Maternal hypercholesterolemia would increase the incidence of embryo aneuploidy in couples with recurrent implantation failure.
Maternal hypercholesterolemia would increase the incidence of embryo aneuploidy in couples with recurrent implantation failure.
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母体高胆固醇血症会增加反复着床失败夫妇胚胎非整倍体的发生率。
DOI：
10.1186/s40001-023-01492-x
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发表时间：
2023-11-21
影响因子：
4.2
通讯作者：
Yan, Junhao
中科院分区：
文献类型：
--
作者：
Liu, Yang;Ni, Tianxiang;Zhao, Qing;Cui, Weiran;Lan, Xiangxin;Zhou, Tingting;Zhang, Qian;Yan, Junhao
关键词：
血脂异常与胚胎发育和妊娠结局的关系在很大程度上是未知的，特别是在原因不明的复发性着床失败（uRIF）患者中。本研究旨在从临床角度探讨植入前非整倍体基因检测（PGT-A）后血脂水平异常对胚胎遗传状态和妊娠结局的影响。本研究回顾性分析了502例诊断为uRIF的患者。根据胆固醇和甘油三酯水平分为非高脂血症组（NonH组）、单纯高胆固醇血症组（SHC组）、单纯高脂血症组（SHC组）和混合性高脂血症组（MixH组）。同时根据HDL-C水平将患者分为非低HDL-C组和低HDL-C组。分析各组间胚胎基因检测结果和PGT-A后妊娠结局。采用二元Logistic回归和/或广义估计方程（GEE）模型分析不同类型血脂异常与胚胎非整倍体率和累积活产率的关系。474例符合纳入标准的女性分为4组：NonH组（N = 349），SHC组（N = 55），SHT组（N = 52）和MixH组（N = 18）。与NonH组相比，SHC组胚胎非整倍体率显著增加[48.3% vs.36.7%，P = 0.006;调整或（95%置信区间）= 1.52（1.04-2.22），P = 0.029]，以及第5或6天优质胚胎数量减少[3.00 ± 2.29 vs. 3.74 ± 2.77，P = 0.033]。SHC组的累积活产率（47.0% vs.40.0%）、良好分娩结局发生率（37.2% vs.34.5%）和临床妊娠丢失风险（11.1% vs.17.9%）有降低趋势，但差异无统计学意义（P > 0.05）。产科或新生儿并发症和其他不良事件的发生率在四组中相似。患者是否有低HDL-C在妊娠结局方面没有差异。我们发现，患有高胆固醇血症的uRIF女性的非整倍体胚胎比例增加，优质胚胎比例减少，而不同类型的高脂血症与累积活产率以及妊娠和新生儿结局无关。在线版本包含补充材料，可通过10.1186/s40001-023-01492-x获得。
The association of dyslipidemia with embryo development and pregnancy outcomes is largely unknown, especially in unexplained recurrent implantation failure (uRIF) patients. Here, this study aimed to explore the impact of abnormal blood lipid levels on embryo genetic status and pregnancy outcomes after preimplantation genetic testing for aneuploidy (PGT-A) from a clinical perspective. This study retrospectively analyzed 502 patients diagnosed as uRIF. They were divided into four groups according to the levels of cholesterol and triglyceride: nonhyperlipidemia group (NonH group), simple hypercholesterolemia group (SHC group), simple hypertriglyceridemia group (SHC group) and mixed hyperlipidemia group (MixH group). At the same time, patients were divided into non-low HDL-C group and low HDL-C group according to their HDL-C level. The outcomes of embryos genetic testing and pregnancy outcomes after PGT-A was analyzed between groups. Binary logistic regression and/or generalized estimating equation (GEE) model were conducted to investigate the association of different types of dyslipidemia with embryonic aneuploidy rate and cumulative live-birth rate. 474 women who met the inclusion criteria were divided into four groups: NonH group (N = 349), SHC group (N = 55), SHT group (N = 52) and MixH group (N = 18). Compared with the NonH group, SHC group had a significantly increased rate of embryo aneuploidy [48.3% vs. 36.7%, P = 0.006; adjusted OR (95% confidence interval) = 1.52(1.04–2.22), P = 0.029], as well as a reduced number of good-quality embryos on day 5 or 6 [3.00 ± 2.29 vs. 3.74 ± 2.77, P = 0.033]. The SHC group showed a tendency of a lower cumulative live birth rate (47.0% vs. 40.0%), a lower incidence of good birth outcome (37.2% vs. 34.5%) and a higher risk of clinical pregnancy loss (11.1% vs. 17.9%), but did not reach statistical significance (P > 0.05). The incidences of obstetric or neonatal complications and other adverse events were similar in the four groups. Whether patients have low HDL-C did not differ in pregnancy outcomes. We found that uRIF women with hypercholesterolemia had an increased proportion of aneuploid embryos and a reduced proportion of high-quality embryos, while different types of hyperlipidemia had no correlation with cumulative live birth rate as well as pregnancy and neonatal outcomes. The online version contains supplementary material available at 10.1186/s40001-023-01492-x.
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