人工授精和自然妊娠早期自然流产绒毛染色体异常相关因素分析

Analysis of Related Factors of Villous Chromosome Abnormality in Artificial Insemination and Spontaneous Abortion in Early Natural Pregnancy

目的:探讨宫腔内夫精人工授精(AIH)与自然妊娠者早期自然流产绒毛染色体异常情况和助孕原因对流产绒毛染色体异常的影响。方法:回顾性分析我院2017年1月-2019年12月早期自然流产患者临床资料104例,其中AIH组27例,自然妊娠组77例。所有流产绒毛样本进行核型分析检测,比较2组患者早期流产绒毛染色体异常的发生率,分析女性年龄和AIH助孕原因对绒毛染色体异常的影响。结果:所有标本早期流产绒毛染色体异常率52.88%(55/104),其中染色体数目异常占94.55%(52/55)。2组患者早期流产绒毛染色体异常发生率比较,差异无统计学意义(χ^2=0.010,P=0.921)。2组患者分别按年龄<25岁、25~29岁、30~34岁、≥35岁分组进行比较,2组患者的各年龄段间绒毛染色体异常率比较,差异有统计学意义(均P<0.05),但每个年龄段的绒毛染色体异常率在2组之间差异无统计学意义(P=1.00)。27例AIH早期流产者中15例存在绒毛染色体异常。结论:AIH不增加自然流产绒毛组织的染色体异常率,对自然流产患者应及时查找流产原因。对于有指征的不孕患者可以推荐AIH助孕。

Objective:To investigate the chromosome abnormalities in early spontaneous abortion villi of artificial intrauterine insemination(AIH)pregnancy and natural pregnancy,as well as the effect of the related factors of assisted reproduction on above chromosome abnormalities.Methods:The clinical data of 104 patients with early spontaneous abortion in our hospital from January 2017 to December 2019 were retrospectively analyzed,including27 in the AIH group and 77 in the natural pregnancy group.All abortion villous samples were tested for karyotype.The incidences of chromosome abnormalities in the two groups were compared.The effects of female age and AIH assisted pregnancy on the chromosome abnormalities were investigated.Results:The total rate of chromosome abnormalities in early abortion villi was 52.88%(55/104),of which the chromosome number abnormality accounted for 94.55%(52/55).There was no significant difference in the incidence of chromosome abnormalities between the two groups(χ^2=0.010,P=0.921).The patients in the two groups were sub-grouped according to their ages<25years,25-29 years,30-34 years and≥35 years,individually.There was significant difference in the rate of villous chromosome abnormalities among the aged-subgroups of the AIH group and the natural pregnancy group(all P<0.05).However,there were no significant differences between the corresponding aged-subgroups of the two groups(P=1.00).In the 27 cases of AIH early abortion,15 cases had villous chromosome abnormalities.Conclusions:AIH does not increase the chromosome abnormalities in early spontaneous abortion villi,and patients with spontaneous abortion should promptly find the causes of abortion.AIH can be recommended for those infertile patients with the AIH-related indications.