高龄与非高龄复发性流产患者行胚胎植入前非整倍体检测的可行性分析  

Feasibility analysis of preimplantation genetic testing for aneuploidies in patients of advanced age and non-advanced age recurrent spontaneous abortion

作　　者：蒲艳[1] 郑爱燕[1] 廖桂芝 偶建 王馥新[1] 王玮[1] 丁洁[1] Pu Yan;Zheng Aiyan;Liao Guizhi;Ou Jian;Wang Fuxin;Wang Wei;Ding Jie(Center of Reproductive and Genetics,Suzhou Municipal Hospital,Suzhou Hospital Affiliated to Nanjing Medical University,Suzhou Jiangsu 215002,P.R.China)

机构地区：[1]南京医科大学附属苏州医院,苏州市立医院生殖与遗传中心,江苏苏州215002

出　　处：《中国计划生育和妇产科》2023年第1期82-87,共6页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的分析高龄及非高龄复发性流产(recurrent spontaneous abortion,RSA)患者行胚胎植入前非整倍体检测(PGT for aneuploidies,PGT-A)后胚胎染色体整倍性以及患者的临床结局,探讨PGT-A在两组患者中的临床应用价值。方法纳入2016年1月至2021年1月在苏州市立医院生殖与遗传中心行PGT-A的高龄组患者(≥38岁,96个活检周期,259枚囊胚)及非高龄RSA组患者(<38岁,99个活检周期,429枚囊胚),所有囊胚均行滋养外胚层活检,采用二代测序技术(NGS)检测,根据不同囊胚发育天数和胚胎质量分析两组患者胚胎染色体的整倍性,比较同时期胚胎冻融移植周期(frozen-thawed embryo transfer,FET)中行PGT-A与未行PGT-A的高龄患者、非高龄RSA患者行PGT-A和未行PGT-A的临床结局。结果高龄患者和非高龄RSA患者D5囊胚的非整倍体率均低于D6囊胚,其中D6非优质囊胚组的非整倍体率最高。FET周期PGT-A高龄组临床妊娠率、种植率和活产率均显著高于未行PGT-A高龄组的患者(P<0.05),而非高龄RSA患者中行PGT-A组与未行PGT-A组临床结局差异无统计学意义(P>0.05)。结论PGT-A技术有助于改善高龄患者的临床结局,对于非高龄RSA患者,应谨慎考虑应用PGT-A技术。Objective To investigate the clinical application value of PGT for aneuploidies(PGT-A)in patients of advanced age and non-advanced age recurrent spontaneous abortion(RSA),the results of embryo chromosome testing and clinical outcomes were analyzed.Methods Patients of advanced age group(≥38 years old,96 biopsy cycles,259 blastocysts)and non-advanced age RSA group(<38 years old,99 biopsy cycles,429 blastocysts)who underwent PGT-A in the Reproductive and Genetic Center of Suzhou Municipal Hospital from January 2016 to Januray 2021 were enrolled.All blastocysts were biopsied by trophoblast ectoderm,and second-generation sequencing(NGS)was used.The euploidy of embryo chromosomes in the two groups was analyzed according to different blastocyst development days and embryo quality,and the clinical outcomes of advanced age patients received or not received PGT-A,non-advanced age RSA patients received or not received PGT-A in embryo freeze-thawing transfer cycle(FET)were compared.Results The aneuploidy rate of D5 blastocysts was lower than that of D6 blastocysts in both advanced age group and non-advanced age RSA group,and the aneuploidy rate of D6 blastocysts with non-high quality was the highest.The clinical pregnancy rate,implant rate and live birth rate of the advanced age group of PGT-A in the FET cycle were significantly higher than those in the advanced age group without PGT-A(P<0.05),while there was no significant difference in non-advanced age RSA patients with or without PGT-A(P>0.05).Conclusion PGT-A technology can improve the clinical outcome of the patients with advanced maternal age,and the application of it for younger RSA patients should be carefully considered.

关 键 词：PGT-A 高龄 复发性流产 临床结局 

分 类 号：R321.3[医药卫生—人体解剖和组织胚胎学]