choose PGT-A or not.The primary outcome was LBR per start/transfer cycle;secondary outcomes were ongoing pregnancy rate and miscarriage rate.Statistical analyses were conducted using univariate and multivariate logistic regression models adjusted for maternal age.Results:LBR per start(26.6%vs.15.4%,relative risk[RR]:2.66,95%confidence interval[CI][1.69-4.20],P<0.0001;adjusted RR[aRR]:2.40,95%CI[1.49-3.86],P=0.0004)and per transfer(44.9%vs.25.1%,RR:3.00,95%CI[1.96-4.60],P<0.0001;aRR:2.64,95%CI[1.68-4.14],P<0.0001)was significantly higher in the PGT-A group than in the non-PGT-A group.The miscarriage rate was significantly lower in the PGT-A group compared to the non-PGT-A group(15.7%vs.34.6%,RR:0.27,95%CI[0.13-0.57],P=0.00005;aRR:0.26,95%CI[0.12-0.57],P=0.0007).Conclusions:LBR per start cycle following PGT-A is significantly higher,and risk of miscarriage is significantly lower among infertile couples with RPL,irrespective of maternal age.PGT-A should be recommended to infertile couples with RPL.

关 键 词：Comprehensive Chromosome Screening Preimplantation Genetic Testing for Aneuploidy Recurrent Pregnancy Loss 

分 类 号：R73[医药卫生—肿瘤]