辅助生殖助孕后稽留流产绒毛染色体核型异常与新鲜周期卵裂期胚和囊胚移植的相关性分析

Correlation Analysis Between Fresh Cycle Cleavage Stage Embryos and Blastocyst Transfer on Chromosomal Karyotype Abnormalities in Retained Miscarriage after Assisted Reproductive Technology

摘要: 目的：分析新鲜周期卵裂期胚和囊胚移植对体外受精/卵胞质内单精子注射(in vitro fertilization/intracytoplasmic sperm injection, IVF/ICSI)助孕后稽留流产绒毛染色体核型异常发生的影响。方法：纳入2020年1月至2024年1月期间于新疆佳音医院行IVF/ICSI助孕新鲜周期卵裂期胚和囊胚移植后稽留流产患者的临床数据及绒毛染色体拷贝数变异(copy number variations, CNVs)的检测结果。采用病例对照研究，根据流产组织绒毛染色体CNVs检测结果将数据分为两组：异常染色体核型组(n = 67)和正常染色体核型组(n = 69)，比较两组患者的基线数据。应用单因素及多因素logistic回归调整女方年龄、女方BMI和基础FSH等混杂因素。结果：基线数据中，异常染色体核型组女方年龄[34.00 (32.00, 37.00)]、女方BMI [23.90 (22.27, 26.33)]和基础FSH [7.12 (6.06, 8.95)]高于正常染色体核型组女方年龄[32.00 (31.00, 34.00)]、女方BMI [22.86 (20.66, 24.92)]和基础FSH [6.31 (5.53, 7.91)]，差异具有统计学意义(P = 0.049, 0.025, 0.028)。将女方年龄和女方BMI分层logistic回归分析差异均无统计学差异(均P > 0.05)。结论：新鲜周期卵裂期胚和囊胚移植对IVF/ICSI助孕稽留流产绒毛染色体核型异常无明显差异。

Abstract: Objective: To analyze the impact of fresh cycle cleavage stage embryo and blastocyst transfer on the occurrence of chromosomal karyotype abnormalities in retained miscarriage following in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). Methods: Clinical data and results of chromosomal copy number variations (CNVs) testing were collected from patients who underwent fresh cycle cleavage stage embryo and blastocyst transfer at Xinjiang Jiayin Hospital for IVF/ICSI-assisted pregnancy from January 2020 to January 2024 and experienced retained miscarriage. A case-control study was conducted, categorizing the data into two groups based on the CNVs testing results of the miscarriage tissue: abnormal karyotype group (n = 67) and normal karyotype group (n = 69), comparing the baseline data of the two groups. Univariate and multivariate logistic regression was applied to adjust for confounding factors such as maternal age, maternal BMI, and baseline FSH. Results: In the baseline data, maternal age [34.00 (32.00, 37.00)], maternal BMI [23.90 (22.27, 26.33)], and baseline FSH [7.12 (6.06, 8.95)] in the abnormal karyotype group were higher than those in the normal karyotype group, with maternal age [32.00 (31.00, 34.00) years], maternal BMI [22.86 (20.66, 24.92)], and baseline FSH [6.31 (5.53, 7.91)], and the differences were statistically significant (P = 0.049, 0.025, 0.028). No statistical differences were found in the stratified logistic regression analysis for age and maternal BMI (all P > 0.05). Conclusion: There is no significant difference in the occurrence of chromosomal karyotype abnormalities in retained miscarriage after fresh cycle cleavage stage embryo and blastocyst transfer in IVF/ICSI-assisted pregnancies.