PGT降低高龄FET患者早期自然流产率的研究
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南京大学医学院附属鼓楼医院生殖医学中心,南京大学分子生殖医学中心

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国家自然科学基金青年科学基金项目(81200127);江苏省社会发展科技计划项目(BL2014003);南京市卫生青年人才培养工程;Merck Serono China Research Fund for Fertility Experts


Research on Reduction of the Early Spontaneous Abortion Rate in Patients of Advanced Maternal Age (AMA) Undergoing Frozen-thawed Embryo Transfer by Preimplantation Genetic Testing
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key lab of reproductive medincine of nanjing medical university,Center for Molecular Reproductive Medicine, Nanjing University

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Youth Science Fund Project of National Natural Science Foundation of China,iangsu social development science and technology plan project,Nanjing health youth talent training project,Merck Serono China Research Fund for Fertility Experts

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    摘要:

    目的 探讨胚胎植入前遗传学检测(Preimplantation Genetic Testing, PGT)对高龄患者冻融胚胎移植(Frozen-thawed Embyo Transfer, FET)周期临床妊娠早期自然流产率的影响。 方法 回顾性分析2015年4月1日至2020年7月30日南京大学医学院附属鼓楼医院生殖医学中心≥35岁行PGT-FET的103个周期与常规FET的1495个周期的患者资料,采用1:2倾向性评分匹配的方法匹配出具有相似基线特征的患者队列,对匹配后的两组进行临床妊娠率、早期自然流产率、活产率等临床指标进行比较。 结果 经1:2倾向性评分匹配(Propensity-Score Matching, PSM),PGT-FET组中103名患者和常规FET组的206名患者成功配对,两组患者基线资料相似,无统计学差异。PGT-FET 组早期自然流产率显著低于对照常规FET组(11.11% vs 27.18%,P<0.05),PGT-FET组活产率高于对照组(43.69% vs 32.52%,P=0.05),但无统计学差异;两组间的生化妊娠率、临床妊娠率、晚期自然流产率、多胎分娩率均无统计学差异。PGT的三个亚组PGT-A(Preimplantation Genetic Testing for Aneuploidy, PGT-A)、PGT-SR(Preimplantation Genetic Testing for Structural Rearrangements)、PGT-M(Preimplantation Genetic Testing for Monogenic Disease,PGT-M)组生化妊娠率、临床妊娠率、早期自然流产率、晚期自然流产率、活产率、多胎分娩率均无统计学差异。

    Abstract:

    Objective: To investigate the effect of preimplantation genetic testing (PGT) on the early spontaneous abortion rate of patients of advanced maternal age (AMA) having a clinical pregnancy during cycles of frozen-thawed embryo transfer (FET). Methods: A retrospective analysis was performed on patients at the age of 35 or above who underwent 103 cycles of PGT-FET or 1495 cycles of conventional FET between April 1, 2015 and July 30, 2020 at the Reproductive Medicine Center of the Affiliated Drum Tower Hospital of Medical School, Nanjing University. Two cohorts with similar baseline characteristics were identified through 1:2 propensity score matching (PSM) for intergroup comparison of clinical indicators, such as clinical pregnancy, early spontaneous abortion, and live birth rates. Results: After 1:2 PSM, 103 patients in the PGT-FET group were successfully matched to 206 patients in the conventional FET group. The two groups showed no statistically significant difference in baseline information. The PGT-FET group had an early spontaneous abortion rate significantly lower than that in the conventional FET group (11.11% vs 27.18%, P <0.05). The live birth rate in the PGT-FET group was higher compared with the control group (43.69% vs 32.52%, P =0.05), but the difference between the two groups showed no statistical significance. No statistically significant difference was found in the rates of biochemical pregnancy, clinical pregnancy, late spontaneous abortion, and multiple delivery between the two groups.There was no significant difference in biochemical pregnancy rate, clinical pregnancy rate, early spontaneous abortion rate, late spontaneous abortion rate, live birth rate and multiple delivery rate among the three subgroups of PGT, PGT-A(Preimplantation Genetic Testing for Aneuploidy, PGT-A)、PGT-SR(Preimplantation Genetic Testing for Structural Rearrangements)、PGT-M(Preimplantation Genetic Testing for Monogenic Disease,PGT-M). Conclusion: PGT can reduce the early spontaneous abortion rate in AMA patients undergoing FET for clinical pregnancies probably because PGT can screen additional aneuploid embryos induced by AMA.

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  • 收稿日期:2021-08-27
  • 最后修改日期:2021-10-28
  • 录用日期:2021-11-04
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