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首页> 外文期刊>Human Reproduction >Cumulative reproductive outcome after preimplantation genetic diagnosis: a report on 1498 couples.
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Cumulative reproductive outcome after preimplantation genetic diagnosis: a report on 1498 couples.

机译：植入前遗传学诊断后的累计生殖结局：1498对夫妇的报告。

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BACKGROUND: Couples undergoing preimplantation genetic diagnosis (PGD) have a different background and set of treatment characteristics to couples undergoing regular IVF or ICSI. The aim of this study was to analyse the cumulative reproductive outcome of a large cohort of couples undergoing PGD in relation to a number of explanatory variables potentially affecting the prognosis. METHODS: Prospective cohort study, Kaplan-Meier analysis was performed to estimate real (observed) and expected (calculated) cumulative delivery rates, and Cox proportional hazard regression analysis was used to assess the effect of age, number of cumulus oocyte complexes collected, fertility status, parity, genetic category and method of pituitary suppression. RESULTS: Between 1993 and 2005, 2753 unselected consecutive cycles of ICSI and PGD were carried out in 1498 couples. The cumulative observed delivery rate overall per couple with a maximum of six treatment cycles of ICSI and PGD performed was 29%. The expected cumulative delivery rate (max six cycles) overall was 62%. There were no significant differences in cumulative delivery rates between the different genetic categories (i.e. availability of transferable embryos after PGD of 50 or 75%, chromosomal translocations or aneuploidy screening). The cumulative reproductive outcome in this PGD cohort was also not significantly affected by the fertility status of the couple, their parity or the method of pituitary suppression. However, the age of the patient and the number of oocytes contributed significantly to the reproductive results. CONCLUSION: This prospective observational study demonstrates that age has a significantly negative effect on outcome of PGD, due to poor reproductive performance of female partners 40 years of age and older. The number of oocytes collected has a significant and independent effect. The other factors studied did not affect the cumulative reproductive outcome in this PGD cohort.
机译：背景：接受植入前遗传学诊断（PGD）的夫妇与接受常规IVF或ICSI的夫妇具有不同的背景和治疗特征。这项研究的目的是分析与PGD相关的大量可能影响预后的解释变量对大批夫妇进行PGD累积生殖结果。方法：进行前瞻性队列研究，进行Kaplan-Meier分析以估计实际（观察）和预期（计算）的累计分娩率，并使用Cox比例风险回归分析评估年龄，收集的卵母细胞复合物数量，生育力的影响。垂体的状态，奇偶性，遗传类别和方法。结果：在1993年至2005年之间，对1498对夫妇进行了2753次未选择的ICSI和PGD连续周期。每对夫妇的整体观察到的总分娩率最高为进行了ICSI和PGD的六个治疗周期，为29％。总体上，预期的累计交付率（最多六个周期）为62％。不同遗传类别之间的累积传递率没有显着差异（即PGD为50或75％后可转移胚胎的可用性，染色体易位或非整倍性筛选）。这对PGD队列的累积生殖结局也不受夫妻的生育状况，其同等或垂体抑制方法的影响。但是，患者的年龄和卵母细胞的数量对生殖结果有重要贡献。结论：这项前瞻性观察研究表明，年龄对PGD的结局有明显的负面影响，这是由于40岁及40岁以上的女性伴侣的生殖能力较差。收集的卵母细胞数量具有显着且独立的作用。研究的其他因素并未影响该PGD队列中的累积生殖结局。

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