高育龄女性行胚胎植入前遗传学筛查的妊娠结局分析

被引：4
|
作者：
刘培昊
李鸿昌
朱月婷
姜文杰
颜军昊
秦莹莹
陈子江
机构：
[1] 山东大学附属生殖医院女性生殖科
[2] 山东大学附属生殖医院生殖遗传科
来源：
中华生殖与避孕杂志 | 2019年 / 06期
关键词：
妊娠结局; 高育龄; 胚胎植入前遗传学检测; 活产率; 妊娠丢失率;
D O I：
暂无
中图分类号：
R714.8 [];
学科分类号：
100211 ;
摘要：
目的 研究胚胎植入前非整倍性遗传学检测(preimplantation genetic testing for aneuploidies,PGT-A)对高育龄女性妊娠结局的影响。方法 选取2015年1月—2017年5月期间于山东大学附属生殖医院进行第1周期PGT-A助孕的≥38岁的女性98例(PGT组),另分别选取同时间段进行体外受精(in vitro fertilization,IVF)及卵胞质内单精子注射(intracytoplasmic sperm injection,ICSI)助孕的患者作为对照组,与PGT组进行1︰2匹配,分别比较PGT组与IVF组、ICSI组的妊娠结局。同时观察拟行PGT-A助孕,但因胚胎培养第3日(D3)优质胚胎数目不足取消PGT-A并行新鲜胚胎移植患者的妊娠结局。结果 PGT组与对照组相比,移植周期活产率显著升高[PGT组(48.44%)比IVF组(24.00%),P<0.001；PGT组比ICSI组(27.62%),P=0.002],妊娠丢失率显著下降[PGT组(22.50%)比IVF组(46.07%),P=0.011；PGT组比ICSI组(45.05%),P=0.014],但PGT组98例中,有34例患者因检测后无可移植胚胎放弃移植。PGT组与对照组间患者活产率、临床妊娠率差异均无统计学意义(P>0.05)。高育龄女性取消PGT-A检测、行D3新鲜胚胎移植后,活产率仅为7.14%。结论 高育龄女性进行PGT-A助孕可显著提高活产率、降低妊娠丢失风险、增加移植效率,但周期取消率增高。另外,优质胚胎数少的高龄女性,是否取消PGT-A检测、行D3新鲜胚胎移植应权衡利弊、慎重考虑。
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页码：436 / 441
页数：6
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