Cleavage-stage biopsy significantly impairs human embryonic implantation potential while blastocyst biopsy does not: a randomized and paired clinical trial
Cleavage-stage biopsy significantly impairs human embryonic implantation potential while blastocyst biopsy does not: a randomized and paired clinical trial
复制标题
DOI：
10.1016/j.fertnstert.2013.04.039
复制
发表时间：
2013-09-01
影响因子：
6.7
通讯作者：
Treff, Nathan R.
中科院分区：
文献类型：
--
作者：
Scott, Richard T., Jr.;Upham, Kathleen M.;Treff, Nathan R.
目的：确定卵裂期或囊胚期胚胎活检是否影响生殖能力。设计：配对随机临床试验。设置：学术辅助生殖项目。患者：尝试通过IVF受孕。干预：选择两个胚胎进行移植后，一个随机进行活检，另一个进行对照。此后不久，两人都被转移。将活检组织提交进行微阵列分析和单核苷酸多态性（SNP）分析。对产后新生儿颊部DNA进行微阵列分析，并与胚胎DNA进行SNP谱比较。匹配证实活检胚胎植入并发育至足月，而不匹配表明对照胚胎导致了deliver.Main结局Measure（s）：对移植胚胎的分娩率进行配对分析。双胞胎分娩或分娩失败代表活检胚胎和对照胚胎的等同结果。相反，单胎被确定为来自活检或对照胚胎。结果：发育第3天的卵裂球活检导致持续植入的显著减少。只有30%的活检胚胎持续着床并最终发育成活产婴儿，而未活检的对照组为50%，相对减少了39%。与此相反，持续植入率相等（51%对54%）活检和控制blastocyst.Conclusions（S）：卵裂阶段活检显着降低胚胎生殖潜力。相比之下，滋养外胚层活检没有可测量的影响，当胚胎活检时可以安全使用。
Objective: To determine if cleavage- or blastocyst-stage embryo biopsy affects reproductive competence.Design: Paired randomized clinical trial.Setting: Academic-assisted reproduction program.Patient(s): Attempting conception through IVF.Intervention(s): After selecting two embryos for transfer, one was randomized to biopsy and the other to control. Both were transferred within shortly thereafter. The biopsy was submitted for microarray analysis and single-nucleotide polymorphism (SNP) profiling. Buccal DNA obtained from the neonate after delivery had microarray analysis and SNP profile compared with that of the embryonic DNA. A match confirmed that the biopsied embryo implanted and developed to term, whereas a nonmatch indicated that the control embryo had led to the delivery.Main Outcome Measure(s): Paired analysis of the delivery rates of the transferred embryos. Either twin delivery or failure to deliver represents equivalent outcomes for the biopsied and control embryos. In contrast, singletons were determined to be from the biopsied or the control embryo.Result(s): Blastomere biopsy on day 3 of development resulted in a significant reduction in sustained implantation. Only 30% of biopsied embryos had sustained implantation and ultimately developed into live-born infants versus 50% of unbiopsied controls, a relative reduction of 39%. In contrast, sustained implantation rates were equivalent (51% vs. 54%) for biopsied and control blastocysts.Conclusion(s): Cleavage-stage biopsy markedly reduced embryonic reproductive potential. In contrast, trophectoderm biopsy had no measurable impact and may be used safely when embryo biopsy is indicated.