Excessive Exogenous Gonadotropins and Genetic and Pregnancy Outcomes After Euploidy Embryo Transfer

胚胎移植 活产 怀孕 不育 非整倍体 妊娠率 妇科 医学 胚胎 优势比 随机对照试验 男科 产科 生物 内科学 遗传学 基因 染色体
作者
Tianxiang Ni,Wei Zhou,Yingbo Liu,Weiran Cui,Liu Yang,Juanjuan Lu,Qian Zhang,Zi‐Jiang Chen,Yan Li,Junhao Yan
出处
期刊:JAMA network open [American Medical Association]
卷期号:7 (4): e244438-e244438
标识
DOI:10.1001/jamanetworkopen.2024.4438
摘要

Importance The safety of exogenous gonadotropin treatment, based on its effect on embryos and pregnancy outcomes, remains inconclusive. Objective To evaluate the associations of different doses and durations of gonadotropins with embryonic genetic status and pregnancy outcomes after euploid embryo transfer in couples with infertility. Design, Setting, and Participants This study was a post hoc analysis of a multicenter randomized clinical trial (RCT) conducted at 14 reproductive centers throughout China from July 2017 to June 2018 that evaluated the cumulative live birth rate with or without preimplantation genetic testing for aneuploidy (PGT-A) among couples with infertility and good prognosis. The PGT-A group from the original RCT was selected for secondary analysis. Patients were divided into 4 groups according to the total dosage of exogenous gonadotropins and treatment duration: group 1 (≤1500 IU and <10 days), group 2 (≤1500 IU and ≥10 days), group 3 (>1500 IU and <10 days), and group 4 (>1 500 IU and ≥10 days). Group 1 served as the control group. Data were analyzed from June through August 2023. Interventions Blastocyst biopsy and PGT-A. Main outcomes and measures The primary outcomes were embryonic aneuploidy, embryonic mosaicism, and cumulative live birth rates after euploid embryo transfer. Results A total of 603 couples (mean [SD] age of prospective mothers, 29.13 [3.61] years) who underwent PGT-A were included, and 1809 embryos were screened using next-generation sequencing. The embryo mosaicism rate was significantly higher in groups 2 (44 of 339 embryos [13.0%]; adjusted odds ratio [aOR], 1.69 [95% CI, 1.09-2.64]), 3 (27 of 186 embryos [14.5%]; aOR, 1.98 [95% CI, 1.15-3.40]), and 4 (82 of 651 embryos [12.6%]; aOR, 1.60 [95% CI, 1.07-2.38]) than in group 1 (56 of 633 embryos [8.8%]). There were no associations between gonadotropin dosage or duration and the embryo aneuploidy rate. The cumulative live birth rate was significantly lower in groups 2 (83 of 113 couples [73.5%]; aOR, 0.49 [95% CI, 0.27-0.88]), 3 (42 of 62 couples [67.7%]; aOR, 0.41 [95% CI, 0.21-0.82]), and 4 (161 of 217 couples [74.2%]; aOR, 0.53 [95% CI, 0.31-0.89]) than in group 1 (180 of 211 couples [85.3%]). Conclusions and relevance In this study, excessive exogenous gonadotropin administration was associated with increased embryonic mosaicism and decreased cumulative live birth rate after euploid embryo transfer in couples with a good prognosis. These findings suggest that consideration should be given to minimizing exogenous gonadotropin dosage and limiting treatment duration to improve embryo outcomes and increase the live birth rate. Trial Registration ClinicalTrials.gov Identifier: NCT03118141
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
黄花完成签到 ,获得积分10
刚刚
刘珍荣完成签到,获得积分10
1秒前
1秒前
紫金之巅完成签到 ,获得积分10
1秒前
Gang完成签到,获得积分10
2秒前
3秒前
3秒前
4秒前
CYYDNDB完成签到 ,获得积分10
4秒前
粿粿一定行完成签到 ,获得积分10
5秒前
6秒前
战战完成签到,获得积分10
7秒前
xlk2222完成签到,获得积分10
10秒前
笨笨以莲完成签到,获得积分10
10秒前
YHX完成签到,获得积分10
11秒前
沐沐心完成签到 ,获得积分10
12秒前
12秒前
13秒前
哭泣笑柳发布了新的文献求助10
13秒前
轻松白桃完成签到,获得积分10
13秒前
JasVe完成签到 ,获得积分10
16秒前
wakkkkk完成签到,获得积分10
16秒前
含蓄听南完成签到,获得积分10
16秒前
HH给HH的求助进行了留言
16秒前
芋你呀完成签到,获得积分10
17秒前
西蓝花香菜完成签到 ,获得积分10
17秒前
无花果应助兔子采纳,获得10
17秒前
请勿继续完成签到,获得积分10
19秒前
搞怪的婴完成签到,获得积分10
20秒前
Loooong完成签到,获得积分0
20秒前
22秒前
fuguier完成签到,获得积分10
24秒前
大橙子发布了新的文献求助10
24秒前
王旭完成签到,获得积分10
26秒前
轻松白桃发布了新的文献求助10
26秒前
26秒前
Distance发布了新的文献求助10
27秒前
鲤鱼青雪完成签到,获得积分10
27秒前
耳机单蹦完成签到,获得积分10
28秒前
苻醉山完成签到 ,获得积分0
28秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038184
求助须知:如何正确求助?哪些是违规求助? 3575908
关于积分的说明 11373872
捐赠科研通 3305715
什么是DOI,文献DOI怎么找? 1819255
邀请新用户注册赠送积分活动 892662
科研通“疑难数据库(出版商)”最低求助积分说明 815022