生长激素预处理在胚胎植入前染色体非整倍体检测中的应用研究  

Application of growth hormone pretreatment in preimplantation genetic testing for aneuploidy

作　　者：周海燕[1,2,3] 吴彩云[1,5,6] 黄德焕 郝燕[1,5,6] 陈大蔚 王孟寒 赵刚[4] 周平 Zhou Haiyan;Wu Caiyun;Huang Dehuan;Hao Yan;Chen Dawei;Wang Menghan;Zhao Gang;Zhou Ping(Dept of Obstetrics and Gynecology,The First Affiliated Hospital of Anhui Medical University,Hefei 230032;Dept of Obstetrics and Gynecology,Chaohu Affiliated Hospital of Anhui Medical University,Chaohu 238000;NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract,Hefei 230032;Dept of Electronic Engineering and Information Sciences,University of Science and Technology of China,Hefei 230027;Anhui Province Key Laboratory of Reproductive Health and Genetics,Hefei 230032;Anhui Provincial Engineering Research Center of Biopreservation and Artificial Organs,Hefei 230032)

机构地区：[1]安徽医科大学第一附属医院妇产科,合肥230032 [2]安徽医科大学附属巢湖医院妇产科,巢湖238000 [3]国家卫生健康委配子及生殖道异常研究重点实验室,合肥230032 [4]中国科学技术大学电子工程与信息科学系,合肥230027 [5]生殖健康与遗传安徽省重点实验室,合肥230032 [6]安徽省生命资源保存与人工器官工程技术研究中心,合肥230032

出　　处：《安徽医科大学学报》2024年第6期988-993,共6页Acta Universitatis Medicinalis Anhui

基　　金：国家自然科学基金(编号:82301896);安徽科技重大专项(编号:202003a07020012)。

摘　　要：目的研究生长激素(GH)预处理对整倍体的改善及妊娠结局的影响。方法前瞻性分析行胚胎植入前染色体非整倍体检测(PGT-A)助孕的134例患者,其中30例行自身对照,104例行组间对照。根据是否添加GH分为GH预处理组和GH非预处理组,GH预处理为促性腺激素(Gn)启动前行4~6周的GH 2 U/d皮下注射,Gn启动日剂量加倍直至扳机日,GH非预处理为未用过GH处理。前次PGT-A周期失败后一年内再次行PGT-A时予GH预处理构成自身对照组。组间对照和自身对照分别比较各组间的基本情况、囊胚情况及助孕结局。结果无论组间对照还是自身对照,GH预处理后的HCG日子宫内膜厚度、卵巢敏感指数(OSI)、获卵数、MII卵数、2PN数、2PN受精率、可利用卵母细胞率、活检囊胚数、整倍体囊胚数、整倍体囊胚率、至少一个整倍体率均明显增加,差异均有统计学意义(P<0.05),GH预处理后的Gn总量、Gn天数、嵌合体囊胚数、嵌合体囊胚率无明显变化,差异均无统计学意义,GH预处理后的种植率、临床妊娠率均有提高,但差异均无统计学意义。结论GH预处理可以明显增加行PGT-A患者的整倍体数和整倍体率,并有改善妊娠结局的趋势。Objective To investigate the effect of growth hormone(GH)pretreatment on the improvement of euploid and pregnancy outcome.Methods A prospective analysis was conducted on 134 patients undergoing preimplantation genetic testing for aneuploidy(PGT-A),among whom 30 patients were self-controlled and 104 patients were inter-group controlled.According to whether GH was added,the patients were divided into GH pretreatment group and GH non-pretreatment group.GH pretreatment included subcutaneous injection of GH 2U/day for 4-6 weeks before the start of gonadotropin(Gn),and the dose was doubled on the day of Gn until the trigger day.GH non-pretreatment meant no GH treatment,GH pretreatment was given when the previous PGT-A cycle failed within one year when the PGT-A was performed again,forming the self-control group.The basic situation,blastocyst situation and pregnancy outcome were compared between the groups by inter-group and self-control.Results No matter in the group control or self-controlled group,the endometrial thickness on the day of HCG,ovarian sensitivity index(OSI),number of oocytes obtained,MII oocytes,2PN number,2PN fertilization rate,available oocyte rate,number of biopsy blastocysts,number of euploid blastocysts,euploid blastocyst rate,and at least one euploid rate significantly increased after GH pretreatment,with statistically significant differences(P<0.05).The total amount of Gn,Gn days,number of mosaic blastocysts,and mosaic blastocyst rate were not significantly changed after GH pretreatment,with no statistically significant differences.The implantation rate and clinical pregnancy rate increased after GH pretreatment,but with no statistically significant differences.Conclusion GH pretreatment can significantly improve the number and rate of euploid embryos in patients undergoing PGT-A,and has a tendency to improve pregnancy outcome.

关 键 词：生长激素预处理 胚胎植入前染色体非整倍体检测 整倍体 妊娠结局 

分 类 号：R715.5[医药卫生—妇产科学]