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目的:分析不育人群中染色体异常的类型和发生频率,探讨不育夫妇染色体核型与辅助生殖技术(ART)临床结局的关系。方法:采用外周血培养常规技术,结合G显带方法对来我院就诊的3 505例不育症患者进行细胞遗传学分析,统计染色体异常类型及检出率。将夫妇其中一方或双方为多态性核型的归入多态性核型组,双方染色体正常的归入正常核型组,比较两组的受精率、卵裂率、优胚率、妊娠率和早期流产率。结果:3 505例不育症患者中,染色体核型异常者196例,异常核型检出率为5.59%(196/3 505)。异常核型中多态性核型者103例,占染色体异常核型的52.55%(103/196),检出率为2.94%(103/3 505)。多态性核型组与正常核型组相比,受精率、卵裂率、优胚率无统计学意义(P>0.05),但多态性核型组早期流产率大于正常核型组(P<0.05)。结论:不育症患者为染色体异常的高危人群,染色体多态性核型可能会导致早期流产率增高,纳入ART治疗的不育患者应常规进行染色体核型分析以明确不良妊娠风险。
Objective: To analyze the types and frequency of chromosomal abnormalities in infertile population and to explore the relationship between chromosomal karyotype and clinical outcome of assisted reproductive technology (ART) in infertile couples. Methods: The 3 505 cases of infertility patients who came to our hospital were analyzed by cytogenetics using routine peripheral blood culture techniques combined with G-banding method. The types and detection rate of chromosomal abnormalities were analyzed. One or both of the couples were polymorphic karyotypes were classified as polymorphic karyotypes. Both chromosomes were normalized into normal karyotype group. The fertilization rate, cleavage rate, excellent embryo rate, pregnancy rate And early abortion rates. Results: Of the 3 505 cases of infertility, 196 cases were found abnormal chromosomal karyotype, the detection rate of abnormal karyotype was 5.59% (196/3 505). There were 103 polymorphic karyotypes in abnormal karyotypes, accounting for 52.55% (103/196) of chromosomal abnormal karyotypes with a detection rate of 2.94% (103/3 505). Polymorphic karyotype group compared with the normal karyotype group, fertilization rate, cleavage rate, excellent embryo rate was not statistically significant (P> 0.05), but the polymorphism karyotype early abortion rate was higher than the normal karyotype group P <0.05). CONCLUSIONS: Infertile patients are at high risk of chromosomal abnormality. Chromosomal polymorphisms may lead to an increase of early miscarriage rates. Infertility patients with ART should be routinely analyzed for karyotype to identify the risk of adverse pregnancy.