当只获得一个或两个胚胎囊时,PGT-A的值:倾向性得分匹配和成本效益研究
D Cimadomo1, M Taggi1, V Cimadomo2
1IVIRMA Global Research Alliance, GENERA, Clinica Valle Giulia, Rome, Italy.
概括
在试管婴儿中,即使只有很少的胚胎囊,对阳积体 (PGT-A) 的植入前遗传检测也很有价值. 它减少了胚胎移植和流产,实现类似的活产率更快,更具成本效益,特别是对于老年患者.
科学领域:
- 生殖医学 生殖医学
- 遗传学 是一个遗传学.
- 在体外受精过程中受精.
背景情况:
- 评估在只有一个或两个胚胎囊细胞可用的体外受精 (IVF) 周期中对阳化 (PGT-A) 的植入前遗传测试的有用性.
- 在特定的患者子组中,比较PGT-A与传统试管婴儿的有效性和成本效益.
研究的目的:
- 为了比较试管婴儿的有效性和成本与或没有PGT-A当一个或两个胚胎囊得到.
- 评估活产率 (LBR),流产率 (MR) 和周期持续时间.
主要方法:
- 1829次试管婴儿周期 (368次非PGT-A,1461次PGT-A) 的回顾性分析,其中包括一个或两个胚胎囊.
- 根据母亲的年龄,受精卵细胞和获得的胚胎囊,根据倾向性得分匹配 (1:1) 每组有242名患者.
- 每个胚胎移植 (ET) 的LBR,每位患者的累积LBR,每位临床怀孕的MR,试管婴儿周期持续时间和增量成本效益比率 (ICER) 的比较.
主要成果:
- 每名患者的累积LBR相似 (23.6%对27.3%),但PGT-A组每次ETLBR较高 (41.5%对16.2%),每次临床怀孕MR较低 (13.9%对30.1%).
- PGT-A显著减少了试管婴儿周期持续时间 (74天 vs 131天,P < 0.001).
- PGT-A的ICER为节省的月份为499欧元,预防流产为18,968欧元,对于年龄≥35岁的患有两个胚胎囊的患者显著下降.
结论:
- 在试管婴儿中,PGT-A在临床上具有价值,即使囊胞数量有限,也能减少外来胎和流产,同时保持累积LBR.
- PGT-A缩短了实现怀孕结果的时间,并提供了有利的成本效益,特别是在特定的患者人口统计学方面.
- PGT-A的成本效益随着母亲的年龄和获得的胚胎细胞的数量而增加.
相关概念视频
01:10P-value
P-value is one of the most crucial concepts in statistics.
P-value stands for the probability value. P-value is the probability that, if the null hypothesis is true, the results from another randomly selected sample will be as extreme or more extreme as the results obtained from the given sample.
A large P-value calculated from the data indicates to not reject the null hypothesis. But a higher P-value does not mean that the null hypothesis is true. The smaller the P-value, the more unlikely...
P-value stands for the probability value. P-value is the probability that, if the null hypothesis is true, the results from another randomly selected sample will be as extreme or more extreme as the results obtained from the given sample.
A large P-value calculated from the data indicates to not reject the null hypothesis. But a higher P-value does not mean that the null hypothesis is true. The smaller the P-value, the more unlikely...
01:09Decision Making: P-value Method
The process of hypothesis testing based on the P-value method includes calculating the P- value using the sample data and interpreting it.
First, a specific claim about the population parameter is proposed. The claim is based on the research question and is stated in a simple form. Further, an opposing statement to the claim is also stated. These statements can act as null and alternative hypotheses: a null hypothesis would be a neutral statement while the alternative hypothesis can have a...
First, a specific claim about the population parameter is proposed. The claim is based on the research question and is stated in a simple form. Further, an opposing statement to the claim is also stated. These statements can act as null and alternative hypotheses: a null hypothesis would be a neutral statement while the alternative hypothesis can have a...
01:24Testing a Claim about Population Proportion
A complete procedure for testing a claim about a population proportion is provided here.
There are two methods of testing a claim about a population proportion: (1) Using the sample proportion from the data where a binomial distribution is approximated to the normal distribution and (2) Using the binomial probabilities calculated from the data.
The first method uses normal distribution as an approximation to the binomial distribution. The requirements are as follows: sample size is large...
There are two methods of testing a claim about a population proportion: (1) Using the sample proportion from the data where a binomial distribution is approximated to the normal distribution and (2) Using the binomial probabilities calculated from the data.
The first method uses normal distribution as an approximation to the binomial distribution. The requirements are as follows: sample size is large...