選擇胚胎最新方法

2014.06.14

 選擇胚胎最新方法  New tools for embryo selection: comprehensive chromosome screening by array comparative genomic hybridization.

使用微陣列基因檢測aCGH胚胎染色體分析，根據最新的研究胚胎染色體正常，儘管婦女年紀很大，只要植入染色體正常的胚胎，仍然有跟年紀很輕試管嬰兒病人的相等懷孕機會，目前選擇胚胎，主流仍然是微陣列基因檢測aCGH胚胎染色體分析，和未來的qPCR，次世代定序NGS，
有一份研究做的很大，總共做了
1240個試管嬰兒治療週期人數，
其中有203個是習慣性流產，
180個多次胚胎著床失敗，
166個男性不孕症、
33個以前生下3套體的胎兒畸形，
880個因為年紀太大來做CCS，
 
CCS是用卵子或胚胎的切片，但他們是使用第3天胚胎切片，做a-CGH第5天才胚胎植入，得到
54.2%的胚胎著床率，
和62.9%的臨床懷孕率，
他們的結論是:在年紀超過40歲，即使能夠用胚胎切片選出染色體正常的胚胎，其實是很高的病人比率，佔85.3%，而我們只植入染色體正常的胚胎，仍然可達到40.3%的活產率，所以他們的結論，仍然鎖定在胚胎之所以著床失敗的原因，仍然在胚胎的染色體!染色體!染色體!
 
Biomed Res Int. 2014;2014:517125. doi: 10.1155/2014/517125. Epub 2014 Apr 29.
New tools for embryo selection: comprehensive chromosome screening by array comparative genomic hybridization.
 
Abstract
The objective of this study was to evaluate the usefulness of comprehensive chromosome screening(CCS) using array comparative genomic hybridization (aCGH). The study included 1420 CCS cycles for recurrent miscarriage (n = 203); repetitive implantation failure (n = 188); severe male factor (n = 116); previous trisomic pregnancy (n = 33); and advanced maternal age (n = 880). CCS was performed in cycles with fresh oocytes and embryos (n = 774); mixed cycles with fresh and vitrified oocytes (n = 320); mixed cycles with fresh and vitrified day-2 embryos (n = 235); and mixed cycles with fresh and vitrified day-3 embryos (n = 91). Day-3 embryo biopsy was performed and analyzed by aCGH followed by day-5 embryo transfer. Consistent implantation (range: 40.5-54.2%) and pregnancy rates per transfer (range: 46.0-62.9%) were obtained for all the indications and independently of the origin of the oocytes or embryos. However, a lower delivery rate per cycle was achieved in women aged over 40 years (18.1%) due to the higher percentage of aneuploid embryos (85.3%) and lower number of cycles with at least one euploid embryo available per transfer (40.3%). We concluded that aneuploidy is one of the major factors which affect embryo implantation.