Research question

Does blastocyst biopsy for preimplantation genetic testing (PGT) increase the risk of adverse maternal and neonatal outcomes?

Study design

Retrospective cohort study of 5097 single vitrified–warmed blastocyst transfer cycles from January 2016 to December 2018, with 2061 cycles in the biopsied group and 3036 cycles in the unbiopsied group enrolled in the analyses. Maternal and neonatal outcomes were compared between the two groups.

Results

The live birth rate in the biopsied group (41.1%) was significantly higher than that in the unbiopsied group (35.6%, adjusted odds ratio [aOR] 1.27, 95% confidence interval [CI] 1.05–1.54, P = 0.012) after adjusting for maternal age, maternal body mass index, gravidity, parity, infertility diagnosis, timing of blastocyst transfer, blastocyst quality, regimen of endometrial preparation, endometrial thickness before transfer and treatment year. The rates of total pregnancy loss (25.4% versus 32.2%, aOR 0.69, 95% CI 0.52–0.91, P = 0.008) and early miscarriage (12.1% versus 17.3%, aOR 0.56, 95% CI 0.38–0.83, P = 0.004) were significantly lower in the biopsied group than in the unbiopsied group. No significant differences were found in sex ratio or the risks of hypertensive disorders in pregnancy, diabetes in pregnancy, placenta previa, preterm premature rupture of membranes, low birthweight, very low birthweight, macrosomia, small for gestational age, large for gestational age or birth defects between the two groups. When the subgroup analyses were conducted based on different types of PGT, similar patterns were found for all types.

Conclusion

Blastocyst biopsy might not increase the risks of adverse maternal and neonatal outcomes in the short term.

中文翻译：

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在单个玻璃化加热胚胎移植周期中进行 PGT 囊胚活检后的孕产妇和新生儿结局

研究问题

用于植入前基因检测 (PGT) 的囊胚活检是否会增加孕产妇和新生儿不良结局的风险？

学习规划

从 2016 年 1 月到 2018 年 12 月，对 5097 个单次玻璃化加热囊胚移植周期进行了回顾性队列研究，其中活检组 2061 个周期和未活检组 3036 个周期参与分析。比较两组产妇和新生儿结局。

结果

调整后活检组的活产率（41.1%）显着高于未活检组（35.6%，调整优势比[aOR] 1.27，95%置信区间[CI] 1.05-1.54，P  = 0.012）孕产妇年龄、孕产妇体重指数、孕次、产次、不孕诊断、囊胚移植时机、囊胚质量、子宫内膜准备方案、移植前子宫内膜厚度和治疗年份。总流产率（25.4% 对 32.2%，aOR 0.69，95% CI 0.52–0.91，P  = 0.008）和早期流产率（12.1% 对 17.3%，aOR 0.56，95% CI 0.38–0.83，P = 0.004) 在活检组中显着低于未活检组。性别比或妊娠期高血压疾病、妊娠期糖尿病、前置胎盘、早产胎膜早破、低出生体重、极低出生体重、巨大儿、小于胎龄、大于胎龄或出生的风险没有显着差异两组之间的缺陷。当基于不同类型的 PGT 进行亚组分析时，所有类型都发现了相似的模式。

结论

囊胚活检可能不会在短期内增加母婴不良结局的风险。