胚胎着床前基因检测的滋养外胚层活检对妊娠早期血清生物标志物水平的影响。

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online Pub Date : 2025-03-01 DOI:10.1016/j.rbmo.2024.104490

Pilar Prats , María Gabriela Palacios-Verdú , Alberto Rodríguez-Melcón , Ignacio Rodríguez , Bernat Serra , Mónica Parriego , Valeria Donno , Nikolaos P. Polyzos

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引用次数: 0

摘要

研究问题：用于胚胎着床前非整倍体基因检测的滋养外胚层活检（PGT-A）是否会影响母体妊娠早期血清生物标志物（妊娠相关血浆蛋白A [ppp -A]、游离β-HCG和胎盘生长因子[PIGF]）？设计:回顾性队列研究的单例妊娠(n = 9794)后自然受孕(n = 8005)体外受精和新鲜胚胎转移(n = 478),冷冻胚胎移植的非PGT-A(场效应晶体管)(n = 963)或PGT-A测试胚胎(场效应晶体管 + PGT-A) (n = 348)。在妊娠8-13.6周时测量所有可孕妇女血清游离β-HCG和ppap - a水平；在3784名妇女中测量了PIGF。将生物标志物转换为相同妊娠日的预期正常中位数（MOM）的倍数。计算和比较中位数倍数的中位数。结果：游离β-HCG在不同受孕方式下无差异。体外受精和新鲜胚胎移植的PAPP-A浓度（-0.1 Log10 MOM raw PAPP-A）显著低于FET + PGT-A （-0.04 Log10 MOM raw PAPP-A, P = 0.009）和自然受孕（-0.0187 Log10 MOM raw PAPP-A）（P < 0.001）。与自然受孕相比，FET + PGTA组的PIGF水平显著降低（P = 0.001）。经冠臀长度调整后的平均差异为自然受孕4.6 pg/ml (95% CI 2.7至6.6)，体外受精3.5 pg/ml (95% CI 0.34至6.6),FET 2.2 pg/ml （95% CI 0.06至4.4）。结论：滋养外胚层活检检测PGT-A对孕早期产妇血清ppp - a和PIGF有显著影响。这需要进一步验证，因为它可能会误导对妊娠早期非整倍体和先兆子痫风险的估计。

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Influence of trophectoderm biopsy for preimplantation genetic testing in the serum level of first trimester biomarkers

Research question

Does trophectoderm biopsy for preimplantation genetic testing for aneuploidies (PGT-A) affect maternal serum first-trimester pregnancy biomarkers (pregnancy-associated plasma protein A [PAPP-A], free β-HCG and placental growth factor [PIGF])?

Design

Retrospective cohort study of all singleton pregnancies (n = 9794) after naturally conceived (n = 8005) IVF and fresh embryo transfers (n = 478), frozen embryo transfer of non PGT-A (FET) (n = 963) or PGT-A tested embryos (FET + PGT-A) (n = 348). Serum levels of free β-HCG and PAPP-A were measured in all women with a viable pregnancy at 8–13.6 weeks of pregnancy; PIGF was measured in 3784 women. Biomarkers were converted to a multiple of the expected normal median (MOM) for a pregnancy of the same gestational day. The medians for the multiple of the median were calculated and compared.

Results

Free β-HCG did not differ according to mode of conception. The PAPP-A concentrations were significantly lower in IVF and fresh embryo transfers (–0.1 Log10 MOM raw PAPP-A) compared with FET + PGT-A (–0.04 Log 10 MOM raw PAPP-A, P = 0.009) and natural conceptions (–0.0187 Log 10 MOM raw PAPP-A) (P < 0.001). The PIGF levels were significantly lower in the FET + PGTA group versus natural conception (P = 0.001). Difference in means adjusted by crown rump length was 4.6 pg/ml (95% CI 2.7 to 6.6) for natural conceptions, 3.5 pg/ml (95% CI 0.34 to 6.6) for IVF and 2.2 pg/ml (95% CI 0.06 to 4.4) for FET.

Conclusion

Trophectoderm biopsy for PGT-A has a significant effect on first-trimester maternal serum PAPP-A and PIGF. This needs to be further validated, as it may mislead the estimation of the first-trimester risk of aneuploidies and pre-eclampsia.

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来源期刊

Reproductive biomedicine online 医学-妇产科学

CiteScore

7.20

自引率

7.50%

发文量

391

审稿时长

50 days

期刊介绍： Reproductive BioMedicine Online covers the formation, growth and differentiation of the human embryo. It is intended to bring to public attention new research on biological and clinical research on human reproduction and the human embryo including relevant studies on animals. It is published by a group of scientists and clinicians working in these fields of study. Its audience comprises researchers, clinicians, practitioners, academics and patients. Context: The period of human embryonic growth covered is between the formation of the primordial germ cells in the fetus until mid-pregnancy. High quality research on lower animals is included if it helps to clarify the human situation. Studies progressing to birth and later are published if they have a direct bearing on events in the earlier stages of pregnancy.