染色体多态性对体外受精-胚胎移植患者助孕结局的影响

Effect of chromosomal polymorphisms on reproductive outcomes of in vitro fertilization-embryo transfer

目的:探讨染色体多态性对IVF/ICSI-ET助孕患者妊娠结局的影响。方法:回顾性分析2021年1月至2023年1月在西安市人民医院(西安市第四医院)生殖医学中心首次进行IVF/ICSI-ET周期不孕不育夫妻的临床资料。根据夫妻双方是否存在染色体多态性分为染色体正常组(A组:夫妻双方染色体均正常)和染色体多态性组(B组:夫妻一方存在染色体多态性变异);将染色体多态性组进一步分为男性染色体多态女性正常组(C组)及女性染色体多态男性正常组(D组)。比较分析A组与B组及A组与C、D组患者的获卵数、受精率、正常受精率、卵裂率、正常卵裂率、多PN率、优胚率、囊胚形成率及临床妊娠率。采用Logistic回归分析染色体多态性与临床妊娠率的关系。结果:共纳入418对不孕不育夫妇,其中A组337对,B组81对。A组和B组优胚率比较,差异具有统计学意义(59.21%vs 52.42%,P<0.05),其余结局均无统计学意义(P>0.05);C组44对,D组37对,比较A、C、D 3组获卵数、受精率、正常受精率、卵裂率、正常卵裂率、多PN率、优胚率、囊胚形成率均无统计学差异(P>0.05),临床妊娠率A组高于C组和D组(56.7%vs 52.3%vs 40.5%),但差异无统计学意义(P>0.05)。Logistic回归分析显示,染色体多态性与临床妊娠率无相关性(P>0.05)。结论:染色体多态性人群的IVF/ICSI-ET妊娠结局与正常人群相比没有明显差异。

Objective:To explore the effect of chromosomal polymorphic variations on the outcome of in vitro fertilization/intra-cytoplasmic sperm injection-embryo transfer(IVF/ICSI-ET)treatment for infertile couples.Methods:In this retrospective study,418 infertile couples,who received their first IVF/ICSI-ET treatment cycles in Reproductive Medicine Center of Xian Peoples Hospital(Xian Fourth Hospital)from Jan.2021 to Jan.2023,were included and divided into two groups:group A(the infertile couples with normal chromosome)and group B(with chromosomal polymorphic variations);The group B divided into 2 groups,group C(male carrier,n-44),group D(female carrier,n-37).The No.of oocyte,2PN fertilization rate,fertilization rate,multi-PN fertilization rate,quality embryo rate,cleavage rate,normal cleavage rate,blastocyst formation rate,clinical pregnancy rate after IVF/ICSI-ET treatment were compared and analyzed.Logistic regression analysis was performed to study the relationship between clinical pregnancy rate and chromosome variation.Results:A total of 418 infertile couples received IVF/ICSI-ET treatment were enrolled,with 81 in the chromosomal polymorphic group(group A),and 337 in the normal chromosomal group(group B).The quality embryo rate were signifcantly higher in the group A(59.21%vs 52.42%,P<0.05),the other outcomes have no significant differences between the two groups(P>0.05).The No.of oocyte,2PN fertilization rate,fertilization rate,multi-PN fertilization rate,quality embryo rate,cleavage rate,normal cleavage rate,blastocyst formation rate showed no signifcantdiferences among group A,group C and group D(P>0.05).The clinical pregnancy rate in group A is higer than group C and group D(56.7%vs 52.3%vs 40.5%),But there were no signifcantly diferent among the three groups(P>0.05).Logistic regression analysis indicated that the Chromosomal polymorphisms were not associated with clinical pregnancy rate(P>0.05).Conclusion:Chromosomal polymorphisms appear to have no significant effect on the outcome of IVF/ICSI-ET treatment for infertile couples.