Blastocyst culture of non-top-quality cleavage embryos may increase the risk of anembryonic pregnancy following in vitro fertilization: a retrospective cohort study.
Blastocyst culture of non-top-quality cleavage embryos may increase the risk of anembryonic pregnancy following in vitro fertilization: a retrospective cohort study.
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非优质卵裂胚胎的囊胚培养可能会增加体外受精后无胚胎妊娠的风险：一项回顾性队列研究
DOI：
10.21037/atm-22-5809
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发表时间：
2022-12
影响因子：
--
通讯作者：
Hua, Rui
中科院分区：
文献类型：
--
作者：
Zhu, Yongtong;Zhou, Yao;Liu, Siping;Guo, Feiyan;Wu, Biao;Xu, Xiya;Luo, Chen;Li, Hong;Hua, Rui
空孕囊妊娠（AP）是人类胚胎发育最严重的畸形，也是早期妊娠丢失（EPL）的常见表现形式。已有研究分析了辅助生殖技术（ART）与早期妊娠丢失之间的关联。然而，ART与空孕囊妊娠之间的具体关系尚未完全阐明。一些研究表明，非基因组异常可能与空孕囊妊娠有关，并且ART可能会增加表观遗传变化的风险，从而可能发现ART与空孕囊妊娠之间存在某些关联。我们的研究旨在找出ART治疗中空孕囊妊娠的任何可能风险因素，并将研究结果应用于临床实践。
在南方医院进行了一项回顾性队列研究。收集了2014年1月至2017年12月期间新鲜或冻融胚胎移植后的1765例单胎妊娠数据，包括早期妊娠丢失和正常活产（NLB）。参与者被分为三组：正常活产组（足月分娩且新生儿体重正常）、伴有胚胎的早期妊娠丢失组（EE，妊娠13周前自然流产）以及空孕囊妊娠组（在连续两次超声检查中未见到胚胎极）。分别使用单因素方差分析（ANOVA）和多变量逻辑回归模型分析患者的基本特征以及ART相关变量与空孕囊妊娠之间的关联。对空孕囊妊娠和伴有胚胎的早期妊娠丢失患者的妊娠产物（POC）使用多重连接依赖式探针扩增（MLPA）技术进行染色体核型分析。
非优质卵裂期胚胎的囊胚培养使早期妊娠丢失中空孕囊妊娠的比例几乎翻倍（45.9%对24.4%，P = 0.037），并且空孕囊妊娠组的正常整倍体率显著更高（50.5%对32.3%，P = 0.003）。通过多变量逻辑回归模型，我们发现囊胚移植和高龄产妇可能是空孕囊妊娠的风险因素（比值比>1，P<0.05）。β - 人绒毛膜促性腺激素（β - HCG）水平降低可能预示其发生（比值比<1，P<0.001），而辅酶Q10补充可能是一个保护因素（比值比<1，P<0.001）。
空孕囊妊娠的发生可能是由于与高龄产妇和体外胚胎培养时间延长相关的表观遗传异常，而辅酶Q10补充可能是预防空孕囊妊娠的一种潜在方法。未来应进行多中心前瞻性队列研究以验证这些结果。
Background Anembryonic pregnancy (AP) is the most severe dysmorphogenesis of human embryo development and a frequent presentation of early pregnancy loss (EPL). Studies have analyzed the association between assisted reproductive technologies (ART) and EPL. However, the specific relationship between ART and AP has not been fully elucidated. Several studies suggested that non-genomic anomalies might be related to AP and ART might increase the risk of epigenetic changes, thus possibly detecting some associations between ART and AP. Our study aims to find out any possible risk factors of AP in ART treatments, and translate the results into clinical practice. Methods A retrospective cohort study was conducted in Nanfang Hospital. Data from 1,765 singleton pregnancies following fresh or frozen-thawed embryo transfer from January 2014 to December 2017 were collated with the inclusion of EPLs and normal live births (NLB). Participants were divided into three groups: NLB (full-term birth with normal body weight infants), EPL (spontaneous pregnancy loss prior to 13 weeks gestation) with embryos (EE), and APs (embryonic pole was invisible in two consecutive ultrasound examinations). The basic characteristics of the patients and the association between ART-related variables and AP were analyzed using one-way analysis of variance (ANOVA) and multivariable logistic regression model, respectively. Products of conception (POC) from AP and EE patients received karyotype analysis using multiplex ligation-dependent probe amplification (MLPA). Results Blastocyst culture of non-top-quality cleavage stage embryos almost doubled the percentage of AP in EPL (45.9% vs. 24.4%, P=0.037), and the normal euploid rate was significantly higher in the AP group (50.5% vs. 32.3%, P=0.003). Using multivariable logistic regression model, we found that blastocyst transfer and advanced maternal age might be risk factors for AP (OR >1, P<0.05). Deceased β-HCG level might indicate its occurrence (OR <1, P<0.001) while CoQ10 supplementation might be a protective factor (OR <1, P<0.001). Conclusions The occurrence of AP may be due to epigenetic abnormalities associated with advanced maternal age and extended in vitro embryo culture, while CoQ10 supplementation may be a potential method in preventing AP. Future multi-center prospective cohort studies should be conducted to verify these results.
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非优质卵裂胚胎的囊胚培养可能会增加体外受精后无胚胎妊娠的风险：一项回顾性队列研究
影响因子：
--
作者：
Zhu, Yongtong;Zhou, Yao;Liu, Siping;Guo, Feiyan;Wu, Biao;Xu, Xiya;Luo, Chen;Li, Hong;Hua, Rui
通讯作者：
Hua, Rui
DOI：
10.1002/uog.14713
发表时间：
2015-01
期刊：
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
影响因子：
--
作者：
Romero ST;Geiersbach KB;Paxton CN;Rose NC;Schisterman EF;Branch DW;Silver RM
通讯作者：
Silver RM
单亲胚胎的单细胞转录组分析揭示了亲本对人类植入前发育的影响
影响因子：
23.9
作者：
Leng, Lizhi;Sun, Jiya;Lin, Ge
通讯作者：
Lin, Ge
DOI：
10.1097/01.jaa.0000733216.66078.ac
发表时间：
2021-03-01
影响因子：
1.1
作者：
Jackson, Toni;Watkins, Elyse
通讯作者：
Watkins, Elyse
影响因子：
3.1
作者：
Lathi, Ruth B.;Mark, Sara D.;Milki, Amin A.
通讯作者：
Milki, Amin A.