微阵列比较基因组杂交胚胎植入前遗传学筛查技术在复发性流产患者中的应用研究

Application of Array Comparative Genomic Hybridization Preimplantation Genetic Screening in Recurrent Miscarriage

目的：探讨微阵列比较基因组杂交胚胎植入前遗传学筛查（aCGH—PGS）技术对复发性流产（RM）患者辅助生殖临床结局的影响。方法：54例RM患者分为aCGH-PGS组（n=25）与非PGS组（n=29）。aCGH-PGS组胚胎行aCGH筛查，选择染色体整倍性胚胎植入，其临床结局与非PGS组相比较。结果：aCGH—PGS组中染色体整倍性胚胎占26．93％（42／156）；平均移植胚胎1．3±0．8个，低于非PGS组2．6±0．6个（P〈0．01）；胚胎着床率（57．58％）与临床妊娠率（61．90％）高于非PGS组（27．03％，P〈0．01；46．43％，P〉0．05），早期流产率（7．69％）低于非PGS组（38．46％，P〈O．01）。结论：经aCGH—PGS，植入1-2个染色体整倍性胚胎，可使RM患者获得更高的胚胎着床率及较低的早期流产率，是RM患者临床治疗的有效途径。

Objective： To investigate the effects of array comparative genomic hybridization-preimplantation genetic screening （aCGH-PGS） on the clinical outcome of assisted reproduction for recurrent miscarriage （RM） patients. Methods： The RM patients were divided into aCGH-PGS group （n=25） and non-PGS group （n=29）. In aCGH-PGS group, the euploid embryos identified by aCGH technology were transferred. The clinical outcomes in two groups were compared. Results： In aCGH-PGS group, the euploid embryos accounted for 26.93% （42/156）, and the average number of embryos transferred was 1.3 ± 0.8, lower than that in non-PGS group （2.6 ± 0.6, P〈0.01）. The embryo implantation rate （57.58%） and clinical pregnancy rate （61.90%） in aCGH-PGS group were higher than those in non-PGS group （27.03%, P〈0.01; 46.43%, P〉0.05, respectively）. The early pregnancy loss rate was 7.69% in the former, lower than that in the latter （38.46%, P〈0.01）. Conclusion： Identification of the euploid embryos by aCGH-PGS then transferred such embryos, can reduce the number of embryos transferred （ET）, and decrease the risks of multiple pregnancy. Furthermore, it can result in the higher embryo implantation rate and the lower early pregnancy loss rate. Application of aCGH-PGS is a valid clinical approach to treatment in assisted reproduction for RM patients.