体外受精-胚胎移植中流产绒毛核型分析

Analyzing karyotype of abortus conceived after in vitro fertilization-embryo transfer ( IVF- ET )

目的 研究体外受精 胚胎移植 (IVF ET)中流产胚胎染色体异常率。方法 对IVF ET成功后自然流产的绒毛标本 5 7例作核型分析 ,按受精过程是否为卵胞浆内精子穿刺术 (ICSI)分为ICSI组 (39例 )和非ICSI组 (18例 ) ,以同期自然妊娠后流产之绒毛 87例作对照 ,比较 3组间绒毛染色体异常率及异常核型构成之差异 ,同时观察不同流产次数对自然流产绒毛染色体异常率的影响。结果 3组绒毛染色体异常率分别为 :ICSI组 6 6 .6 7% ,非ICSI组 5 5 .5 6 % ,自然流产组 5 2 .87% ,差异无显著性 (P >0 .0 5 )。异常核型以 16三体最多 ,3组共发现 15例 ,占全部异常核型的 18.0 7% (15 / 83) ;3组多倍体发生率分别为 :ICSI组 7.6 9% (3/ 39) ,非ICSI组16 .6 7% (3/ 18) ,自然流产组 5 .75 % (5 / 87) ,差异无显著性 (P >0 .0 5 ) ;而单体的发生率分别为 :ICSI组 10 .2 6 %(4 / 39) ,非ICSI组 0 ,自然流产组 6 .90 % (6 / 87) ,差异无显著性 (P >0 .0 5 )。自然流产组患者中 ,既往有无自然流产史及流产次数不同者其绒毛核型异常率不同 :无自然流产史者 6 6 .6 7% ,1～ 2次自然流产史者 5 6 .14% ,该两组均显著高于 3～ 10次自然流产史的 16 .6 7% (P <0 .0 1、P <0 .0 5 )。除自然流产组中 2例异常核型来自母方遗传外 。

Objective To assess the chromosome abnormalities in the abortus conceived through intracytoplasmic sperm injection ( ICSI ) and conventional in vitro fertilization ( IVF ). Fifty-seven abortus conceived after ICSI (39 cases) and conventional IVF(18 cases) were studied, 87 spontaneous abortus with 0-10 miscarriages before served as control. The villi collected at curettage from 144 abortus were karyotyped by standard G-banding technique, the incidence and types of aberrations were then assessed. Results In 144 specimens, 82 had chromosome aberrations. The frequency of chromosome abnormality in the three groups was as follows: 66.67% (26/39) in ICSI; 55.56% (10/18) in conventional IVF and 52.87% (46/87) in spontaneous abortion, P>0.05. The most prevalent anomalies were trisomy 16. Among the spontaneous abortion patients, the incidence of chromosome abnormality in those with no miscarriage before was 66.67%, patients with 1-2 miscarriages before had the middle, 56.14%, and patients with 3-10 miscarriages before had the lowest, 16.67% ( P<0.01, P<0.05). Of the 82 abnormal karyotypes, only two were inherited from their mother. Conclusion The frequency of chromosome abnormality in abortus conceived through ICSI and conventional IVF is the same as that conceived naturally. The incidence of abnormal embryonic karyotypes decrease with the number of previous miscarriages.