Effect of the second biopsy on the clinical outcomes of patients with preimplantation genetic testing
10.3760/cma.j.cn101441-20230905-00105
- VernacularTitle:囊胚二次活检对胚胎植入前遗传学检测患者临床结局的影响
- Author:
Yanru LI
1
;
Yiwen WANG
1
;
Yuanhui CHEN
1
;
Huijuan ZHANG
1
;
Baoli YIN
1
;
Cuilian ZHANG
1
Author Information
1. 郑州大学人民医院 河南省人民医院生殖医学中心，郑州 450003
- Publication Type:Journal Article
- Keywords:
Blastocyst;
Propensity score matching;
Secondary biopsy;
Preimplantation genetic testing;
Neonatal outcomes
- From:
Chinese Journal of Reproduction and Contraception
2024;44(5):447-455
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of rebiopsy blastocyst on clinical pregnancy and neonatal outcomes in patients with preimplantation genetic testing (PGT) before embryo implantation.Methods:A retrospective cohort study analyzed the clinical pregnancy and neonatal outcomes of one biopsy and rebiopsy patients (453 and 60 patients, respectively) with PGT in the Reproductive Medicine Center of Henan Provincial People's Hospital from January 2019 to December 2022. The 2∶1 propensity score matching (PSM) method was used to match the age, body mass index (BMI) and infertility duration of women in the two groups, and the laboratory indexes and related indexes of transplant fertility and neonatal outcomes of PGT patients were compared between the two groups. The rebiopsy patients with PGT were divided into PGT for aneuploidy (PGT-A) subgroup, PGT for structural rearrangements (PGT-SR) subgroup and PGT for monogenic (PGT-M) subgroup according to PGT types, and the rebiopsy rate, the success rate of amplification and the rate of transferrable embryo were compared between each two subgroups.Results:After PSM, there were no significant differences in women's age, female body mass index, infertility type, ovulation induction program, PGT type and laboratory-related indexes between the two groups (all P>0.05). At the same time, the implantation rate, the clinical pregnancy rate and the live birth rate of rebiopsy embryos decreased, and the miscarriage rate increased, but the differences were not statistically significant (all P>0.05). The rate of day 3 available embryo in the rebiopsy PGT group [87.50% (434/496)] was significantly increased, and the number of blastocyst [4.00 (2.25,6.75)] was significantly decreased compared with one biopsy PGT group [82.19% (812/980), P=0.020; 5.50 (3.00,8.00), P=0.028]. Then the chromosomal euploidy rate of the rebiopsy embryo [35.9% (28/78)] decreased and the abnormality rate [9.0% (7/78)] increased in the rebiopsy PGT group compared with one biopsy PGT group [49.3% (226/458), P=0.028; 0.9% (4/458), P<0.001], and the differences were statistically significant. The aneuploidy rate and multi-chromosome mosaic rate in the rebiopsy PGT group were higher than those in the one biopsy PGT group, but the difference was not statistically significant (all P>0.05). There were no significant differences in birth weight, gestational age, sex ratio, low birth weight infants, macrosomia, small-for-gestational-age infants, large-for-gestational-age infants, and incidence of birth defects between the two groups (all P>0.05). There was no significant difference in the rebiopsy rate, the success rate of amplification and the rate of transferrable embryo between the subgroups of the PGT group (all P>0.05). Conclusion:For patients who fail the first biopsy, the clinical pregnancy rate, the live birth rate, the neonatal birth weight, and the birth defect incidence rate after the second biopsy of PGT are comparable to those of the patients with the first biopsy of PGT.
