根据卵子储备和年龄的减少与正常,比较使用无创产前检测发现 13、18 和 21 三体综合征的频率

Brooke Neumann, Nicole Weitz, Jerome H. Check, Carrie Wilson, A. Diantonio, Megan O’Neil
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摘要

研究背景本研究旨在确定通过无创产前检测(NIPT)评估,卵母细胞储备减少(DOR)是否会增加 10 周时胎儿罹患 13、18 或 21 三体综合征的风险,并评估高龄的混杂效应。方法:对一家不孕不育中心所有通过自然疗法或辅助生殖技术受孕且受孕 10 周后胎儿存活的孕妇进行无创产前检测。根据血清抗穆勒氏管激素(AMH)< 1 ng/mL和≥1 ng/mL对数据进行分层。结果没有小于 39 岁或 AMH≥1 纳克/毫升的女性通过 NIPT 发现 13、18 或 21 三体综合征。只有年龄≥39 岁且有 DOR 的女性才有上述三体之一。结论:希望这些数据以及其他因素(如不孕症的病因、年龄、保险或经济状况以及个人对终止妊娠的看法)能帮助 DOR 患者选择治疗方案,包括自然受孕、IVF-ET、植入前非整倍体基因检测的 IVF 或受精捐卵移植。
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A Comparison of the Frequency of Trisomy 13, 18, and 21 Using Non-Invasive Prenatal Testing According to Diminished vs. Normal Egg Reserve and Age
Background: This study’s aim was to determine whether diminished oocyte reserve (DOR) increases the risk of having a fetus with trisomy 13, 18, or 21 at 10 weeks as evaluated by non-invasive prenatal testing (NIPT) and to evaluate the confounding effect of advanced age. Methods: NIPT was undertaken in all pregnancies conceived through natural treatment or assisted reproductive technology that reached 10 weeks from conception with a viable fetus from one infertility center. Data were stratified according to serum anti-Mullerian hormone (AMH) < 1 ng/mL and ≥1 ng/mL. Results: No woman < 39 or with AMH ≥ 1 ng/mL showed trisomy 13, 18, or 21 by NIPT. Only women ≥ age 39 with DOR had one of these trisomies. Conclusions: Hopefully these data, coupled with other factors, e.g., etiology of infertility, age, insurance, or financial circumstances, and personal views of pregnancy termination, will aid patients with DOR when choosing treatment options, including natural conception, IVF-ET, IVF with pre-implantation genetic testing for aneuploidy, or transfer of fertilized donor eggs.
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