D/G组染色体随体多态性变异患者IVF/ICSI治疗结局探究

Outcomes of IVF/ICSI in patients with D/G group chromosome satellite heteromorphism

目的探究D/G组染色体随体多态性变异(satellite heteromorphism of D/G group chromosome,DGs)患者与核型正常对照组之间体外受精(in vitro fertilization,IVF)/卵胞浆内单精子显微注射(intracytoplasmic sperm injection,ICSI)结局有无差异,以及变异携带者的性别效应。方法选取DGs 54例作为病例组,核型正常108例作为对照组。统计分析两组在IVF/ICSI治疗时受精率、异常受精率、卵裂率、可用胚胎率,ICSI卵子成熟率;新鲜胚胎移植后临床妊娠率、种植率及活产率有无差异。同时比较IVF治疗病例组中男/女性携带者上述指标。结果与对照组比较,病例组胚胎学结果中受精率、卵裂率、可用胚胎率均未见明显差异(P>0. 05);新鲜胚胎移植后临床妊娠率、胚胎种植率及活产率均未见明显差异(P>0. 05)。DGs病例组异常受精率在IVF治疗时显著高于对照组(11. 53%vs 7. 78%,P=0. 038),在ICSI治疗时未见明显差异。IVF治疗女性携带者受精率、临床妊娠率、胚胎种植率均显著高于男性携带者(85. 71%vs 74. 44%,P=0. 001; 75%vs 30. 77%,P=0. 024; 72. 73%vs 26. 09%,P=0. 002)。结论 IVF治疗中DGs病例异常受精率增高,女性携带者临床预后明显优于男性携带者。

Objective To analyze the outcomes of IVF/ICSI in patients with D/G group chromosome satellite heteromorphism. Methods The clinical data of 54 couples with D/G group chromosome satellite heteromorphism (DGs)(case group),and 108 karyotype normal couples (control group) receiving in vitro fertilization/intracytoplasmic sperm injection embryo transfer (IVF/ICSI-ET) were retrospectively reviewed.The fertilization rate,abnormal fertilization rate,cleavage rate,utilization rate,mature oocyte rate in ICSI,clinical pregnancy rate,implantation rate and live birth rate were compared between the two groups.These indicators were also compared between female carrier group and male carrier group. Results There were no significant differences in fertilization rate,cleavage rate and utilization rate between DGs group and control group( P >0.05).For fresh embryo transfer cycles,there were also no significant differences in clinical pregnancy rate,implantation rate and live birth rate between two groups.Higher abnormal fertilization rate was found in the DGs group than control in IVF (11.53% vs 7.78%,P =0.038),but there was no significant difference between two groups in ICSI.Female carriers had higher fertilization rate,clinical pregnancy rate and implantation rate in IVF than male carriers (85.71% vs 74.44%,P =0.001;75% vs 30.77%,P =0.024;72.73% vs 26.09%,P =0.002). Conclusion In IVF,DGs patients may have higher abnormal fertilization rate than normal subjects,female DGs carriers would have better outcome of IVF/ICSI-ET than male carriers.