促排卵方案对染色体易位携带者胚胎植入前检测结局的影响

Effects of different controlled ovarian stimulation protocols on preimplantation genetic testing outcomes of chromosomal translocation carriers

目的探讨促性腺激素释放激素(Gn RH)激动剂长方案与拮抗剂方案对染色体易位携带者胚胎植入前检测(PGT)结局的影响。方法回顾性分析2015年1月至2017年12月于中国医科大学附属盛京医院行胚胎植入前检测助孕的226例染色体易位携带夫妇的临床资料,根据促排卵方案分为长方案组(174例)和拮抗剂组(52例),对比两组间Gn用量、Gn天数、胚胎质量、正常和平衡胚胎数、每移植周期临床妊娠率、流产率、持续妊娠率等差异。结果长方案组和拮抗剂组的获卵数、MⅡ卵子数、正常受精率、卵裂率、囊胚形成率、优质囊胚数、活检囊胚数、正常和平衡胚胎数、每移植周期临床妊娠率、流产率、持续妊娠率和累积持续妊娠率差异均无统计学意义(P>0.05)。而拮抗剂组Gn用量(2100 U vs. 2400 U)和天数(9 d vs. 10 d)显著少于长方案组(P<0.05)。结论在胚胎植入前检测助孕过程中,长方案与拮抗剂方案的胚胎质量和妊娠率无明显差异,但拮抗剂方案在Gn用量和天数上占有优势。

Objective To investigate the effects of GnRH agonist and antagonist protocols on preimplantation genetic testing outcomes of chromosomal translocation carriers.Methods The clinical data of 226 patients with chromosomal translocation were analyzed retrospectively between Jan.2015 and Dec.2017 in Shengjing Hospital Affiliated to China Medical University.The patients were divided into GnRH agonist group(174 cases)and GnRH antagonist group(52 cases),then the duration of gonadotropin stimulation,dosage of gonadotropin used,embryonic quality,normal and balanced embryo numbers,per transfer cyclepregnancy rate,abortion rate and continuous pregnancy rate and accumulated pregnancy rate were analyzed.Results There were no statistical differences in the number of retrieved oocytes,number of MⅡoocytes,fertilization rate,cleavage rate,blastocyst formation rate,number of high-quality embryo,number of blastocyst biopsy,normal and balanced embryo numbers,per transfer cycle pregnancy rate,abortion rate,continuous pregnancy rate or accumulated pregnancy rate between GnRH agonist group and GnRH antagonist group(P>0.05).The duration of gonadotropin stimulation(9 d vs.10 d)and dosage of gonadotropin(2100 U vs.2400 U)used in the GnRH antagonist group were significantly less than the GnRH agonist group(P<0.05).Conclusion There are no significant differences in embryo quality or pregnancy rate between the GnRH agonist group and antagonist group during preimplantation genetic testing,but the GnRH antagonist group have an advantage in Gn duration and dosage.