Idiopathic recurrent miscarriage is caused mostly by aneuploid embryos
Idiopathic recurrent miscarriage is caused mostly by aneuploid embryos
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DOI：
10.1016/j.fertnstert.2012.05.025
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发表时间：
2012-09-01
影响因子：
6.7
通讯作者：
Munne, Santiago
中科院分区：
文献类型：
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作者：
Hodes-Wertz, Brooke;Grifo, Jamie;Munne, Santiago
目的：应用阵列比较基因组杂交技术对特发性复发性妊娠丢失患者进行植入前遗传学筛查，并与预期丢失率进行比较。设计：病例系列报告。背景：多生育中心。患者(S)：特发性复发性妊娠丢失夫妇共287个周期(定义为两次或两次以上丢失)。干预(S)：采用第3天活检法(n=193)或胚泡活检法(n=94)进行植入前遗传学筛查，然后用CGH软件进行分析。主要结局指标(S)：自然流产率、自然流产率、自然流产率结果：共分析2,282枚胚胎，其中整倍体胚胎占35%，非整倍体胚胎占60%。共移植181个胚胎周期，其中妊娠100个(55%)，着床率45%(136个囊/299个替换胚胎)，94个(92%)妊娠正在进行中(中期妊娠)或分娩。流产率仅为6.9%(7/102)，而正常妊娠组的流产率为33.5%，不孕对照组为23.7%。结论：目前的妊娠期妊娠结局显示，特发性妊娠高血压综合征患者的流产率显著降低，妊娠率高。此外，这表明特发性复发性流产主要是由胚胎中的染色体异常引起的。(Fertil Steril(R)2012；98：675-80。(C)2012年，由美国生殖医学学会主办。)
Objective: To determine any beneficial effects of preimplantation genetic screening (PGS) of all chromosomes by array comparative genomic hybridization (aCGH), with either day 3 or blastocyst biopsy, for idiopathic recurrent pregnancy loss (RPL) patients compared with their expected loss rate.Design: Case series report.Setting: Multiple fertility centers.Patient(s): A total of 287 cycles of couples with idiopathic RPL (defined as two or more losses).Intervention(s): PGS was done with day 3 biopsy (n = 193) or blastocyst biopsy (n 94), followed by analysis with aCGH.Main Outcome Measure(s): Spontaneous abortion rate, euploidy rate.Result(s): A total of 2,282 embryos were analyzed, of which 35% were euploid and 60% were aneuploid. There were 181 embryo transfer cycles, of which 100 (55%) became pregnant with an implantation rate of 45% (136 sacs/299 replaced embryos) and 94 pregnancies (92%) were ongoing (past second trimester) or delivered. The miscarriage rate was found to be only 6.9% (7/102), compared with the expected rate of 33.5% in an RPL control population and 23.7% in an infertile control population.Conclusion(s): Current PGS results with aCGH indicate a significant decrease in the miscarriage rate of idiopathic RPL patients and high pregnancy rates. Furthermore, this suggests that idiopathic recurrent miscarriage is mostly caused by chromosomal abnormalities in embryos. (Fertil Steril (R) 2012; 98: 675-80. (C) 2012 by American Society for Reproductive Medicine.)