Anastasia A. Salame, Elias M. Dahdouh, Rania Aljafari, David A. Samuel, Bhavya P. Koodathingal, Aparna Bajpai, Shabin Kainoth, Michael Fakih
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The primary outcome was the rate of aneuploid embryos per patient’s history as well as per embryo characteristics. The aneuploidy rate (AR) in our cohort was 43.4%. The woman’s age was found to be a significant predictor (OR 1.045, 95% CI 1.008–1.084, p = 0.016). Biopsy on day 5 as well as degree of expansion 3 was also found to affect significantly (OR 0.724, 95% CI .541–.970, p = 0.03 and OR 2.645, 95% CI 1.252–5.585, p = 0.011). Lack of consanguinity decreased the AR by an OR 0.274 with 95% CI .137–.547, p < 0.001. The number of blastocysts available, trophectoderm quality, embryo grade, gonadotropins as well as trigger used were not found to be significant predictors (p = 0.495, 0.649, 0.264, 0.717 and 0.659 respectively). Advanced female age, consanguinity, the day of embryo biopsy, and the degree of blastocyst expansion were all found to affect the incidence of AR. 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引用次数: 0
摘要
PGT-A 已成为试管婴儿治疗的重要组成部分。尽管PGT-A的使用越来越多,但其在改善ART周期生殖结果方面的作用却存在着相互矛盾的结果。鉴于非整倍体是试管婴儿成功率的主要限制因素,我们旨在研究接受试管婴儿治疗的不孕患者非整倍体的预测因素,从而突出基因检测的最大受益者。我们对在 PGT-A 周期中活检的 1242 个囊胚进行了回顾性分析。优倍体组包括 703 个胚胎,而非整倍体组有 539 个胚胎。分析的因素包括夫妇的病史和胚胎特征。主要结果是根据患者病史和胚胎特征得出的非整倍体胚胎率。我们队列中的非整倍体率(AR)为 43.4%。妇女的年龄是一个重要的预测因素(OR 1.045,95% CI 1.008-1.084,p = 0.016)。第 5 天的活组织检查和扩张程度 3 也有显著影响(OR 0.724,95% CI .541-.970,p = 0.03 和 OR 2.645,95% CI 1.252-5.585,p = 0.011)。缺乏血缘关系会降低 AR,OR 值为 0.274,95% CI 为 .137-.547,p < 0.001。可用囊胚数量、滋养层质量、胚胎等级、促性腺激素以及使用的触发器都不是重要的预测因素(p = 0.495、0.649、0.264、0.717 和 0.659)。高龄女性、近亲结婚、胚胎活检日和囊胚扩张程度都会影响 AR 的发生率。男性伴侣的年龄、不孕原因和活检时胚胎的等级与非整倍体没有关联。
Predictive factors of aneuploidy in infertile patients undergoing IVF: a retrospective analysis in a private IVF practice
PGT-A has become an important part of IVF treatments. Despite its increased use, there are contradicting results on its role in improving reproductive outcomes of ART cycles. Given that aneuploidy is a main limiting factor for IVF success, we aimed to study the predictive factors of aneuploidy in infertile patients undergoing IVF and hence highlight the patients who would benefit the most from genetic testing. A retrospective analysis of 1242 blastocysts biopsied in the setting of PGT-A cycles was performed. The euploid group included 703 embryos, while the aneuploid group had 539 embryos. The factors included in the analyses were the couple’s history as well as the embryo characteristics. The primary outcome was the rate of aneuploid embryos per patient’s history as well as per embryo characteristics. The aneuploidy rate (AR) in our cohort was 43.4%. The woman’s age was found to be a significant predictor (OR 1.045, 95% CI 1.008–1.084, p = 0.016). Biopsy on day 5 as well as degree of expansion 3 was also found to affect significantly (OR 0.724, 95% CI .541–.970, p = 0.03 and OR 2.645, 95% CI 1.252–5.585, p = 0.011). Lack of consanguinity decreased the AR by an OR 0.274 with 95% CI .137–.547, p < 0.001. The number of blastocysts available, trophectoderm quality, embryo grade, gonadotropins as well as trigger used were not found to be significant predictors (p = 0.495, 0.649, 0.264, 0.717 and 0.659 respectively). Advanced female age, consanguinity, the day of embryo biopsy, and the degree of blastocyst expansion were all found to affect the incidence of AR. The age of the male partner, cause of infertility, and grade of embryo at biopsy were not found to correlate with aneuploidy.