37例胚胎停育绒毛染色体核型分析

Analysis on chorionic villus karyotype for 37 cases of embryonic diapause

目的分析胚胎停育与绒毛染色体异常的关系,同时探讨人类辅助生殖技术的安全性。方法收集2012年4月~2013年8月来武汉大学人民医院生殖中心就诊的37例发生胚胎停育患者的绒毛组织,进行体外原代培养、染色体制备和核型分析。结果在37例胚胎停育的患者中,2例培养失败,2例培养污染,成功率89.19%,16例检出染色体核型异常,异常率43.23%,其中7、13、15和16三体各1例,21三体3例,22三体2例,X单体1例,多倍体4例,结构异常1例;16例核型异常中,行辅助生殖技术妊娠10例,占异常核型的62.50%,其中供卵1例,供精1例,冻融胚胎移植2例。结论胚胎染色体异常是胚胎停育的重要原因,人类辅助生殖技术可能会增加胚胎染色体异常的风险。

Objective： To analyze the relationship between embryonic diapause and fetal chorionic villus karyotype and preliminary discuss the safety of assisted reproductive technology（ ART）. Methods： The villus tissues of 37 pregnancies diagnosed with embryonic diapause were collected,in the centre of our hospital from April 2012 to August 2013,then primary culture in vitro chromosomal preparation and karyotype analysis were performed. Results： Of the 37 cases,34 cases was successfully cultured（ 89. 19%）,of which 2 cases failed to collect enough chorionic villus and and 2 cases were contaminated and abnormal embryo karyotypes were identified in 16 cases（ 43. 23%）,including 10 cases of trisome karyotype,X monomer 1 case,polyploid 4 cases and alteration of chromosome structure 1 case. Among 16 cases of chromosome abnormolity,10 cases conceived vitro fertilization（ IVF）,account for 62. 50% of abnormal karyotypes,including one case of donor eggs,one case of donor sperm and 2 cases of frozen embryo transfer（ FET）. Conclusion： Embryo chromosomal abnormality is the most important reason of embryonic diapause and ART is possible to increase the risk of abnormal embryo karyotypes.