植入前遗传学检测第2次活检后胚胎移植结局分析

Analysis of the Embryo Transfer Outcomes after the Second Biopsy for Preimplantation Genetic Testing

目的:探讨胚胎植入前遗传学检测(preimplantation genetic testing,PGT)周期中首次活检诊断不明再行第2次活检的临床价值,及其对胚胎移植结局的影响。方法:回顾性分析2015年9月—2021年5月南京医科大学第一附属医院临床生殖医学中心2199个PGT周期中75个PGT周期的107枚胚胎首次活检遗传学诊断不明后,再行第2次活检检测后的临床结局。结果:在75个周期中,共有107枚胚胎活检后首次遗传学诊断不明,其中96枚胚胎申请重新复苏活检,86枚胚胎第2次检测成功。基于高通量测序检测平台分析,获得可移植胚胎46枚(39枚整倍体胚胎,7枚嵌合体胚胎)。在27个复苏周期中,24枚囊胚存活并进入移植周期,二次活检的复苏存活率为88.89%(24/27),临床妊娠率为50%(12/24),活产率45.8%(11/24),1例早期流产。结论:对第1次活检遗传学诊断不明且无其他可移植胚胎的患者,第2次活检检测是可行的,并可获得一定的可移植胚胎和活产率。

Objective:To evaluate the clinical value of the re-biopsied blastocysts after the first test-unknown preimplantation genetic testing(PGT)cycles,and the effect of the re-biopsied blastocysts on the clinical outcomes of embryo transfer.Methods:The pregnancy outcomes of the 107 re-biopsied blastocysts after the first test-unknown of 75 PGT cycles of 2199 PGT cycles from September 2015 to May 2021 in the clinical reproductive center of The First Affiliated Hospital with Nanjing Medical University were retrospectively analyzed.Results:In 75 PGT cycles,107 blastocysts were categorized as unknown diagnosis.Among them,96 embryos were resuscitated and biopsied,and PGT was successfully carried out in 86 embryos finally.After next-generation sequencing analysis,46 blastocysts were confirmed as transplantable embryos(39 euploid embryos and 7 chimeric embryos).In 27 warming cycles,24 blastocysts were survived and entered the transfer cycle.After the second biopsy,the survival rate of embryo resuscitation was 88.89%(24/27),the clinical pregnancy rate 50%(12/24),and the live birth rate 45.8%(11/24).There was one case of early abortion.Conclusions:The blastocysts with unknown diagnosis in the first round of PGT could withstand the second round of biopsy,freezing and resuscitation,and still possessing certain transferable embryos and live birth rate after transplantation.