胚胎植入前非整倍体遗传学检测在中国东北地区高龄复发性流产患者中的应用价值

目的探讨胚胎植入前非整倍体遗传学检测(PGT-A)在高龄复发性流产(RSA)患者中的临床应用价值。方法收集2017年5月-2019年2月在沈阳市妇婴医院生殖中心行PGT-A助孕的RSA患者,根据年龄将患者分为A组(年龄>35岁)、Y组(年龄≤35岁)、A-SET组(行单囊胚解冻移植且未行PGT-A助孕的年龄>35岁的患者)及Y-SET组(行单囊胚解冻移植且未行PGT-A助孕的年龄≤35岁的患者)。分析行PGT-A患者胚胎的染色体非整倍性情况及各组患者胚胎移植后的临床结局。结果A组256枚胚胎扩增成功,染色体异常率为67.2%;Y组162枚胚胎扩增成功,染色体异常率为46.9%,两组差异有统计学意义(P<0.05)。A组h CG阳性率(66.7%vs.42.3%)、临床妊娠率(66.7%vs.34.9%)及活产率(63.3%vs.33.3%)与A-SET组比较,差异均有统计学意义(均P<0.05);A组h CG阳性率(66.7%vs.60.6%)、临床妊娠率(66.7%vs.53.1%)及活产率(63.3%vs.51.2%)与Y-SET组比较,差异均无统计学意义(均P>0.05)。结论为获得整倍体胚胎和良好的临床结局,建议高龄女性在行体外受精-胚胎移植时结合PGT-A。

Application value of preimplantation genetic testing for aneuploidies in advanced age patients of recurrent abortion in northeast China

Objective To evaluate the clinical value of Preimplantation Genetic Testing for Aneuploidies(PGT-A)in advanced age patients of recurrent abortion.Methods Collection of patients with PGT-A in Reproductive Medicine Center of Shenyang Women’s and Children’s Hospital from May 2017 to February 2019,Patients were divided into group A(age>35 years),group Y(age≤35 years),and A-SET group(patients who underwent single-embolic thawing and did not undergo PGT-A and age>35 years),Y-SET group(patients who underwent single-embolic thawing and did not undergo PGT-A and age≤35 years).Analized chromosome aneuploidy in embryos undergoing PGT-A and clinical outcomes after embryo transfered.Results A group of 256 embryos were successfully expanded,and the chromosomal abnormal rate was 67.2%.Y group of 162 embryos were successfully expanded,and the chromosomal abnormal rate was46.9%.There was significant difference between the two groups(P<0.05).There were significant differences in h CG positive rate(66.7%vs.42.3%),clinical pregnancy rate(66.7%vs.34.9%)and live birth rate(63.3%vs.33.3%)between A and A-SET groups(P<0.05);There were no significant differences in h CG positive rate(66.7%vs.60.6%),clinical pregnancy rate(66.7%vs.53.1%)and live birth rate(63.3%vs.52.1%)between A and Y-SET groups(P>0.05).Conclusion In order to obtain euploid embryos and good clinical outcomes,it is recommended that older women combine PGT-A during in vitro fertilization-embryo transfer.