Preimplantation Genetic Screening Efficacy on Pregnancy Outcome in Recurrent Gestational Trophoblas-tic Disease

سال انتشار: 1398
نوع سند: مقاله کنفرانسی
زبان: انگلیسی
مشاهده: 291

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شناسه ملی سند علمی:

RROYAN20_377

تاریخ نمایه سازی: 29 مهر 1398

چکیده مقاله:

Background: Gestational trophoblastic disease (GTD) charac-terized by abnormally proliferating trophoblastic tissues. Ge-netically, the presence of excess paternal genome and maternal chromosome loss resulted in 46XX embryo (androgenic hyda-tidiform mole). Recurrent GTD are defined by the occurrence of at least two GTD pregnancies in the same patient. Intracy-toplasmic sperm injection (ICSI) could be prevent of recurrent GTD through ensure fertilization by a single sperm. Also, ICSI with preimplantation genetic screening (PGS) assurances that only one spermatozoa enters the oocyte and identifies the 46XY embryos can be prevented from recurrent GTD. We aimed to evaluate the pregnancy outcome following ICSI and ICSI/PGS in recurrent GTD.Materials and Methods: In this retrospective study, we re-cruited all couple who referred to Royan Institute causes infer-tility complaint with GTD history during 2010 to 2015 years. GTD confirmed by serial βhCG titer, ultrasonography and his-topathology assessment of the evacuated uterine contents. The ICSI procedure was routinely performed in order to prevent dispermia. The fluorescent in situ hybridization (FISH) probes were specifiic for chromosomes 13, 16, 21, X and Y.Results: In this study, we analyzed all patients with GTD histo-ry that included total 56 cycles. ICSI and ICSI/PGS was 32 cy-cles (57.1%) and 24 cycles (42.9%), respectively. We analyzed between women with only one GTD history who underwent ICSI cycles (72.1%) and who was ≥2 GTD history that per-formed ICSI/PGS cycles (27.9%). In all groups, the total dose of received gonadotropins, total oocyte retrieved numbers, the number of MII and the embryos in the ICSI/PGS group were significantly higher than the ICSI group (P≤0.05). Pregnancy outcome was shown, GTD not observed in all groups, however, ongoing pregnancy for ICSI and ICSI/PGS in both compared group was 20%-20.6% and 16.5%-20.8%, respectively, which was almost the same (P> 0.05).Conclusion: Despite receiving a high dose of gonadotropins in ICSI/PGS cycles and achieving more embryos, the success rate of pregnancy in both ICSI and ICSI/PGS groups is approxi-mately the same, and both of these methods can be effective in preventing GTD pregnancy by considering that ICSI/PGS is an expensive method.

کلیدواژه ها:

Gestational Trophoblastic Disease (GTD) ، Recurrent GTD ، Intracytoplasmic Sperm Injection (ICSI) ، Preimplanta-tion Genetic Screening (PGS) ،

نویسندگان

M Hafezi

Department of Endocrinology and Female Infertility, Reproduc-tive Epidemiology Research Center, Royan Institute for Reproduc-tive Biomedicine, ACECR, Tehran, Iran

Z Chekini

Department of Endocrinology and Female Infertility, Reproduc-tive Epidemiology Research Center, Royan Institute for Reproduc-tive Biomedicine, ACECR, Tehran, Iran

S Vesali

Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran

H Gourabi

Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran