RESUMO
BACKGROUND: Assisted reproduction techniques (ARTs) and the preimplantation genetic test for aneuploidies (PGT-A) help couples with fertility problems to achieve a healthy live birth around the world. The aim of this study was to determine the rate of whole chromosomal copy number variations in embryos from couples undergoing ART and PGT-A, associations of chromosomal variations with embryo morphological parameters, and their relationship to maternal age. METHODS: This study included a retrospective analysis of the number of whole chromosomal copies identified by aCGH in embryos from couples undergoing ART. RESULTS: Seventy-six embryos from 29 couples using their own gametes were analyzed, of which 25 (32.9%) were chromosomally normal, and 51 (67.1%) were abnormal. Eleven embryos were evaluated from the group of couples with donated gametes, of which 5 (45.4%) embryos were chromosomally normal, and 6 (54.5%) embryos were abnormal. The main aneuploidies observed were trisomy X (7.8%), trisomy 21 (5.9%), trisomy 9 (3.9%), monosomy 11 (3.9%), monosomy 13 (3.9%) and monosomy X (3.9%), and the principal chromosomes affected were 19, X and 13. A significant association was found between the quality of the embryo and the genetic condition: embryos with euploidy and aneuploidy (p=0.046). CONCLUSION: The rate of aneuploidies from couples with their own gametes was 67.1% (51/76) and from couples with donated eggs and/or sperm was 54.5% (6/11). The quality of the embryo determinated by the morphological parameters was not associated with the embryo genetic status, and also there was no association between maternal age and aneuploidy rate.
RESUMO
Recurrent pregnancy loss (RPL) is a reproductive disorder defined as two or more successive and spontaneous pregnancy losses (before 20 weeks of gestation), which affects approximately 1-2% of couples. At present, the causes of RPL remain unknown in a considerable number of cases, leading to complications in treatment and high levels of stress in couples. Idiopathic recurrent pregnancy loss (iRPL) has become one of the more complicated reproductive problems worldwide due to the lack of information about its etiology, which limits the counseling and treatment of patients. For that reason, iRPL requires further study of novel factors to provide scientific information for determining clinical prevention and targeted strategies. The aim of this study is to describe the most recent and promising progress in the identification of potential genetic and epigenetic risk factors for iRPL, expanding the genetic etiology of the disease.
Assuntos
Aborto Habitual/genética , Epigênese Genética , Tolerância Imunológica/genética , Aberrações Cromossômicas , Feminino , Predisposição Genética para Doença , Variação Genética , Humanos , Masculino , Gravidez , Telômero , Trombofilia/genéticaRESUMO
Objetivo: comparar la calidad embrionaria y describir las tasas de implantación, embarazo y aborto en las técnicas de fertilización in vitro (FIV) y el cultivo intravaginal de ovocitos. Materiales y métodos: cohortes históricas de pacientes con tratamiento de fertilización in vitro y el cultivo intravaginal de ovocitos en el Centro Colombiano de Fertilidad y Esterilidad (Cecolfes) durante el año 2010. Se incluyeron 137 pacientes aspiradas dentro de los cuatro grupos de estudio: Grupo 1, FIV/Incubadora; Grupo 2, FIV/INVO; Grupo 3, ICSI/INVO, y Grupo 4, ICSI/Incubadora. Se midió el peso de la paciente, el número de ovocitos recuperados y óvulos maduros (MII), la tasa de implantación y la tasa de embarazo y aborto en cada uno de los grupos. Se realizó análisis mediante la prueba de Kruskal-Wallis; la calidad embrionaria fue evaluada con un análisis de covarianza multivariado (MANOVA). Resultados: se observó diferencia significativa en la calidad embrionaria entre las dos técnicas FIV e INVO (p = 0,0388). En la técnica INVO se presentaron mayores tasas de división embrionaria (μ = 7,35/INVO frente a 6,64/Incubadora) y menor fragmentación (μ = 4,67/INVO frente a 4,59/ Incubadora). En cuanto a la tasa de implantación, embarazo y aborto se obtuvieron más altos porcentajes en los grupos INVO. Conclusión: la técnica INVO se asoció a mejor calidad embrionaria. Las tasas de implantación, embarazo y bajas tasas de aborto son semejantes a las descritas en la técnica FIV.
Objective: Comparing embryo quality and describing implantation, pregnancy and abortion rates regarding in vitro fertilization (IVF) and intravaginal oocyte culture (INVO) techniques. Materials and methods: The study involved historical cohorts of patients undergoing IVF and INVO treatment in the Colombian Fertility and Sterility Centre (Centro Colombiano de Fertilidad y Esterilidad Cecolfes) during 2010. It involved 137 aspirated patients, covering four study groups: Group 1 IVF/incubator, Group 2 IVF/INVO, Group 3 ICSI/INVO and Group 4 ICSI/incubator. The patients weight, the number of ovocytes retrieved, mature ovules (M2), implantation rate, pregnancy and abortion rates were measured in each group. The Kruskal-Wallis test was used for statistical analysis; embryo quality was evaluated by multivariate covariance analysis (MANOVA). Results: A significant difference was observed regarding embryo quality between IVF and INVO (p = 0.0388), the INVO technique having higher embryo cleavage rates (μ = 7.35/INVO cf 6.64/ incubator) and lower embryo fragmentation (μ = 4.67/INVO cf 4.59/incubator). INVO groups also had higher percentages concerning their implantation, pregnancy and abortion rates. Conclusion: The INVO technique led to obtaining better quality embryos; implantation, pregnancy and abortion rates were similar to those described for the IVF technique.
