Preimplantation genetic testing and chances of a healthy live birth amongst recipients of fresh donor oocytes in the United States
Preimplantation genetic testing and chances of a healthy live birth amongst recipients of fresh donor oocytes in the United States
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DOI：
10.1007/s10815-020-01874-8
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发表时间：
2020-07-02
影响因子：
3.1
通讯作者：
Polotsky, Alex J.
中科院分区：
文献类型：
--
作者：
Roeca, Cassandra;Johnson, Rachel;Polotsky, Alex J.
目的评价植入前基因检测（PGT）是否能提高新鲜供体卵母细胞受体的健康活产几率。方法我们进行了一项回顾性队列研究，包括2013年至2015年期间向辅助生殖技术临床结果报告系统报告的使用新鲜供体卵母细胞的女性体外受精周期。根据PGT对周期进行分类。主要结局指标是良好的出生结局（GBO），定义为单胎足月活产，平均出生体重。采用多变量广义估计方程模型分析PGT的作用。测试了循环类型（新鲜与冷冻）与PGT之间的交互作用。结果28,153个周期中，3708个周期发生PGT，24,445个周期未发生PGT。PGT周期不太可能导致胚胎移植（ET）（64 vs 94%），但与冷冻ET（70 vs 41%），单一ET（67 vs 44%）和囊胚ET（87 vs 65%）的比率增加相关。PGT与周期类型之间存在显著的交互作用。使用PGT的周期使冷冻周期中GBO的概率增加12%（RR 1.12; 95% CI 1.02，1.22;p = 0.018），但PGT不利于新鲜周期的成功，GBO的可能性降低53%（RR 0.47; 9% CI 0.41，0.54;p < 0.001）。结论PGT，在最近可用的国家数据中使用新鲜供体卵母细胞的妇女中实施，与冷冻周期中健康活产的概率增加相关，但在新鲜周期中没有益处。
Purpose To evaluate if preimplantation genetic testing (PGT) improves the odds of a healthy live birth amongst recipients of fresh donor oocytes. Methods We performed a retrospective cohort study including in vitro fertilization cycles of women using fresh donor oocytes reported to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System, between 2013 and 2015. Cycles were categorized based on PGT. Primary outcome measure was a good birth outcome (GBO), defined as a singleton, term, live birth with an average birthweight. Multivariable generalized estimating equation models were fit to analyze the effect of PGT. Interaction effect between cycle type (fresh vs frozen) and PGT was tested. Results Of 28,153 included cycles, 3708 had PGT while 24,445 did not. PGT cycles were less likely to result in an embryo transfer (ET) (64 vs 94%), but were associated with increased rates of frozen ET (70 vs 41%), single ET (67 vs 44%), and blastocyst ET (87 vs 65%). There was a significant interaction between PGT and cycle type. Cycles using PGT increased the probability of a GBO 12% in frozen cycles (RR 1.12; 95% CI 1.02, 1.22;p = 0.018), but PGT was detrimental to success in fresh cycles with a 53% reduced likelihood of GBO (RR 0.47; 9% CI 0.41, 0.54;p < 0.001). Conclusion PGT, as practiced during the most recently available national data in women using fresh donor oocytes, was associated with increased probability of a healthy live birth amongst frozen cycles, but was not beneficial in fresh cycles.