冻融胚胎行植入前遗传学检测的安全性与临床结局分析  

The Safety and Clinical Pregnancy Outcome of Preimplantation Genetic Testing in Frozen-Thawed Embryos

作　　者：张笑兰 武恂[1] 曹善仁[1] 张军强[1] 凌秀凤[1] 李秀玲[1] ZHANG Xiao-lan;WU Xun;CAO Shan-ren;ZHANG Jun-qiang;LING Xiu-feng;LI Xiu-ling(Center of Reproductive Medicine,Women′s Hospital of Nanjing Medical University,Nanjing 210004,China)

机构地区：[1]南京医科大学附属妇产医院生殖医学中心,210004

出　　处：《国际生殖健康／计划生育杂志》2023年第2期102-106,共5页Journal of International Reproductive Health/Family Planning

基　　金：国家自然科学基金(81871210)。

摘　　要：目的:探讨冻融胚胎行植入前遗传学检测(preimplantation genetic testing,PGT)的安全性及对临床结局的影响。方法:收集2016年8月—2021年12月南京医科大学附属妇产医院生殖医学中心(本中心)对冻融胚胎行PGT的95个周期(冻融PGT组,截至2021年12月31日已移植37个周期)和同期常规新鲜胚胎行PGT的145个周期(新鲜PGT组,已移植95个周期)的临床资料,比较2组PGT的结果以及2组已移植周期的临床妊娠结局。结果:①新鲜PGT组145个周期共活检囊胚742枚,获得整倍体胚胎283枚;冻融PGT组95个周期共活检囊胚279枚,获得整倍体胚胎90枚。2组整倍体胚胎率比较差异无统计学意义(38.14%vs.32.26%,P=0.082)。②新鲜PGT组与冻融PGT组已移植周期的胚胎种植率(56.84%vs.54.05%)、临床妊娠率(56.84%vs.54.05%)、流产率(9.26%vs.15.00%)、活产率(51.58%vs.45.95%)和早产率(8.16%vs.11.76%)比较差异均无统计学意义(均P>0.05)。结论:冻融胚胎行PGT的检测结果和妊娠结局与新鲜胚胎行PGT相似,可作为特殊情况下的一种较安全的处理方式。Objective:To explore the safety of preimplantation genetic testing(PGT)in frozen-thawed embryos and its effects on the clinical pregnancy outcome.Methods:From August 2016 to December 2021,a total of 95 clinical cases of PGT in frozen-thawed embryos were collected from the Center of Reproductive Medicine,Women′s Hospital of Nanjing Medical University(referred to as the frozen-thawed embryos PGT group,37 cases had been transplanted up to December 31,2021)and 145 clinical cases of PGT in fresh embryos during the same period(referred to as the fresh-embryos PGT group,95 cases had been transplanted).The differences in PGT results and the clinical pregnancy outcome of transplanted cases were analyzed between the two groups.Results:①In 145 cases of the fresh-embryos PGT group,742 blastocysts were biopsied and 283 euploid embryos were obtained;In 95 cases of the frozen-thawed embryos PGT group,279 blastocysts were biopsied and 90 euploid embryos were obtained.There was no significant difference in the euploid embryos rates between the two groups(38.14%vs.32.26%,P=0.082).②There were no significant differences in the embryo implantation rate(56.84%vs.54.05%),clinical pregnancy rate(56.84%vs.54.05%),miscarriage rate(9.26%vs.15.00%),live birth rate(51.58%vs.45.95%)and the early birth rate(8.16%vs.11.76%)between the two groups(all P>0.05).Conclusions:PGT in the frozen-thawed embryos is consistent with PGT in the fresh embryos about diagnostic result and pregnancy outcome.Therefore,PGT in the frozen-thawed embryos can be used as a relatively safe treatment under some special circumstances.

关 键 词：胚胎 哺乳动物 体外受精 活组织检查 植入前诊断 妊娠结局 

分 类 号：R714.8[医药卫生—妇产科学]