PGT-A患者不同活检日囊胚的染色体非整倍体情况及妊娠结局  

Chromosomal aneuploidy and pregnancy outcomes for D5/D6 blastocysts from patients undergoing PGT-A treatment

作　　者：石森林[1] 石琼瑶 姚桂东[1] 刘艳[1] 张福利[1] Shi Senlin;Shi Qiongyao;Yao Guidong;Liu Yan;Zhang Fuli(Center of Reproductive Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China)

机构地区：[1]郑州大学第一附属医院生殖医学中心,郑州450052

出　　处：《中华医学遗传学杂志》2023年第9期1062-1067,共6页Chinese Journal of Medical Genetics

基　　金：河南省医学科技攻关计划省部共建重点项目(SBGJ202102108)。

摘　　要：目的比较行胚胎植入前染色体非整倍体遗传学检测(PGT-A)患者的D5和D6囊胚的染色体非整倍体情况及妊娠结局。方法收集2018年9月至2020年9月在郑州大学第一附属医院生殖中心行PGT-A并进行解冻移植的268例患者的临床及实验室资料,比较D5和D6囊胚(分别为975个、710个)的染色体非整倍体情况及妊娠结局。结果D5囊胚的整倍体占比显著高于D6囊胚(49.1%vs.41.1%,P=0.0011),非整倍体的占比则显著低于D6囊胚(50.9%vs.58.9%,P=0.0011),其中D6囊胚染色体数目异常率显著高于D5囊胚(27.9%vs.20.2%,P=0.0005)。>35岁者D5/D6囊胚整倍体和非整倍体率无差异,而≤35岁者D5囊胚整倍体比率显著高于D6囊胚(53.8%vs.44.3%,P=0.001),非整倍体率则显著低于D6囊胚,且以染色体数目为甚(16.3%vs.23.9%,P=0.001)。无论D5还是D6囊胚,≤35岁者整倍体比率均显著高于>35岁者,非整倍体率均显著低于>35岁者,且均以染色体数目异常为主。高龄组囊胚整倍体比率与活产率最低。解冻移植D5囊胚的妊娠率(60.2%vs.37.0%,P=0.0003)、种植率(59.1%vs.37.0%,P=0.0006)和活产率(47.7%vs.28.3%,P=0.002)均显著高于D6囊胚。结论对于PGT-A患者,D5囊胚整倍体比率高于D6囊胚,移植D5正常信号囊胚的临床结局优于D6囊胚;高龄患者非整倍体率高,且以染色体数目异常为主。ObjectiveTo compare the prevalence of chromosomal aneuploidies and pregnancy outcomes of D5 and D6 blastocysts subjected to preimplantation genetic testing for aneuploidy(PGT-A).MethodsClinical and laboratory data of 268 couples who underwent PGT-A at the Reproductive Center of the First Affiliated Hospital of Zhengzhou University from September 2018 to September 2020 were collected.The prevalence of chromosomal aneuploidies and pregnancy outcomes of D5/D6 biopsied blastocysts were compared.ResultsCompared with D6 blastocysts,the euploidy rate of D5 blastocysts was significantly higher(49.1%vs.41.1%,P=0.0011),whilst their aneuploidy rate was significantly lower(50.9%vs.58.9%,P=0.0011).The rate of numerical abnormalities of D6 blastocysts was significantly higher than that of D5 blastocysts(27.9%vs.20.2%,P=0.0005).For patients under 35 years old,the euploidy rate of D5 blastocysts was significantly higher than that of D6 blastocysts(53.8%vs.44.3%,P=0.001),whilst the numerical abnormality rate was significantly lower(16.3%vs.23.9%,P=0.001).For both D5 and D6 blastocysts,the euploidy rates for patients≤35 were significantly higher than those for>35.The elder group had the lowest rates for aneuploidies and live births.Compared with those receiving D6 blastocysts transplantation,the pregnancy rate,implantation rate and live birth rate for those receiving thawed D5 blastocysts transplantation were significantly higher(60.2%vs.37.0%,P=0.0003;59.1%vs.37.0%,P=0.0006;47.7%vs.28.3%,P=0.002).ConclusionFor patients undergoing PGT-A,the chromosomal euploidy rate for D5 blastocysts is higher than that for D6 blastocysts,and the clinical outcome of D5 blastocysts with normal signal is better than that of D6 blastocysts.Elder patients have a higher rate of aneuploidies.

关 键 词：胚胎植入前染色体非整倍体遗传学检测 非整倍体 囊胚 妊娠结局 

分 类 号：R714.8[医药卫生—妇产科学]