The current status of preimplantation genetic screening: British Fertility Society Policy and Practice Guidelines.
The current status of preimplantation genetic screening: British Fertility Society Policy and Practice Guidelines.
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DOI：
10.1080/14647270802041607
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发表时间：
2008-06-01
期刊：
影响因子：
--
通讯作者：
Pickering, Sue
中科院分区：
文献类型：
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作者：
Anderson, Richard A;Pickering, Sue
植入前遗传学筛查（PGS）已被提出作为一种方法，以提高某些适应症的辅助受孕成功率。最常见的技术包括通过荧光原位杂交分析一个或两个活组织检查的卵裂球的部分核型，从而检测非整倍体胚胎，然后不转移到子宫。建议的适应症包括高龄产妇，多次试管婴儿失败和反复流产。虽然有相当数量的使用该技术的报道，但目前只有两个随机对照试验报道，都是针对高龄产妇的指示。两者都没有显示出活产率的增加，事实上，最近的研究（使用相对较低的35岁年龄界限）表明，使用PGS降低了活产率。讨论了两项研究的方法学方面。在某些情况下，PGS仍然有可能是有益的。然而，目前应该告知患者，没有强有力的证据表明高龄产妇的PGS可以提高每个周期开始的活产率，PGS最好在设计可靠的随机试验的背景下提供，在适当的经验丰富的中心进行。
Preimplantation genetic screening (PGS) has been proposed as a method to improve the success rates of assisted conception in certain indications. Most commonly the technique involves analysing part of the karyotype of one or two biopsied blastomeres by fluorescence in situ hybridisation and thus detecting aneuploid embryos which are then not transferred into the uterus. Proposed indications include advanced maternal age, repeated IVF failure and recurrent miscarriage. While there are a considerable number of reports of the use of this technique, there are only two randomised controlled trials reported at present, both for the indication of advanced maternal age. Neither show an increase in live birth rate, and indeed the more recent (using a relatively low age cut-off of 35 years) suggests that live birth rate is reduced by the use of PGS. Methodological aspects of both studies are discussed. It remains possible that PGS may be of benefit under certain circumstances. However at present patients should be informed that there is no robust evidence that PGS for advanced maternal age improves live birth rate per cycle started, and PGS should preferably be offered within the context of robustly designed randomised trials performed in suitably experienced centres.