植入前遗传学筛查对不明原因反复种植失败患者的临床治疗价值

doi:10.6040/j.issn.1671-7554.0.2017.1105

摘要/Abstract

摘要： 目的探讨植入前遗传学筛查(PGS)对不明原因反复种植失败(uRIF)患者的临床治疗价值。方法回顾性分析诊断为uRIF的患者140例,根据是否行PGS治疗进行分组,PGS组(72例)和未行PGS治疗的体外受精-胚胎移植(IVF-ET)/卵胞浆内单精子注射(ICSI)对照组(68例),分析了189个冷冻后胚胎移植周期(PGS组95个周期,对照组94个周期)的妊娠结局。PGS组与对照组均根据年龄分为两个亚组(<35岁,≥35岁),并比较亚组间的妊娠结局。结果 PGS组与对照组患者的妊娠结局比较,PGS组的种植率(P=0.001)、临床妊娠率(P=0.045)均升高。PGS组患者的流产率、首次移植周期活产率、累计活产率、双胎率与对照组患者比较,差异均无统计学意义(P>0.05)。在≥35岁组患者的移植周期妊娠结局中,PGS组患者种植率(P=0.003)、临床妊娠率(P=0.027)高于对照组,但两组间的流产率、继续妊娠率、首次移植周期活产率、累计活产率差异均无统计学意义。在35岁组患者的妊娠结局中,PGS组患者的种植率、临床妊娠率、继续妊娠率、流产率、首次移植周期活产率、累计活产率与对照组比较,差异均无统计学意义(P>0.05)。结论 PGS提高了≥35岁高龄uRIF女性的胚胎种植率和临床妊娠率。

关键词: 植入前遗传学筛查, 不明原因反复种植失败, 种植率, 临床妊娠率, 活产率

Abstract: Objective To evaluate the clinical results of preimplantation genetic screening(PGS)in patients with unexplained recurrent implantation failure(uRIF). Methods A total of 140 patients diagnosed as having uRIF were collected and 189 transfers after referral were analyzed(95 circles in PGS group, 94 circles in control group); 72 patients who underwent PGS were included in the PGS group, while 68 non-PGS patients were included in the control group. All the subjects were divided into two subgroups by age(<35 years, ≥35 years), and the clinical outcome were compared. Results After referral, the implantation rate(P=0.001)and clinical pregnancy rate(P=0.045)per transfer were significantly higher in the PGS group than those in the control group. There were no significant differences between the two 山东大学学报 (医学版)56卷4期 -张丹丹,等.植入前遗传学筛查对不明原因反复种植失败患者的临床治疗价值 \=-groups in abortion rate, live birth rate of the first transfer, cumulative live birth and twinning rates. Among women aged ≥35 years, the implantation rate(P=0.003)and clinical pregnancy rate(P=0.027)per transfer were significantly higher in the PGS group than those in the control group, and there were no significant differences between the two groups in abortion rate, ongoing pregnancy rate, live birth rate of the first transfer and cumulative live birth(P>0.05). However, among women aged <35 years, no significant differences were found between two groups in the implantation rate, clinical pregnancy rate, ongoing pregnancy rate, abortion rate, live birth rate of the first transfer and cumulative live birth(P>0.05). Conclusion PGS can improve the implantation rate and clinical pregnancy rate among patients over 35 years old with uRIF.

Key words: Preimplantation genetic screening, Unexplained recurrent implantation failure, Implantation rate, Clinical pregnancy rate, Live birth rats

中图分类号:

R714.8

张丹丹,解洪强,吴倩倩,李鸿昌,朱月婷,鲁娟娟,姜文杰,颜军昊. 植入前遗传学筛查对不明原因反复种植失败患者的临床治疗价值[J]. 山东大学学报 (医学版), 2018, 56(4): 64-69.

ZHANG Dandan, XIE Hongqiang, WU Qianqian, LI Hongchang, ZHU Yueting, LU Juanjuan, JIANG Wenjie, YAN Junhao. Clinical treatment value of preimplantation genetic screening for unexplained repeated implantation failure[J]. Journal of Shandong University (Health Sciences), 2018, 56(4): 64-69.

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