胚胎植入前遗传学筛查(PGS)在高龄和复发性流产(RSA)患者中的应用价值

目的探究高龄和复发性流产(RSA)患者开展胚胎植入前遗传学筛查(PGS)临床应用价值。方法纳入2017年1月~2018年12月期间我院收入高龄及RSA患者共计82例作为本次研究对象,纳入对象均开展单细胞全基因组扩增(WGA)结合二代测序技术(NGS),分别对胚胎23对染色体开展筛查,对筛查结果中染色体正常胚胎进行移植,并观察临床结局。结果本次研究对纳入82例患者125个取卵周期,共计456枚胚胎开展PGS,其中卵裂胚68枚,囊胚388枚,结果检测中287枚胚胎为染色体异常,胚胎染色体异常率总计为62.94%,35~40岁整倍体胚胎数占比为35.71%,低于>40岁的60%,差异显著(P<0.05),35~40岁患者胚胎异常率为66.67%低于>40岁组82.09%,临床妊娠率为68.78%高于>40岁组37.80%,流产率6.25%,低于>40岁组0.00%,两组差异显著(P<0.05)。结论高龄、复发性流产患者中往往胚胎异常率显著上升,此时通过开展PGS并选择健康胚胎植入,能改善妊娠结局。

Application value of preimplantation genetic screening(PGS)in elderly and recurrent spontaneous abortion (RSA)patients

Objective:To explore the clinical value of preimplantation genetic screening(PGS)in elderly and recurrent spontaneous abortion(RSA)patients.Methods:From January 2017 to December 2018,82 elderly and RSA patients were enrolled in this study.All the subjects were screened for 23 pairs of chromosomes by single cell whole genome amplification(WGA)combined with Next-generation sequencing(NGS).The normal embryos of chromosomes in the screening results were transferred and the clinical outcomes were observed.Results:In this study,125 fetal cycles of 82 patients were included.A total of 456 embryos were treated with PGS,included 68 cleavage embryos and 388 blastocysts.The results showed that 287 embryos were chromosomal abnormalities.The total chromosomal abnormality rate of embryos was 62.94%.The percentage of haploid embryos aged 35-40 was 35.71%.The difference was significant(P<0.05).The abnormality rate of embryos in patients aged 35-40 was 66.67%.The clinical pregnancy rate was 68.78%,higher than 37.80% and the abortion rate was 6.25%,lower than 0.00% in the 40-year-old group(P<0.05).Conclusion:In elderly patients with recurrent abortion,the abnormal rate of embryos often rises significantly.At this time,through the development of PGS and the selection of healthy embryo implantation,pregnancy outcomes can be improved.