低比例嵌合型性染色体异常不孕患者辅助生殖结局分析  

Analysis of assisted reproduction outcomes in infertility patients with low proportion of chimeric sex chromosome abnormalities

作　　者：曹芳 胡丽敏 夏西洋 戴秀亮 高亭亭 陈莉 CAO Fang;HU Limin;XIA Xiyang;DAI Xiuliang;GAO Tingting;CHEN Li(Reproductive Center,Changzhou Maternal and Child Health Care Hospital Changzhou,Changzhou,Jinagsu 213000,China)

机构地区：[1]常州市妇幼保健院生殖中心,江苏常州213000

出　　处：《现代医药卫生》2023年第7期1135-1140,共6页Journal of Modern Medicine & Health

基　　金：南京医科大学科技发展基金重点项目(2017NJMUZD041);南京医科大学科技发展基金一般项目(NMUB20210055)。

摘　　要：目的探讨低比例嵌合型性染色体异常(SCA)患者的临床表型及其是否影响辅助生殖结局。方法回顾性分析2017年6月至2020年6月在该中心进行辅助生殖助孕的28例低比例嵌合型性SCA不孕患者(病例组)的发育情况,根据年龄和促排卵方案按1∶2匹配该中心同期收治的56例染色体核型正常的不孕患者作为对照组,分析比较2组患者临床资料、胚胎发育情况并随访胚胎移植后临床妊娠结局。结果2组患者体重指数、基础抗缪勒氏管激素、基础促卵泡生成素、基础雌二醇、不孕原因、不孕年限比较,差异均无统计学意义(P>0.05)。病例组患者共42个取卵周期,对照组患者共72个取卵周期,促排过程中平均外源性促性腺激素用量、授精方式、平均获卵数、成熟卵子数,以及正常受精率、胚胎培养第3天优胚率和囊胚形成率比较,差异均无统计学意义(P>0.05);病例组患者成熟卵子比例明显低于对照组,差异有统计学意义(P<0.05)。病例组患者共46个移植周期,对照组患者共97个移植周期,2组患者临床妊娠率、种植率,活胎分娩率,流产率、单胎妊娠的新生儿出生体重比较,差异均无统计学意义(P>0.05)。病例组患者中获得活胎分娩17例,妊娠早期行产前诊断检查羊水染色体核型正常8例,行无创胚胎染色体筛查检测核型正常7例。结论对低比例嵌合性SCA患者通过辅助生殖助孕受孕的成功率与染色体正常不孕患者相同。Objective To investigate the clinical phenotype of low proportion of chimeric sex chromosome abnormalities(SCA)and its effect on the outcome of assisted reproduction.Methods The state of development of 28 infertility patients with low proportion of chimeric SCA underwent assisted reproduction in this center(the case group)were retrospectively analyzed.A total of 56 infertile patients with normal chromosome karyotype during the same period in this center were matched with 1∶2 as the control group according to age and ovarian stimulation plan.The basic clinical data and embryo development of the two groups were analyzed and compared,and the clinical pregnancy outcomes after embryo transplantation were followed up.Results There were no significant differences in body mass index(BMI),basal anti-Mullerite hormone(AMH),basal follicle-stimulating hormone(FSH),basal estradiol(E2),causes of infertility and years of infertility between the two groups(P>0.05).There were 42 ovulation cycles in the case group and 72 ovulation cycles in the control group.There were no statistically significant differences in the average amount of gonadal hormone(Gn),insemination method,average number of obtained eggs,number of mature eggs in the process of ovulation promotion,and normal fertilization rate,fine embryo rate and embryo rate and blastocyst formation rate at day three between the two groups(P>0.05).The proportion of mature ovum in the control group was higher than that in the case group(P<0.05).There were 46 transplant cycles in the case group and 97 transplant cycles in the control group.There were no significant differences in clinical pregnancy rate,implantation rate,live birth rate,abortion rate and fetal weight in single pregnancy between the two groups(P>0.05).A total of 17 patients in the case group were born alive,and eight cases had normal chromosome karyotype in amniotic fluid,and seven cases were normal in the results of non-invasive embryo chromosome screening.Conclusion For low proportion of SCA patients,the success

关 键 词：TURNER综合征 嵌合体 辅助生殖 胚胎 

分 类 号：R715.5[医药卫生—妇产科学]