| 摘要: |
| 目的：探讨PGT-A周期中胚胎植入前滋养外胚层细胞活检对冻融单囊胚移植患者妊娠早期血清β-人绒毛膜促性腺激素（β-hCG）水平及妊娠结局的影响。方法：回顾性纳入2023年1月至2024年12月在南京市妇幼保健院生殖中心行冻融单囊胚移植的患者，分为PGT-A组（898 周期）与常规IVF组（1599周期）。收集两组基线资料，比较移植后14天血清β-hCG水平及临床妊娠率、流产率、早产率、活产率等结局指标；采用单因素与多因素线性回归分析血清β-hCG的独立影响因素。结果：两组之间年龄、不孕年限、BMI、转化日内膜厚度、LH、AMH存在统计学差异（均P＜0.05）。妊娠结局方面，经二元logistic回归分析校正混杂因素后显示，PGT-A组流产率显著低于常规IVF组（P=0.003），活产率显著高于常规IVF组（P=0.009）。分层分析显示，临床妊娠及活产亚组中PGT-A组β-hCG 水平更低（P＜0.001）；多因素回归校正混杂因素后，滋养外胚层活检并非妊娠早期β-hCG水平的独立影响因素（P=0.253）；年龄、BMI、子宫内膜厚度、囊胚内细胞团和滋养层细胞等级为独立影响因素（均P＜0.05）。结论：PGT-A周期中，囊胚滋养外胚层活检不是胚胎移植后妊娠早期血清β-hCG水平的独立影响因素，且对妊娠结局无不良影响。 |
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chen mengxi1,2,3,2,4
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1.Nanjing Women and Children&2.#39;3.&4.s Healthcare Hospital
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| Abstract: |
| 【Abstract】 Objective: This study aimed to investigate whether trophectoderm biopsy in PGT-A cycles influences serum β-hCG levels in early pregnancy and subsequent pregnancy outcomes among patients receiving frozen-thawed single blastocyst transfer. Methods: A retrospective analysis was conducted on patients who received frozen-thawed single blastocyst transfer at Reproductive Center of Nanjing Women and Children''s Healthcare Hospital from January 2023 to December 2024. The participants were divided into the PGT-A group (898 cycles) and the standard IVF group (1,599 cycles). Baseline data were collected and compared between the two groups. Serum β-hCG levels on day 14 post-transfer, together with clinical pregnancy rate, miscarriage rate, preterm birth rate, live birth rate and other pregnancy outcomes, were analyzed for intergroup differences. Univariate and multivariate linear regression analyses were used to identify independent influencing factors of serum β-hCG levels. Results:There were statistically significant differences between the two groups in age, duration of infertility, BMI, endometrial thickness on the day of progesterone conversion, LH, and AMH (all P < 0.05). Regarding pregnancy outcomes, after adjusting for confounding factors using binary logistic regression analysis, the miscarriage rate in the PGT-A group was significantly lower than that in the standard IVF group (P=0.003), while the live birth rate was significantly higher (P=0.009). Stratified analysis showed that within the clinical pregnancy and live birth subgroups, the PGT group had lower β-hCG levels (P<0.001). After adjusting for confounding factors in multivariate regression, trophectoderm biopsy was not an independent influencing factor for early pregnancy β-hCG levels (P=0.253); trophectoderm biopsy was not an independent influencing factor for early?pregnancy serum β?hCG levels (P = 0.217). In contrast, age, BMI, endometrial thickness and blastocyst morphological grading were identified as independent influencing factors (all P < 0.05). Conclusion: Blastocyst trophectoderm biopsy in PGT-A cycles has no influence on serum β hCG concentrations in early gestation following frozen thawed blastocyst transfer, and is not associated with detrimental pregnancy outcomes. |
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