囊胚期胚胎嵌合发生主要影响因素分析

Analysis of major factors of mosic embryo in blastocyst stage

目的:分析染色体结构异常患者行卵胞质内单精子注射(intracytoplasmic sperm injection,ICSI)后形成的囊胚发生嵌合的主要影响因素。方法:回顾性队列研究福建省妇幼保健院生殖医学中心从2018年1月至2019年12月期间进行针对染色体结构异常的胚胎植入前遗传学检测(preimplantation genetic testing for chromosomal structural rearrangement,PGT-SR)周期94个和ICSI周期551个,采用SPSS21.0软件分析女方年龄、获卵数、平均每个卵子的促性腺激素(gonadotropin,Gn)量(Gn/卵)、囊胚分级,以及不同性别染色体携带者与胚胎染色体嵌合的关系。结果:PGT-SR周期中,单因素分析显示嵌合体胚胎与年龄和精子浓度有关(P=0.01,P=0.04),而多因素logistic回归分析显示,年龄(OR=3.41,95%CI=1.34~8.66,P=0.01)、精子浓度(OR=0.41,95%CI=0.17~0.96,P=0.04)和不同性别的染色体易位携带(OR=2.21,95%CI=1.04~4.70,P=0.04)是胚胎嵌合发生的主要影响因素。结论:PGT-SR患者体外形成的囊胚发生嵌合现象可能与女方年龄、精子浓度和相互易位患者性别有关,为选择性移植嵌合胚胎提供理论依据。

Objective To analyze of the main influecing factors of mosic embryos during the preimplantation genetic test for chromosomal structural rearrangement(PGT-SR)to avoid the increase of risk of abortion and genetic abnormalities and to improve the diagnostic rate of mosic embryos.Methods We used a retrospective cohort study to analyze 94 cycles of infertile patients undergoing PGT-SR and 551 cycles of intracytoplasmic sperm injection(ICSI)from January 2018 to December 2019 in the Reproductive Medical Center of the Maternal and Child Health Hospital.The relationship of mosic embryos was analyzed between the age,the number of oocytes,gonadotropin(Gn)/oocyte,the grade of blastocysts and chromosome carrier of different genders by the SPSS21.0 software.Results In the PGT-SR cycle,single factor analysis found that mosaic embryos were related to age and sperm concentration(P=0.02,P=0.04),but multivariate logistic regression analysis showed that age(OR=3.41,95%CI=1.34-8.66,P=0.01),sperm concentration(OR=0.41,95%CI=0.17-0.96,P=0.04)and chromosome carrier of different genders(OR=2.21,95%CI=1.04-4.70,P=0.04)were the main factors of embryo mosaicism.Conclusion Female age,sperm concentration and chromosome carrier of different genders maybe affect the formation of mosaic embryos,providing theoretical basis for selective transfer of mosaic embryos.