Chromosomal polymorphisms in assisted reproduction: an analysis of 942 cycles.

Reproduction & Fertility Pub Date : 2022-07-14 eCollection Date: 2022-07-01 DOI:10.1530/RAF-21-0116
Madara S B Ralapanawe, Sugandika Lakmali Gajaweera, Nishendra Karunaratne, Malcolm James Price, Pedro Melo, Arri Coomarasamy, Ioannis Gallos
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引用次数: 1

Abstract

The use of intracytoplasmic sperm injection (ICSI) has recently increased worldwide. The live birth rate per ICSI cycle is low, and over half of infertile couples remain childless. Chromosomal polymorphisms are up to five times more common in couples with infertility compared to the general population. We aimed to investigate the association between chromosomal polymorphisms and reproductive outcomes in couples undergoing ICSI treatment. We analysed 942 ICSI fresh and frozen embryo transfer cycles in 697 women who underwent karyotyping analysis using Giemsa-Trypsin-Leishman banding prior to assisted conception at the Fertility Centre of Lanka Hospitals, Sri Lanka, between 2016 and 2018. The primary outcomes were pregnancy, miscarriage, and live birth rates. We compared outcomes according to the presence or absence of chromosomal polymorphism in females, males and couples. There were 294 pregnancies (31.2%) recorded in the study; 130 suffered a miscarriage (13.8%), 13 were ectopic pregnancies (1.3%) and 151 resulted in a live birth (16.0%). The evidence from univariable and multivariable analyses (adjusted for age, BMI, ovarian reserve and treatment type) did not confidently identify a difference in pregnancy, miscarriage or live birth rates between couples with no chromosomal polymorphisms compared to couples where the female, male or both partners were carriers of a chromosomal polymorphism. Further, we did not identify a clear association between the presence of chromosomal polymorphisms and reproductive outcomes compared to participants without chromosomal polymorphisms. Wide CIs precluded the identification of clinically meaningful associations.

Lay summary: Infertility affects approximately one in eight couples worldwide. The use of intracytoplasmic sperm injection (ICSI), where the sperm is directly injected into an egg using a micromanipulator outside the body, has become particularly popular in recent years. However, the success rate remains low. In human cells, the genetic material is arranged in structures called chromosomes. Chromosomal polymorphism is a normal variation where the genetic material is arranged differently to the average individual and is more common in infertile couples compared to the general population. We analysed data from 942 ICSI cycles in 697 couples who underwent karyotyping analysis to assess the changes in chromosomes between 2016 and 2018. The pregnancy rate was 31.2%, with 16.0% of participants experiencing a live birth, while 13.8% of pregnancies resulted in a miscarriage and 1.3% were outside the womb cavity (ectopic). The evidence did not identify a clear association between the chromosomal polymorphism and the outcome of treatment.

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辅助生殖中的染色体多态性:942个周期的分析。
胞浆内单精子注射(ICSI)的使用近年来在世界范围内有所增加。每个ICSI周期的活产率很低,超过一半的不育夫妇仍然没有孩子。与一般人群相比,染色体多态性在不育夫妇中的发生率高达五倍。我们的目的是研究染色体多态性与接受ICSI治疗的夫妇的生殖结果之间的关系。我们分析了2016年至2018年期间在斯里兰卡Lanka医院生育中心进行辅助受孕前使用giemsa - trypin - leishman带进行核型分析的697名妇女的942个ICSI新鲜和冷冻胚胎移植周期。主要结局是妊娠、流产和活产率。我们根据女性、男性和夫妇中染色体多态性的存在与否来比较结果。研究记录了294例怀孕(31.2%);流产130例(13.8%),异位妊娠13例(1.3%),活产151例(16.0%)。来自单变量和多变量分析的证据(根据年龄、BMI、卵巢储备和治疗类型进行调整)并不能确定没有染色体多态性的夫妇与女性、男性或双方都携带染色体多态性的夫妇在怀孕、流产或活产率方面的差异。此外,与没有染色体多态性的参与者相比,我们没有确定染色体多态性的存在与生殖结果之间的明确关联。宽ci排除了临床意义关联的识别。概要:全世界大约八分之一的夫妇受到不孕症的影响。近年来,使用卵胞浆内单精子注射(ICSI),即使用体外的微操纵器将精子直接注射到卵子中,已经变得特别流行。然而,成功率仍然很低。在人类细胞中,遗传物质排列在称为染色体的结构中。染色体多态性是一种正常的变异,遗传物质的排列与一般个体不同,与一般人群相比,在不育夫妇中更常见。我们分析了697对夫妇的942个ICSI周期的数据,这些夫妇进行了核型分析,以评估2016年至2018年期间染色体的变化。怀孕率为31.2%,其中16.0%的参与者经历了活产,而13.8%的怀孕导致流产,1.3%是子宫外腔(异位)。证据没有确定染色体多态性与治疗结果之间的明确关联。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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