控制性卵巢刺激相关参数与染色体结构异常中新发染色体异常的关系分析  

Analysis of the relationship between parameters of controlled ovarian stimulation and de novo chromosomal abnormalities in chromosomal structural abnormalities

作　　者：张静[1] 田烨 李芳[1] 张妍[1] 宋学茹[1] 田文艳[1] 陈海霞[1] 白晓红[1] Zhang Jing;Tian Ye;Li Fang;Zhang Yan;Song Xueru;Tian Wenyan;Chen Haixia;Bai Xiaohong(Department of Obstetrics and Gynecology,Reproductive Medicine Center of Tianjin Medical University General Hospital,Tianjin Key Laboratory of Female Reproductive Health and Eugenics,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院妇产科生殖中心、天津市女性生殖健康与优生重点实验室,天津300052

出　　处：《中华生殖与避孕杂志》2024年第11期1164-1169,共6页Chinese Journal of Reproduction and Contraception

基　　金：国家自然科学基金面上项目(82171625);天津市医学重点学科(专科)建设项目(TJYXZDXK-031A)。

摘　　要：目的研究胚胎植入前染色体结构变异遗传学检测(preimplantation genetic testing for structural rearrangements,PGT-SR)周期中,控制性卵巢刺激(controlled ovarian stimulation,COS)相关参数对新发染色体异常的影响。方法采用病例对照研究,回顾性分析天津医科大学总医院妇产科生殖中心2023年1月至2024年8月期间行PGT-SR助孕的70个周期及行胚胎植入前单基因遗传学检测(preimplantation genetic testing for monogenic,PGT-M)的39个周期的患者临床资料,分析COS中促排卵方案、不同促性腺激素(gonadotropin,Gn)使用时间和总量、人绒毛膜促性腺激素(human chorionic gonadotropin,hCG)注射日雌二醇水平和孕酮水平与新发染色体异常的相关性。结果①PGT-SR组的341个囊胚和PGT-M组的196个囊胚进行活检。PGT-SR组的非整倍体率[62.1%(205/330)]和PGT-M组[30.2%(58/192)]比较,差异有统计学意义(P<0.001)。两组的新发染色体异常率比较差异无统计学意义(P>0.05)。②校正女方年龄、男方年龄、囊胚质量后,新发染色体异常率在不同促排卵方案之间、不同Gn使用时间和总量之间、hCG注射日不同雌二醇水平和孕酮水平之间差异均无统计学意义(均P>0.05)。③新发染色体整条异常、片段异常和复杂异常发生率在不同促排卵方案、不同Gn使用时间和总量、hCG注射日不同雌二醇和孕酮水平间差异均无统计学意义(均P>0.05)。结论不同的促排卵方案、Gn使用时间、Gn使用总量、hCG注射日雌二醇和孕酮水平不影响染色体结构异常患者的总体新发染色体异常率及新发整条、片段和复杂染色体异常率。Objective:To explore the parameters of controlled ovarian stimulation(COS)on the occurrence of de novo chromosomal abnormalities in preimplantation genetic testing for structural rearrangements(PGT-SR)cycles.Methods:A retrospective analysis control study was performed on 70 PGT-SR cycles and 39 preimplantation genetic testing for monogenic(PGT-M)embryos in the Department of Obstetrics and Gynecology,Reproductive Medicine Center of Tianjin Medical University General Hospital from January 2023 to August 2024.The correlation between de novo chromosomal abnormalities and ovarian stimulation protocol,duration and total dosage of gonadotropin(Gn)used,estradiol and progesterone levels on human chorionic gonadotropin(hCG)trigger day in COS were analyzed.Results:1)Biopsies were performed on 341 blastocysts in the PGT-SR group and 196 blastocysts in the PGT-M group.There was a significant difference in aneuploid rate of blastocyst between PGT-SR and PGT-M groups[62.1%(205/330)vs.30.2%(58/192),P<0.001].There was no significant difference in the incidence of de novo chromosomal abnormalities,between PGT-SR and PGT-M groups(P>0.05).2)After adjusting for couples'age and blastocyst grade,there were no significant differences in the incidence of de novo chromosomal abnormalities among different ovarian stimulation protocols,different duration and total dosage of Gn used,different estradiol and progesterone levels on hCG trigger day(all P>0.05).3)There were no significant differences the incidence of de novo whole,fragment and complex chromosomal abnormalities among different ovarian stimulation protocols,different duration and total dosage of Gn used,different estradiol and progesterone levels on hCG trigger day(all P>0.05).Conclusion:Different ovarian stimulation protocols,duration and total dosage of Gn used,estrogen and progesterone levels on hCG trigger day don't affect the whole de novo chromosomal abnormalities,de novo whole,fragment,complex chromosomal abnormalities in patients with structural chromosomal abnormalities.

关 键 词：控制性卵巢刺激 胚胎植入前染色体结构变异遗传学检测 新发染色体异常 

分 类 号：R714.8[医药卫生—妇产科学]