刘珊,史霖,王婷
LIU Shan,SHI Lin,WANG Ting

• 1:西北妇女儿童医院辅助生殖中心
• 2:西安交通大学基础医学院病原生物学与免疫学系

摘要(Abstract)：

目的:探讨不同类型男性染色体多态性对体外受精—单精子显微注射并胚胎移植(IVF/ICSI-ET)助孕结局的影响。方法:选取1 936例首次接受IVF/ICSI-ET治疗的不孕夫妇中单纯男方染色体多态患者340例,分为常染色体长臂次缢痕多态组(n=84)、D/G组染色体随体多态组(n=81)、9号染色体臂间倒位组(n=25)及Y染色体多态组(n=150),同期行IVF/ICSI-ET助孕且男女双方染色体均正常的夫妇作为对照组(n=1 596);记录各组被检者的基本情况、基础性激素水平、促排卵情况及妊娠结局,采用Logistic回归分析包括各型男方染色体多态性在内的17项协变量因素与异常妊娠发生、成功临床妊娠及活产的相关性。结果:4组常染色体多态性患者基本情况、基础性激素水平、促排卵情况及妊娠结局与正常对照组比较,差异无统计学意义(P>0.05);Logistic回归分析结果显示,9号染色体臂间倒位与异常妊娠(早期流产和胚胎停止发育)的发生呈显著正相关,Y染色体多态与成功临床妊娠呈显著负相关,常染色体次缢痕区多态及Y染色体多态与成功活产呈显著负相关。结论:男性1、9及16号常染色体长臂次缢痕长度变异、9号染色体臂间倒位及Y染色体长臂异染色质区长度变异是IVF/ICSI-ET不良妊娠结局的影响因素,可能增加辅助生殖助孕患者发生不良妊娠的风险。
Objective: To investigate the effects of different types of male chromosome polymorphism on outcome in IVF/ICSI-ET.Methods:Data of 1936 infertile couples receiving IVF/ICSI-ET for the first time were retrospectively analyzed.According to the type of chromosome polymorphism,the patients with male chromosome polymorphism were divided into four groups: autosomal long arm secondary constriction polymorphism(n=84),Dand G group chromosomessatellite polymorphism(n=81),interarm inversion of chromosome 9(n=25) and Y chromosome polymorphism(n=150).Couples with normal chromosomes of both spouses who were assisted by IVF/ICSI-ET during the same period were served as control group(n=1596).The differencein the basic situation,basic sex hormone levels,ovulation promotion and pregnancy outcomes between the four chromosome polymorphism groups and control group were compared.Logistic regression was used to analyze the correlation between 17 covariate factors(including chromosome polymorphism) and abnormal pregnancy,clinical pregnancy and live birth.Results:There was no significant difference in the basic information,basic sex hormone level,induction of pregnancy and pregnancy outcome between the 4 groups and the normal control group(P>0.05).Logistic regression analysis results showed that interarm inversion of chromosome 9 was positively correlated with the occurrence of abnormal pregnancy(early abortion+embryonic arrest).Y chromosome polymorphism was negatively correlated with successful clinical pregnancy.The polymorphisms of autosomal subconstriction region and Y chromosome were negatively correlated with successful live birth.Conclusion:In IVF/ICSI-ET treatment,1,9 and 16 chromosomal polymorphism,interarm inversion of chromosome 9 and Y chromosome polymorphism are the influencing factor of adverse pregnancy outcomes.These chromosome polymorphisms in male patients may increase the risk of adverse pregnancy in assisted reproductive assistedpregnancies.

关键词(KeyWords)： 染色体多态性;体外受精;单精子显微注射并胚胎移植;胚胎移植;辅助生殖;妊娠结局
chromosome polymorphism;in vitro fertilization;intracytoplasmicsperm injection;embryotransfer;assisted reproduction;pregnancy outcome

Abstract:

Keywords:

基金项目(Foundation): 陕西省重点研发计划项目(2017SF-121)

作者(Author): 刘珊,史霖,王婷
LIU Shan,SHI Lin,WANG Ting

DOI: 10.19367/j.cnki.1000-2707.2019.08.011

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