多囊卵巢综合征对胚胎染色体非整倍体率和发育潜能的影响  

The Impact of PCOS on the Rate of Aneuploidy and Developmental Potential of Embryos

作　　者：宋雪梅[1] 邓星 柏明珠 袁振亚 袁牧 严为巧[1] 李园园[1] SONG Xuemei;DENG Xing;BAI Mingzhu;YUAN Zhenya;YUAN Mu;YAN Weiqiao;LI Yuanyuan(Xuzhou Maternity and Child Health Care Hospital,Xuzhou 221009,Jiangsu,China;Yichun Maternity and Child Health Care Hospital,Yichun 336000,Jiangxi,China)

机构地区：[1]徐州市妇幼保健院生殖医学中心,江苏徐州221009 [2]宜春市妇幼保健院生殖医学中心,江西宜春336000

出　　处：《昆明理工大学学报（自然科学版）》2024年第2期112-118,共7页Journal of Kunming University of Science and Technology(Natural Science)

基　　金：江苏省妇幼健康科研项目(F202162)。

摘　　要：研究多囊卵巢综合征(PCOS)患者异常内分泌水平对其胚胎染色体非整倍体率和最终妊娠结局的影响.分析2019年1月至2023年4月在徐州市妇幼保健院行胚胎植入前遗传学检测的261个治疗周期.比较PCOS组和非PCOS组在年龄、不孕年限、BMI、FSH、LH、E_(2)、P、AMH、T、AFC、促性腺激素用量、促性腺激素使用时间和HCG日E_(2)水平的差异,分析两组患者2PN率、D_(3)天优质胚胎率、D_(5)/D_(6)天囊胚形成率、活检囊胚整倍体率、活检囊胚非整倍体率和每周期活检囊胚个数等指标,以及整倍体囊胚解冻移植以后的临床妊娠结局.PCOS组的年龄、不孕年限、BMI、FSH、E_(2)、P、T、促性腺激素用量和促性腺激素使用时间与非PCOS组相比均无统计学差异(P>0.05);LH、AMH、HCG日E_(2)水平和AFC显著高于非PCOS组(P<0.01).PCOS患者的2PN率、D_(3)天优质胚胎率、D_(5)/D_(6)天囊胚形成率、活检囊胚整倍体率和活检囊胚非整倍体率分别为77.67%、50.64%、53.29%、57.14%,34.40%,与非PCOS组无统计学差异(P>0.05);但每周期活检囊胚个数(5.44个)高于非PCOS组(2.64个);PCOS患者移植高占比D_(5)天优质整倍体囊胚后(76.67%),其临床妊娠率、种植率、流产率和活产率分别为78.33%、78.33%、5.00%、58.33%,与非PCOS患者无统计学差异(P>0.05).PCOS并不显著增加不孕症患者囊胚染色体非整倍体率,整倍体囊胚移植后的临床妊娠率、种植率、流产率和活产率均与非PCOS组无统计学差异,对PCOS患者而言获得足够数量的可供选择的优质囊胚移植是得到理想妊娠结局的关键.This study investigates the impact of abnormal endocrine levels in patients with polycystic ovary syndrome(PCOS)on the rate of embryo chromosomal aneuploidy and the final pregnancy outcome.A total of 261 treatment cycles undergoing preimplantation genetic testing at Xuzhou Maternal and Child Health Hospital from January 2019 to April 2023 were analyzed.The differences in age,infertility years,BMI,FSH,LH,E_(2),P,AMH,T,AFC,dosage of gonadotropin,duration of gonadotropin use and E_(2) level on HCG day were compared between PCOS group and non-PCOS group.Meanwhile,other influence factors,such as the 2PN rate,Day 3 high-quality embryo rate,Day5/Day6 blastocyst formation rate,available blastocyst euploidy rate,available blastocyst aneuploidy rate and the number of biopsy per cycle of the two groups,as well as the clinical pregnancy outcome after FET of euploidy blastocysts,etc.were analyzed.There were not obvious differences of PCOS group in age,infertility years,BMI,FSH,E_(2),P,T,the dosage of gonadotropin and days of ovarian stimulation from non-PCOS group(P>0.05).Nonetheless,LH,AMH and E_(2) levels in HCG days as well as AFC(P<0.01)were significantly higher than those in non-PCOS.The 2PN rate,Day 3 high-quality embryo rate,Day5/Day6 blastocyst formation rate,available blastocyst euploidy rate and available blastocyst aneuploidy of PCOS patients were 77.67%,50.64%,53.29%,57.14%and 34.40%,respectively.It was shown that no statistical differences in above datas of PCOS compared with non-PCOS group(P>0.05),but the number of biopsy per cycle(5.44)was higher than that in the non-PCOS group(2.64).After transferring a high proportion of day 5 high-quality euploid blastocysts(76.67%)in PCOS patients,the clinical pregnancy rate,implantation rate,miscarriage rate,and live birth rate were 78.33%,78.33%,5.00%,and 58.33%,respectively,with no statistically significant difference compared to non-PCOS patients(P>0.05).PCOS does not significantly increase the rate of blastocyst chromosomal aneuploidy in infertile patients.The clinical

关 键 词：胚胎染色体 多囊卵巢综合征 胚胎植入前遗传学检测 妊娠结局 

分 类 号：R711.75[医药卫生—妇产科学] R714.8[医药卫生—临床医学]