囊胚形态学评价参数对IVF/ICSI助孕后稽留流产绒毛染色体核型异常的影响  

Influence of morphological evaluation parameters of blastocysts on chromosomal karyotype abnormalities of chorionic villi in missed abortion after IVF/ICSI treatment

作　　者：李梦娜 郑威 杨宸 任炳楠 袁二凤 高松占 俎若雯 邝义会 吴静 曹梦依 韩静宜 李培鑫 申冉 管一春[1] Li Mengna;Zheng Wei;Yang Chen;Ren Bingnan;Yuan Erfeng;Gao Songzhan;Zu Ruowen;Kuang Yihui;Wu Jing;Cao Mengyi;Han Jingyi;Li Peixin;Shen Ran;Guan Yichun(Reproductive Medicine of the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院生殖医学中心,郑州450052

出　　处：《中华生殖与避孕杂志》2024年第6期628-634,共7页Chinese Journal of Reproduction and Contraception

基　　金：国家重点研发计划重点专项(2021YFC2700602);国家卫生健康委科学研究基金河南省医学科技攻关计划省部共建项目(SBGJ202102180)。

摘　　要：目的分析囊胚形态学评价参数包括囊胚发育天数(第5天和第6天)、囊胚扩张程度(4、5、6)、内细胞团和滋养外胚层分级对体外受精/卵胞质内单精子注射(in vitro fertilization/intracytoplasmic sperm injection,IVF/ICSI)助孕新鲜或冻融单囊胚移植后稽留流产绒毛染色体核型异常发生的影响。方法纳入2015年2月至2023年2月期间于郑州大学第三附属医院生殖医学中心行IVF/ICSI助孕新鲜或冻融单囊胚移植后稽留流产患者的临床数据及绒毛染色体拷贝数变异(copy number variations,CNVs)的检测结果。采用病例对照研究,根据流产组织绒毛染色体CNVs检测结果将数据分为两组:异常染色体核型组(n=139)和正常染色体核型组(n=82),比较两组患者的基线数据。应用单因素logistic回归分析囊胚形态学评价参数对流产组织绒毛染色体核型异常发生的影响,同时应用多因素logistic回归调整男方年龄、精子正常形态率和女方年龄混杂因素。结果基线数据中,异常染色体核型组男方年龄[(34.12±6.49)岁]、精子正常形态率[5.00(4.00,6.00)%]和女方年龄[33.00(30.00,37.00)岁]高于正常染色体核型组[(32.38±4.69)岁、4.00(2.00,5.00)%和31.50(29.00,34.00)岁],差异均具有统计学意义(P=0.022、P=0.020、P=0.009)。单因素和多因素logistic回归分析数据显示,囊胚发育天数、扩张程度、内细胞团和滋养外胚层等级均没有增加绒毛染色体核型异常发生的风险(均P>0.05)。结论囊胚形态学评价参数与IVF/ICSI助孕新鲜或冻融单囊胚移植后稽留流产绒毛染色体核型异常无明显相关性。Objective Analyzing the influence of morphological evaluation parameters of blastocysts,including days of blastocyst development[day 5(D5)and day 6(D6)],degree of blastocyst expansion(4,5,6),inner cell mass and trophectoderm grade,on the occurrence of chromosomal karyotype abnormalities of chorionic villi in missed abortion after in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)treatment and fresh/frozen-thawed single blastocyst transfer.Methods The clinical data of patients with missed abortion after IVF/ICSI treatment and fresh/frozen-thawed single blastocyst transfer from February 2015 to February 2023 in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University were included.Using a case-control study,the data were divided into two groups according to the detection results of chromosomal copy number variations(CNVs)in chorionic villi of missed abortion abnormal karyotype group(n=139)and normal karyotype group(n=82).The baseline data between the two groups were compared.Univariate logistic regression was used to investigate the effect of blastocyst morphological rating parameters on the occurrence of chromosomal karyotype abnormalities of chorionic villi in aborted tissues,and multivariate logistic regression was also used to adjust confounding factors.Results Male age[(34.12±6.49)years],sperm morphology rate[5.00(4.00,6.00)%]and female age[33.00(30.00,37.00)years]in abnormal karyotype group were higher than those in the normal karyotype group[(32.38±4.69)years,4.00(2.00,5.00)%and 31.50(29.00,34.00)years],and the differences were statistically significant(P=0.022,P=0.020,P=0.009).Univariate and multivariate logistic regression analyses showed that days of blastocyst development,degree of blastocyst expansion,inner cell mass and trophectoderm grade did not increase the risk of chromosomal karyotype abnormalities of chorionic villi(all P>0.05).Conclusion There is no significant correlation between blastocyst morphological evaluation parameters and chromosomal karyotype ab

关 键 词：单囊胚 胚胎形态学参数 内细胞团 滋养外胚层 稽留流产 绒毛染色体核型异常 

分 类 号：R714.8[医药卫生—妇产科学]