Analysis of factors related to pregnancy outcome after mosaic embryo transfer
10.3760/cma.j.cn101441-20221230-00600
- VernacularTitle:嵌合型胚胎移植妊娠结局的影响因素分析
- Author:
Chenxi JIN
1
;
Wenhao YU
1
;
Qian ZHANG
1
;
Jing LI
1
;
Hongchang LI
1
;
Junhao YAN
1
Author Information
1. 山东大学生殖医学研究中心 山东省生殖健康临床医学研究中心 国家辅助生殖与优生工程技术研究中心，济南 250021
- Publication Type:Journal Article
- Keywords:
Pregnancy outcome;
Preimplantation genetic testing;
Next-generation sequencing;
Mosaic embryo;
Mosaic ratio;
Mosaic type
- From:
Chinese Journal of Reproduction and Contraception
2023;43(5):440-447
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the pregnancy outcome of mosaic embryo transfer in next-generation sequencing (NGS) based-preimplantation genetic testing (PGT), and the effect of different mosaic ratios and types on the pregnancy outcome.Methods:This was a retrospective, single-center, cohort study of 308 mosaic embryo transfer cycles (named mosaic group) and 904 euploid embryo transfer cycles (named euploid group) from January 2018 to December 2021 at Center for Reproductive Medicine, Cheeloo College of Medicine. Pregnancy outcomes, including biochemical pregnancy, clinical pregnancy, ongoing pregnancy, early miscarriage, live birth and pregnancy complication rate, were compared between the mosaic and euploid groups. The mosaic group was further divided into low- and high-level mosaicism subgroups according to mosaic ratio, and fragmental deletion/duplication, chromosomal monosomy/trisomy and complex mosaicism subgroups according to the chimerism type, in order to analyze the effects of different mosaic ratios and types on the transfer outcome of mosaic embryos.Results:Compared with euploid group, the rates of ongoing pregnancy [49.35% (152/308) vs. 58.19% (526/904), P=0.020, OR=0.924] and live birth [48.38% (149/308) vs. 55.75% (504/904), P=0.031, OR=0.930] were significantly lower in mosaic group, but there was no significant difference in the risk of pregnancy complications between the two groups ( P>0.05). The high-level mosaic subgroup had a significantly lower live birth rate [35.00% (14/40)] compared with low-level mosaic subgroup [50.37% (135/268), P=0.028, OR=0.840]. The biochemical pregnancy rate [58.49% (62/106) vs. 70.91% (641/904), P=0.020, OR=0.891], the clinical pregnancy rate [49.06% (52/106) vs. 64.82% (586/904), P=0.003, OR=0.864], the ongoing pregnancy rate [43.40% (46/106) vs. 58.19% (526/904), P=0.003, OR=0.864] and the live birth rate [43.40% (46/106) vs. 55.75% (504/904), P=0.008, OR=0.868] of chromosomal monosomy/trisomy mosaic subgroup were significantly lower than those of euploid group. The biochemical pregnancy rate [64.47% (49/76) vs. 84.13% (53/63), P=0.002, OR=0.793], the clinical pregnancy rate [57.89% (44/76) vs. 77.78% (49/63), P=0.006, OR=0.814], the ongoing pregnancy rate [47.37% (36/76) vs. 68.25% (43/69), P=0.017, OR=0.829] and the live birth rate [46.05% (35/76) vs. 65.08% (41/63), P=0.042, OR=0.850] of fragmental deletion mosaic embryos were significantly lower than those of fragmental duplication mosaic embryos. Conclusion:Partial mosaic embryo transfer can also achieve healthy live births, and different mosaic ratios and types affect the pregnancy outcomes. Therefore, patients with no available euploid embryos could be counseled about the possibility of transferring a mosaic embryo, taking into consideration the different mosaic ratios and types.
