Clinical Outcomes of Single Mosaic Embryo Transfer: High-Level or Low-Level Mosaic Embryo, Does It Matter?
Clinical Outcomes of Single Mosaic Embryo Transfer: High-Level or Low-Level Mosaic Embryo, Does It Matter?
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DOI：
10.3390/jcm9061695
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发表时间：
2020-06-01
影响因子：
3.9
通讯作者：
Lee, Maw-Sheng
中科院分区：
文献类型：
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作者：
Lin, Pin-Yao;Lee, Chun-, I;Lee, Maw-Sheng
最近有报道称，植入前非整倍体基因检测(Pre-ploid Genetic Testing for Non-Placeid，PGT-A)后鉴定为嵌合体的胚胎，与整倍体胚胎相比，可以获得较低妊娠率和较高妊娠率的活产。然而，嵌合体水平对生殖结果的影响仍然存在争议。这项研究旨在检查马赛克对妊娠结局的影响程度。对108名只有马赛克胚胎的妇女进行了单次马赛克胚胎移植。利用基于下一代测序(NGS)的PGT-A标记马赛克胚胎，进行第5/6天滋养外胚层(TE)活组织检查。含有50%异常细胞的TE活检组织被归类为低水平嵌合体，>；=50%为高水平嵌合体。为了进一步证实TE和内细胞团(ICM)的染色体构成的一致性，还分析了41个用于研究的被指定为镶嵌囊胚的剩余胚胎。高水平组的活产率(LBR)与高水平组相似，但流产率(MR)较高。(低比高：44.5%比36%；p=0.45，MR：低比高：5.1%比30.7%；p=0.012)。对剩余的马赛克胚泡进行的TE和ICM分析显示一致性很差。这项初步研究表明，高水平的马赛克胚胎可以产生类似的LBR，但MR更高。
Recently, reports showed that embryos identified as mosaic after preimplantation genetic testing for aneuploid (PGT-A) could result in live birth with lower pregnancy and higher pregnancy loss rates compared with euploid embryos. However, the effects of mosaicism level on reproductive outcomes remain controversial. This study aimed to examine the level of mosaicism on pregnancy outcomes. Single mosaic embryo transfer was offered to 108 women who only had mosaic embryos. Mosaic embryos were labeled by utilizing next generation sequencing (NGS) based PGT-A for day 5/6 trophectoderm (TE) biopsies. TE biopsies containing < 50% abnormal cells were classified as low-level mosaicism and >= 50% as high-level mosaicism. To further confirm the concordance of chromosome constitution between TE and inner cell mass (ICM), 41 remaining embryos designated as mosaic blastocysts donated for research were also analyzed. Comparable live birth rate (LBR) but higher miscarriage rate (MR) was found in the high-level group. (LBR: low vs. high: 44.5% vs. 36%;p= 0.45, MR: low vs. high: 5.1% vs. 30.7%;p= 0.012). Analyses of TE and ICM from the remaining mosaic blastocysts show a poor concordance. This preliminary study demonstrated that high-level mosaic embryos could result in comparable LBR but higher MR.