Maternal age, morphology, development and chromosome abnormalities in over 6000 cleavage-stage embryos
Maternal age, morphology, development and chromosome abnormalities in over 6000 cleavage-stage embryos
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DOI：
10.1016/s1472-6483(10)61057-7
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发表时间：
2007-05-01
影响因子：
4
通讯作者：
Cohen, J.
中科院分区：
文献类型：
--
作者：
Munne, S.;Chen, S.;Cohen, J.
以前评估胚胎发育，母体年龄和染色体异常之间关系的研究要么规模较小，要么分析的大多是不适合替代的胚胎。目前的研究包括> 6000个胚胎，包括许多适合替换的胚胎。在小于35岁的患者中，具有最佳形态和发育的胚胎为44%的整倍体，在41岁及以上的患者中降至21%。最差形态组中，35岁以下患者的正常胚胎仅占30%，41岁及以上患者的胚胎占12%。因此，形态学分析在最好的情况下只能将正常胚胎的数量从30%提高到44%。关于特定的异常，20%的胚胎是非整倍体，32%的非整倍体加上其他异常，其余的有减数分裂后异常。其中，只有非整倍体随着母亲年龄的增加而增加。在相似的年龄组内，根据患者适应症的不同，染色体异常的频率没有太大差异。总之，先前在次优胚胎中检测到的趋势也在用于替换的最佳胚胎中得到证实。虽然畸形和高龄产妇都与染色体异常有关，但这些参数最多可以产生< 50%的整倍体胚胎，需要其他技术如植入前诊断来确保只有整倍体胚胎被替换。
Previous studies assessing the relationship between embryo development, maternal age and chromosome abnormalities were either small or analysed mostly embryos not suitable for replacement. The present study includes > 6000 embryos, including many suitable for replacement. Embryos with the best morphology and development were 44% euploid in patients younger than 35, decreasing to 21% in patients 41 and older. The worst morphology group had only 30% normal embryos from patients younger than 35, and 12% in embryos from patients 41 and older. Thus morphological analysis was able to improve the population of normal embryos only from 30 to 44% in the best of cases. Regarding specific abnormalities, 20% of embryos were aneuploid, 32% aneuploid plus other abnormalities, and the rest had post-meiotic abnormalities. Of those, only aneuploidy increased with maternal age. There were no big differences in the frequency of chromosome abnormalities depending on patient indication, within a similar age group. In summary, previous trends detected in suboptimal embryos were also confirmed in the best embryos for replacement. Although dysmorphism and advanced maternal age are both related to chromosome abnormalities, these parameters can yield at most < 50% euploid embryos, and other techniques such as preimplantation diagnosis are required to ensure that only euploid embryos are replaced.