染色体异常对IVF-ET妊娠结局的影响

The effect of chromosomal abnormalities on the outcome of in vitro fertilization and embryo transfer treatment

目的探讨体外受精助孕中染色体异常对妊娠结局的影响。方法2009年1月到2011年8月期间，对接受体外受精的1584对不孕不育夫妇进行外周血染色体检测，对其助孕过程进行回顾性分析。根据染色体检测结果，常规分为染色体异常组和染色体正常组，其中染色体异常包括染色体多态性改变和非多态性改变。探讨两组受精率、有效胚胎率、妊娠率、早期流产率等相关指标的关系。结果在1584对夫妇中，染色体异常病例106例，男方染色体异常62例，女方染色体异常38例，有3对夫妇双方染色体均异常。染色体异常组与染色体正常组相比，受精率、有效胚胎率、妊娠率等因素无差异，但是流产率在染色体异常组升高（P值分别为0．021〈0．05）。结论在体外受精中，染色体异常可能会增加流产的风险，在助孕前应该进行染色体核型检查，对染色体异常患者应该进行遗传咨询。

Objective To investigate the effect of chromosomal abnormalities on the outcome of in vitro fertilization （IVF） and embryo transfer treatment for infertile couples. Methods During the period from January 2009 to August 2011, 1584 infertile couples who underwent first IVF-ET treatment cycle in our hospital were received chromosome analysis and selected for this retrospective study. They were divided into two groups based on chromo- some analysis： Group 1/the control group（1478 couples with normal chromosomes） Group2 （106 couples with chro- mosomal abnormalities such as chromosomal polymorphic variations and non-polymorphic variations）. The clinical fertilization rate, effective rate of embryo, clinical pregnancy rates（CPR）, early miscarriage rates after IVF-ET treatment were compared between these two groups. Results Of 1584 couples, 106 individuals had abnormal chromosomes including 38 couples with chromosomal polymorphic variations in only females and 62 couples with chromosomal polymorphic variations in only males, 3 couples with chromosomal polymorphic variations in both. No statistically significant differences were found in fertilization rate, effective rate of embryo and CPR between the two groups. But a significant difference in early miscarriage rates was found between couples with chromosomal polymorphic variations and couples with normal karyotype. Conclusion Chromosomal polymorphic variations were important risks for early miscarriage.Chromosome analysis should be carried out before IVF-ET treatment.