目的:研究整倍体率和妊娠结局是否受平滑肌内质网簇(SERc)和其他中期II人类卵母细胞形态异常的影响。
方法:回顾性分析中期II(MII)人卵母细胞的形态,在2013年3月至2017年12月期间接受非整倍体植入前遗传学检测(PGT-A)周期的109例患者中,该基因已发展成590个活检囊胚.分析了起源于形态异常或正常卵母细胞的胚泡的整倍体率。在滋养外胚层活检后,通过阵列比较基因组杂交(aCGH)或下一代测序(NGS)确定并分析了胚泡的染色体状态。
结果:根据每种卵母细胞形态的比值比,卵母细胞形态异常与整倍体率无统计学意义。具体来说,尽管SERc阳性卵母细胞在两个原核有较高的停滞率,或2PN(26.7%与19.4%,P>0.05),与SERc阴性卵母细胞相比,囊胚形成率不受影响(40.0%vs.38.6%,p>0.05)。在9个来自具有SERc的卵母细胞的整倍体胚胎中,进行了三次单整倍体胚胎移植,其中一个导致了枯萎的卵子,两个导致两个健康的人出生,单胎足月婴儿。
结论:此处呈现的结果表明,卵母细胞形态异常并不影响胚泡的整倍体率。卵母细胞中SERc的出现似乎既不会损害发育中的胚泡,也不会干扰良好的胚胎形成率和整倍体率。因此,如果没有其他胚胎,来自SERc阳性卵母细胞的胚胎仍可考虑用于胚胎移植.
OBJECTIVE: To investigate whether the rate of euploidy and pregnancy outcomes are affected by smooth endoplasmic reticulum clusters (SERc) and other metaphase II human oocyte dysmorphisms.
METHODS: Retrospective analysis of the morphologies of metaphase II (MII) human oocytes, which had developed into 590 biopsied blastocysts derived from 109 patients that received preimplantation genetic testing for aneuploidies (PGT-A) cycles between March 2013 and December 2017. The euploid rate of blastocysts that originated from morphologically abnormal or normal oocytes were analyzed. The chromosome status of the blastocysts was determined and analyzed by array comparative genomic hybridization (aCGH) or next generation sequencing (NGS) following trophectoderm biopsy.
RESULTS: According to the odds ratios obtained for each oocyte morphotype, no statistically significant relationship was found between oocyte dysmorphisms and euploid rate. Specifically, although SERc-positive oocytes had a higher rate of arrest at two pronuclei, or 2 PN (26.7% vs. 19.4%, p > 0.05), the blastocyst formation rate was not affected as compared with SERc-negative oocytes (40.0% vs. 38.6%, p > 0.05). Among nine euploid embryos derived from oocytes with SERc, three single euploid embryo transfers were performed, of which one resulted in blighted ovum, and two resulted in the births of two healthy, singleton term babies.
CONCLUSIONS: The results presented here suggest that oocyte dysmorphisms do not affect the euploidy rate of the blastocyst. The occurrence of SERc in the oocyte does not seem to impair the developing blastocyst nor does it interfere with good embryo formation rate and euploid rate. Thus, the embryos derived from SERc-positive oocytes could still be considered for embryo transfer if there are no other embryos available.