外周血染色体多态性对IVF-ET助孕治疗临床结局的影响

Effect of peripheral blood chromosomal polymorphism on clinical outcomes of IVF-ET assisted pregnancy treatment

目的分析外周血染色体多态性对体外受精-胚胎移植技术(IVF-ET)助孕治疗临床结局的影响。方法回顾性分析2017年9月至2022年9月四川锦欣西囡妇女儿童医院2765个IVF-ET新鲜胚胎移植周期,其中夫妻一方或双方有染色体多态性的周期纳入染色体多态性组;其余夫妻双方染色体均正常的周期纳入对照组。比较两组一般资料、IVF-ET治疗情况、晚期卵泡日孕酮(P)及人绒毛膜促性腺激素(hCG)日激素水平及临床结局。结果2765个周期中,35个周期为夫妻一方或双方有染色体多态性,其中常染色体次缢痕增加10例,染色体臂间倒位12例,D/G组变异8例,Y染色体变异5例,上述周期纳入染色体多态性组;其余2730个周期夫妻双方染色体均正常,纳入对照组;两组年龄、身体质量指数(BMI)、不孕年限、基础卵泡雌激素(FSH)、基础促黄体生成素(LH)、基础雌二醇(E2)、泌乳素(PRL)、促甲状腺激素(TSH)、窦状卵泡数(AFC)、降调日至促排日间隔、促性腺激素(Gn)用量、Gn使用天数、移植日内膜厚度、获卵数、移植胚胎数比较差异无统计学意义(P>0.05);两组晚期卵泡日、hCG日P、hCG日LH、hCG日E2比较差异无统计学意义(P>0.05);两组1PN受精率、2PN受精率、多PN受精率、卵裂率、优质胚胎率、妊娠率、生化妊娠率、种植率、早期流产率比较差异无统计学意义(P>0.05)。结论IVF-ET助孕治疗者中染色体多态性以臂间倒位、常染色体次缢痕增加常见,与染色体正常的IVF-ET助孕者比较,染色体多态性并未造成显著的IVF-ET助孕结局差异。

Objective To analyze the effect of peripheral blood chromosomal polymorphism on clinical outcomes of in vitro fertilization-embryo transfer(IVF-ET).Methods A retrospective analysis was conducted on 2,765 fresh IVF-ET cycles conducted by the Sichuan Jinxin Xinan Women and Children Hospital from September 2017 to September 2022.Among them,cycles in which one of the spouses or both spouses had chromosomal polymorphism were defined as the chromosomal polymorphism group.The other cycles in which both couples had normal chromosomes were defined as the control group.General information,situation of IVFET,the levels of progesterone(P)on late follicular day and hormones on human chorionic gonadotropin(hCG)day,and clinical outcomes were compared between the two groups.Results Among the 2765 cycles,35 cycles were chromosomal polymorphisms in one or both spouses,including 10 cases of increased autosomal secondary constriction,12 cases of inversion between chromosome arms,8 cases of D/G group variation,and 5 cases of Y chromosome variation For example,the above cycle is included in the chromosomal polymorphism group.The remaining 2,730 cycles in which both couples had normal chromosomes were included in the control group.There was no statistically significant difference between the two groups in terms of age,body mass index(BMI),infertility years,basal follicle-stimulating hormone(FSH),basal luteinizing hormone(LH),basal estradiol(E2),prolactin(PRL),thyroid-stimulating hormone(TSH),antral follicle count(AFC),the interval between down-regulation day and ovulation induction day,the dosage of gonadotropin(Gn),the days of Gn use,endometrial thickness on transfer day,the number of oocytes retrieved,and the number of embryos transferred(P>0.05).There was no significant difference in late follicle day,hCG day P,hCG day LH,and hCG day E2 between the two groups(P>0.05).There was no significant difference in 1PN fertilization rate,2PN fertilization rate,multiple PN fertilization rate,cleavage rate,high-quality embryo rate,pregnancy rate,biochemical pregnancy rate,implantation rate,and early miscarriage rate between the two groups(P>0.05).Conclusion Chromosomal polymorphisms in IVF-ET patients are common in the form of interarm inversion and increased autosomal secondary constriction.Compared with IVF-ET patients with normal chromosomes,chromosomal polymorphisms did not lead to significant differences in IVF-ET assisted pregnancy outcomes.