无创胚胎染色体筛查技术在单囊胚冻胚复苏移植中的应用价值及其活产结局的因素分析

Application Value of Noinvasive Embryo Chromosome Screening Technology in Single Blastocyst Frozen Embryo Resuscitation Transplantation and the Factors Analysis of Live Birth Outcome

目的:探讨无创胚胎染色体筛查技术(NICS)在单囊胚冻胚复苏移植中的应用价值,分析影响活产结局的因素。方法:回顾性分析2019年1月至2021年12月我院收治的197例行单囊胚冻胚复苏移植患者的临床资料,53例行NICS检查且检测结果提示囊胚染色体拷贝数正常(NICS组),26例NICS检测结果异常予以排除,118例未接受NICS检测(非NICS组)。收集临床资料并追踪妊娠结局,根据妊娠结局将患者分为活产组(75例)和非活产组(96例),采用单因素及多因素Logistic回归分析影响单囊胚冻胚复苏移植活产的因素。结果:NICS组活产率高于非NICS组(P<0.05)。单因素分析显示活产组女方年龄小于非活产组(P<0.05),基础卵泡雌激素(FSH)水平、常规试管婴儿(IVF)周期≥2个低于非活产组(P<0.05),优质胚胎数、移植日子宫内膜厚度和NICS检查比例、发育成囊胚时间为D5比例高于非活产组(P<0.05)。多因素logistic回归分析显示女方年龄偏大、发育成囊胚时间为D6是影响单囊胚冻胚复苏移植活产的危险因素(P<0.05),NICS检查是其保护因素(P<0.05)。结论:NICS筛查胎儿染色体异常可提高单囊胚冻胚复苏移植活产率,产妇高龄和囊胚发育速度过慢是影响活产的主要危险因素。在单囊胚冻胚复苏移植前有必要进行NICS检查,并尽量选择D5囊胚以提高活产率。

Objective:To explore the application value of noinvasive embryo chromosome screening technology(NICS)in single blastocyst frozen embryo resuscitation transplantation,and to analyze the factors affecting of live birth outcome.Methods:The clinical data of 197 patients who underwent single blastocyst frozen embryo resuscitation transplantation in our hospital from January 2019 to December 2021 were retrospectively analyzed,53 cases NICS was performed and the results showed that the blastocyst chromosome copy number was normal(NICS group),26 cases NICS abnormal test results were excluded,118 cases did not receive NICS test(non NICS group).Clinical data were collected and pregnancy outcomes were tracked,patients were divided into live birth group(75 cases)and non live birth group(96 cases)according to the pregnancy outcome,the factors affecting the live birth of single blastocyst frozen embryo resuscitation transplantation were analyzed by univariate and multivariate Logistic regression analysis.Results:The live birth rate in NICS group was higher than that in non NICS group(P<0.05).Univariate analysis showed that the age of women in live birth group was younger than that in non live birth group(P<0.05),the basal follicle stimulating hormone(FSH)level and routine in vitro fertilization(IVF)cycle≥2 were lower than those in non viable group(P<0.05),the number of high quality embryos,endometrial thickness on the day of transplantation and the proportion of NICS examination,the proportion in D5 blastocysts were higher than those in non live birth group(P<0.05).Multivariate logistic regression analysis showed that the older age of the woman and the time of blastocyst development to D6 were the risk factors affecting the live birth of single blastocyst frozen embryo resuscitation transplantation(P<0.05),and NICS examination was its protective factor(P<0.05).Conclusion:NICS screening for fetal chromosomal abnormalities can improve the live birth rate of single blastocyst frozen embryo resuscitation transplantation,maternal age and slow blastocyst development are the main risk factors affecting live birth.It is necessary to perform NICS examination before single blastocyst frozen embryo resuscitation transplantation,and try to choose D5 blastocysts to improve the live production rate.