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目的:分析30例体外受精-胚胎移植(IVF-ET)流产胚胎绒毛染色体核型组成,探讨流产原因。方法:收集30例IVF-ET流产胚胎绒毛,行体外原代培养、染色体制备及核型分析。观察既往不同流产次数对胚胎绒毛染色体异常率的影响;按流产胚胎性别,分析性别差异与染色体异常率间的关系。结果:30例IVF-ET流产胚胎绒毛体外培养成功30例,成功率100%。30例标本中染色体异常核型20例,占66.70%,其中三体核型14例,21单体型1例,多倍体1例,嵌合体2例,其他异常核型2例。单次流产史患者13例,胚胎异常核型9例(69.23%);反复流产(≥2次)史患者17例,胚胎异常核型11例(64.71%),两组间比较无显著性差异。14例男胎中异常核型10例,占71.42%;15例女胎中异常核型9例,占60.00%,两组比较差异有统计学意义(P<0.05)。结论:胚胎染色体异常是IVF-ET早期自然流产的主要原因,绒毛染色体检查对寻找IVF-ET失败原因具有重要的指导意义。
OBJECTIVE: To analyze the karyotypes of chorionic villi in 30 aborted embryos of IVF-ET and to discuss the causes of abortion. Methods: 30 cases of IVF-ET abortion embryos were collected for in vitro primary culture, chromosome preparation and karyotype analysis. To observe the effect of different abortion times on the chromosomal aberration rate of embryos; to analyze the relationship between gender differences and chromosomal abnormalities according to the gender of aborted embryos. Results: 30 cases of IVF-ET abortion embryos villi were successfully cultured in vitro, the success rate was 100%. There were 20 cases of chromosomal aberrations karyotypes in 66 cases, accounting for 66.70%. There were 14 cases of trisomy, 1 case of 21 haplotypes, 1 case of polyploidy, 2 cases of chimerism and 2 cases of other abnormal karyotypes. There were 13 cases of single abortion history, 9 cases of embryo abnormal karyotype (69.23%), 17 cases of recurrent miscarriage (≥2 times) history and 11 cases of embryonic abnormal karyotype (64.71%). There was no significant difference between the two groups . There were 10 cases of abnormal karyotype in 14 male fetuses, accounting for 71.42%. There were 9 cases of abnormal karyotype in 15 cases (60.00%), the difference was statistically significant (P <0.05). Conclusion: Embryo chromosomal abnormalities are the major cause of spontaneous abortion in early stage of IVF-ET. Chorionic villus examination is of great significance in finding the cause of failure of IVF-ET.