摘要
目的:探讨辅助生殖技术(ART)与早期流产胚胎染色体数目异常的关系。方法:通过多重连接依赖探针扩增技术对145例ART妊娠和36例自然妊娠孕早期自然流产的绒毛组织进行染色体数目检测,分析流产胚胎的染色体异常情况,比较不同受孕方式、受精方式、移植新鲜/冷冻胚胎妊娠后自然流产绒毛染色体异常率。结果:所有早期自然流产绒毛标本染色体总异常率为66.85%(121/181),以常染色体三体为主,非整倍体涉及除1号染色体以外所有染色体,以16号染色体最多见。流产胚胎非整倍体发生率在自然妊娠组与ART组间(66.67%vs 66.90%,P=1.000)、新鲜胚胎移植组与冷冻胚胎移植组间(65.91%vs 68.42%,P=0.857)均无统计学差异,体外受精(IVF)组略高于卵胞质内单精子注射(ICSI)组,但无统计学差异(73.26%vs 57.63%,P=0.072)。结论:胚胎染色体数目异常是自然流产的主要病因,ART包括ICSI和冻融胚胎均没有增加胎儿非整倍体发生率。
Objective： To explore the relationship between the numerical abnormalities of fetal chromosomes and spontaneous abortion during the first trimester following assisted reproductive technology （ART）. Methods： A total of 145 cases of ART and 36 cases of natural conception （NC） suffered from spontaneous abortion during the first trimester were included in this study. Chorionic villus specimens were tested for the chromosome number by multiplex ligation-dependent probe amplification （MLPA） method, and then the incidence and types of aberrations were assessed. Comparisons were performed between different conception ways, different fertilization ways and the fresh or frozen-thawed embryo transfer. Results： The overall chromosomal abnormality＇s rate of early spontaneous abortion was 66.85% （121/181）, and the most prevalent abnormality was autosomal trisomy. Aberration for each chromosome, with the exception of chro- mosome 1, was identified and the most common trisomy was chromosomes 16. No difference in the preva- lence of chromosomal aberrations was found by comparing NC to ART （66.67% vs 66.90%, P=I.000）, or between the fresh embryo transfer （fresh-ET subgroup） and the frozen-thawed embryo transfer （FET subgroup） （65.91% vs 68.42%, P=0.857）. The aneuploidy rate of the IVF subgroup was higher than that of the ICSI subgroup but with no statistical difference （73.26% vs 57.63%, P=0.072）. Conclusion： Fetal chromosomal abnormality is the most important reason of spontaneous abortion during the first trimester. ART, ICSI or the cryopreservation of embryo does not increase the risk of aneuploidy.
出处
《生殖与避孕》
CAS
CSCD
2013年第10期658-664,共7页
Reproduction and Contraception
基金
广东省医学科研基金
项目号:B2010292
关键词
非整倍体
自然流产
辅助生殖技术(ART)
绒毛
aneuploidy
spontaneous abortion
assisted reproductive technology （ART）
chorionic villus
