Different Strategies of Preimplantation Genetic Testing for Aneuploidies in Women of Advanced Maternal Age: A Systematic Review and Meta-Analysis.
Different Strategies of Preimplantation Genetic Testing for Aneuploidies in Women of Advanced Maternal Age: A Systematic Review and Meta-Analysis.
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高龄女性非整倍体植入前基因检测的不同策略：系统评价和荟萃分析
DOI：
10.3390/jcm10173895
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发表时间：
2021-08-30
影响因子：
3.9
通讯作者：
Xu CM
中科院分区：
文献类型：
--
作者：
Shi WH;Jiang ZR;Zhou ZY;Ye MJ;Qin NX;Huang HF;Chen SC;Xu CM
背景：胚胎植入前非整倍体基因检测（PGT-A）广泛应用于高龄产妇（AMA）。然而，其有效性仍然存在争议。方法：我们于2021年1月在PubMed、Embase和科克伦对照试验中心进行了一项全面的文献综述，比较了AMA女性在有或没有PGT-A的情况下进行IVF的结局。所有纳入的试验均符合标准，构成了涉及AMA女性（≥35岁）的PGT-A随机对照试验。排除综述、会议摘要和观察性研究。主要结局是随机对照试验（RCT）中的活产率。结果：9项随机对照试验符合我们的纳入标准。对于遗传分析技术，采用全面染色体筛查进行的3项试验（270例事件）显示，随机接受IVF/ICSI联合PGT-A的女性活产率显著较高（RR = 1.30，95%CI 1.03-1.65），而在6项使用FISH的试验以及所有9项试验中均未观察到这一点。在不同的胚胎活检阶段，只有囊胚活检亚组显示PGT-A妇女的活产率较高（RR = 1.36，95%CI 1.04-1.79）。结论：PGT-A在AMA患者中的应用较FISH有更好的筛查效果。此外，囊胚活检似乎与一个更好的结果比极体活检和卵裂期活检。
Background: Preimplantation genetic testing for aneuploidies (PGT-A) is widely used in women of advanced maternal age (AMA). However, the effectiveness remains controversial. Method: We conducted a comprehensive literature review comparing outcomes of IVF with or without PGT-A in women of AMA in PubMed, Embase, and the Cochrane Central Register of Controlled Trials in January 2021. All included trials met the criteria that constituted a randomized controlled trial for PGT-A involving women of AMA (≥35 years). Reviews, conference abstracts, and observational studies were excluded. The primary outcome was the live birth rate in included random control trials (RCTs). Results: Nine randomized controlled trials met our inclusion criteria. For techniques of genetic analysis, three trials (270 events) performed with comprehensive chromosomal screening showed that the live birth rate was significantly higher in the women randomized to IVF/ICSI with PGT-A (RR = 1.30, 95% CI 1.03–1.65), which was not observed in six trials used with FISH as well as all nine trials. For different stages of embryo biopsy, only the subgroup of blastocyst biopsy showed a higher live birth rate in women with PGT-A (RR = 1.36, 95% CI 1.04–1.79). Conclusion: The application of comprehensive chromosome screening showed a beneficial effect of PGT-A in women of AMA compared with FISH. Moreover, blastocyst biopsy seemed to be associated with a better outcome than polar body biopsy and cleavage-stage biopsy.
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影响因子：
6.7
作者：
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通讯作者：
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