Differences in pregnancy outcomes in donor egg frozen embryo transfer (FET) cycles following preimplantation genetic screening (PGS): a single center retrospective study.
Differences in pregnancy outcomes in donor egg frozen embryo transfer (FET) cycles following preimplantation genetic screening (PGS): a single center retrospective study.
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DOI：
10.1007/s10815-016-0832-z
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发表时间：
2017-01
影响因子：
3.1
通讯作者：
Munne S
中科院分区：
文献类型：
--
作者：
Coates A;Bankowski BJ;Kung A;Griffin DK;Munne S
本研究旨在通过单中心回顾性分析检验这一假设，即在使用年轻匿名捐赠者卵子的冻融胚胎移植患者中，使用植入前遗传筛查 (PGS) 与不使用 PGS 相比，活产率存在显着差异。因此，问题是 PGS 是否是对供卵周期的适当干预措施。对选择进行 PGS 的患者与未进行 PGS 的患者进行了比较，检查了每个周期的活产率以及 398 个冷冻胚胎移植 (FET) 周期后每个移植胚胎的活产率。对来自供体卵子的囊胚进行滋养外胚层活检，并使用阵列比较基因组杂交 (aCGH) 或下一代测序 (NGS) 测试非整倍性，然后玻璃化以供将来使用（测试）或玻璃化未测试（对照）。随后将胚胎加热并转移到受体或妊娠载体子宫中。分别分析单胚胎移植（SET）、双胚胎移植（DET）以及自己的受体子宫和妊娠携带者（GC）子宫受体的数据。与无 PGS 组相比，移植两个胚胎 (DET) 的 PGS 组的胚胎着床率显着高于无 PGS 组（GC，72% vs. 56%；自体子宫，60% vs. 36%）。与对照组相比，SET 组自身子宫组的活产着床率较高（58% vs. 36%），这几乎达到了显着性，但 SET GC 组的活产着床率对于测试和未测试的胚胎都保持相同。与非 PGS 胚胎移植相比，PGS GC DET 以及自体子宫 SET 和 DET 组的每个周期的活产率名义上更高。这些差异几乎达到了显着的程度。 SET GC 组每个周期的活产率几乎相同。仅 DET 存在显着差异；然而，需要平衡多胎妊娠带来的益处和风险。 SET 观察到的结果需要在更大的系列和随机队列中得到证实。
This study aims to test the hypothesis, in a single-center retrospective analysis, that live birth rates are significantly different when utilizing preimplantation genetic screening (PGS) compared to not utilizing PGS in frozen–thawed embryo transfers in our patients that use eggs from young, anonymous donors. The question therefore arises of whether PGS is an appropriate intervention for donor egg cycles. Live birth rates per cycle and live birth rates per embryo transferred after 398 frozen embryo transfer (FET) cycles were examined from patients who elected to have PGS compared to those who did not. Blastocysts derived from donor eggs underwent trophectoderm biopsy and were tested for aneuploidy using array comparative genomic hybridization (aCGH) or next-generation sequencing (NGS), then vitrified for future use (test) or were vitrified untested (control). Embryos were subsequently warmed and transferred into a recipient or gestational carrier uterus. Data was analyzed separately for single embryo transfer (SET), double embryo transfer (DET), and for own recipient uterus and gestational carrier (GC) uterus recipients. Rates of implantation of embryos leading to a live birth were significantly higher in the PGS groups transferring two embryos (DET) compared to the no PGS group (GC, 72 vs. 56 %; own uterus, 60 vs. 36 %). The live birth implantation rate in the own uterus group for SET was higher in the PGS group compared to the control (58 vs. 36 %), and this almost reached significance but the live birth implantation rate for the SET GC group remained the same for both tested and untested embryos. Live births per cycle were nominally higher in the PGS GC DET and own uterus SET and DET groups compared to the non-PGS embryo transfers. These differences almost reached significance. The live birth rate per cycle in the SET GC group was almost identical. Significant differences were noted only for DET; however, benefits need to be balanced against risks associated with multiple pregnancies. Results observed for SET need to be confirmed on larger series and with randomized cohorts.