Higher chromosomal aberration rate in miscarried conceptus from polycystic ovary syndrome women undergoing assisted reproductive treatment
Higher chromosomal aberration rate in miscarried conceptus from polycystic ovary syndrome women undergoing assisted reproductive treatment
复制标题
接受辅助生殖治疗的多囊卵巢综合征妇女流产胎儿染色体畸变率较高
DOI：
10.1016/j.fertnstert.2019.01.026
复制
发表时间：
2019-05-01
影响因子：
6.7
通讯作者：
Sun, Yingpu
中科院分区：
文献类型：
--
作者：
Li, Ying;Wang, Linlin;Sun, Yingpu
目的：评估辅助生殖技术（ART）治疗期间多囊卵巢综合征（PCOS）与染色体异常流产之间的潜在关联。设计：回顾性单中心研究。设置：大学附属生殖中心。患者：2013年1月至2014年9月，我中心共有328例孕早期流产患者在ART后送绒毛进行遗传学检查2016年，其中119例为PCOS女性，209例为非PCOS对照。干预措施：对所有收集的样本进行单核苷酸多态性阵列分析。主要结果测量：流产胎儿的异常核型频率以及PCOS和染色体异常流产之间的相关性。结果：单核苷酸多态性分析结果表明，173例（52.7%）胎儿染色体异常。PCOS患者妊娠染色体畸变率高于对照组（61.3% vs. 47.8%）。此外，单变量和多变量分析均将PCOS确定为胚胎/胎儿染色体异常的危险因素，比值比为1.957（95%置信区间，1.067-3.590）和2.008（95%置信区间，1.038-3.883）。在ART治疗期间，与非PCOS对照组相比，PCOS妇女流产染色体异常胚胎/胎儿的风险增加。机制需要进一步研究。胚胎植入前遗传学筛查可能是降低PCOS患者自然流产风险的有效方法。((C)2019年由美国生殖医学学会（American Society for Reproductive Medicine）
Objective: To assess the potential association between polycystic ovary syndrome (PCOS) and chromosomally aberrant miscarriage during treatment with assisted reproductive technology (ART).Design: A retrospective, single-center study.Setting: University-affiliated reproductive center.Patient(s): A total of 328 patients sent their first trimester miscarried chorionic villus for genetic examination after ART in our center from January 2013 to September 2016, of which 119 cases were women with PCOS and 209 were non-PCOS controls. No known definite miscarriage-related concomitants existed in any study subject.Intervention(s): Single nucleotide polymorphism array analysis was performed on all collected samples.Main Outcome Measure(s): Frequency of aberrant karyotype of miscarried conceptus and the correlation between PCOS and chromosomally aberrant miscarriage.Result(s): A total of 173 (52.7% of 328) conceptuses were identified as chromosomally aberrant by single nucleotide polymorphism array. Chromosomal aberrations were more frequent in conceptuses from PCOS patients compared with controls (61.3% vs. 47.8%). Furthermore, both univariate and multivariable analysis identified PCOS as a risk factor for an embryo/fetus to be chromosomally abnormal, with odds ratios of 1.957 (95% confidence interval, 1.067-3.590) and 2.008 (95% confidence interval, 1.038-3.883), respectively.Conclusion(s): Women with PCOS were at an increased risk of miscarrying a chromosomally aberrant embryo/fetus compared with non-PCOS controls during ART. Mechanisms require further investigation. Preimplantation genetic screening might be an effective approach to decrease the risk of spontaneous miscarriage for women with PCOS. ((C) 2019 by American Society for Reproductive Medicine.)