ORİJİNAL ARAŞTIRMALAR
İleri Anne Yaşı Olan Vakalarda Anöploidi için Preimplantasyon Genetik Tanı (Pgt-A) Yapılması Canlı Doğum Oranını Arttırır Mı?
Does Pgt-A Increase the Live Birth Rate in Cases with Advanced Maternal Age?
Received Date : 27 Sep 2022
Accepted Date : 17 Jan 2023
Available Online : 18 Jan 2023
Sevinç ÖZMENa, Esra Nur TOLAb
aMedipol Mega Hospital, In Vitro Fertilization Unit, İstanbul, Türkiye
bİstanbul Medipol Unıversity Faculty of Medicine, Department of Obstetrics and Gynecology, Medipol Pendik Hospital, İstanbul, Türkiye
Doi: 10.24074/tjrms.2022-93484 - Makale Dili: TR
TJRMS. 2022;6(3):179-84
ÖZET
Amaç: Anöploidi nedeniyle embriyolara preimplantasyon genetik tarama (PGT-A) yapılmasının in vitro fertilizasyon (IVF) başarısını artırabileceği
öne sürülmüştür. Ancak PGT-A’ nın invazif bir işlem olması ve embriyoya zarar verilebileceği kaygısı bazı klinisyenlerde bu işlemi yapma
konusunda çekingen davranmaya yol açar. Buradan yola çıkarak ileri yaş olup IVF başarısının iyi beklendiği normal overyan rezervli ve iyi kalite
blastokist transferi yapılan kadınlarda PGT-A’ nın canlı doğum üzerine etkisini araştırdık. Gereç ve Yöntemler: ≥37 yaş ve dondurulmuş
iyi kalite blastokist transferine giden 85 vaka retrospektif olarak çalışmaya dahil edildi. Vakalar blastların dondurulma nedenine göre iki gruba
ayrıldı: PGT-A nedeniyle embriyosu dondurulmuş grup PGT-A grubu (n=27) ve PGT-A dışı herhangi bir nedenle embriyosu dondurulmuş grup
non-PGT-A grubu (n=58) olarak adlandırıldı. Gruplar arası implantasyon (embriyo transferinden 9 gün sonra kanda pozitif gebelik testi), klinik
gebelik (embriyo transferinden 6 hafta sonra ultrasonda fetal kalp atımı), biyokimyasal gebelik (kanda gebelik testi pozitif çıkıp sonrasında gerileyen
vakalar), klinik abort (20. gebelik haftadan önce gebelik terminasyonu) ve canlı doğum oranları (20, gebelik haftasından sonra canlı bebek
doğumu) karşılaştırıldı. Bulgular: Her iki grup demografik özellikler açısından benzerdi. Non-PGT-A grubunda transfer edilen embriyo sayısı
önemli ölçüde daha fazla olmasına rağmen çoğul gebelik oranı her iki grupta benzerdi. Gruplar arası implantasyon, klinik gebelik, biyokimyasal
gebelik ve canlı doğum oranları benzerdi (p>0,05). Klinik abort non-PGT-A grubunda (24,2%) PGT-A grubuna (0) göre (p=0,04) daha yüksekti.
Sonuç: İleri yaş, iyi over rezervi olan ve iyi kalite blastokiste sahip kadınlarda anöploidi taraması için PGT-A yapmak klinik abort oranlarını azaltmasına
rağmen canlı doğum oranlarını etkilememektedir.
Anahtar Kelimeler: İleri anne yaşı; preimplantasyonel genetik tanı; anöploidi; embriyo transferi
ABSTRACT
Objective: It has been suggested that preimplantation genetic testing for aneuploidi (PGT-A) of embryos may increase the success of in vitro fertilization
(IVF). However, since PGT is an invasive procedure, there is a concern that it may harm the embryo, Therefore, some clinicians are
hesitant to perform this procedure. Based on this thought, we compared the pregnancy outcomes of women with advanced age, normal ovarian
reserve, and good quality blastocyst who underwent PGD with those who did not. Materials and Methods: 85 cases aged ≥37 years and undergoing
frozen good quality blastocyst transfer were retrospectively included in the study, Cases were divided into 2 groups according to the reason
for freezing the blasts. The group whose embryos were frozen due to PGT was called the PGT group (n=27) and the group whose embryos
were frozen for any reason other than PGT was named the non-PGT group (n=58). Demographic data and cycle characteristics of the cases were
recorded. Intergroup implantation (positive blood pregnancy test 9 days after embryo transfer), clinical pregnancy (fetal heartbeat on ultrasound
6 weeks after embryo transfer), biochemical abortion (cases with a positive blood pregnancy test and a regression in bHcg), clinical miscarriage
(termination of pregnancy before 20th gestational week) and live birth rates (live baby births after 20 weeks of gestation) were compared. Results:
Both groups were similar in terms of demographic characteristics. Although the number of embryos transferred was significantly higher
in the non-PGT group, the multiple pregnancy rate was similar in both groups. Implantation, clinical pregnancy, biochemical pregnancy, and live
birth rates were similar between groups. Clinical abortion in the non-PGT group (24,2%-%0) was higher than in the PGT group (p=0,04). Conclusion:
We found that performing PGT for aneuploidy screening in women 37 years of age or older does not affect live birth rates, although it
reduces clinical abortion rates.
Keywords: Advanced maternal age; preimplantation genetic testing for aneuploidy; embryo transfer
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