From Embryos to Adults: A DOHaD Perspective on In Vitro Fertilization and Other Assisted Reproductive Technologies.
From Embryos to Adults: A DOHaD Perspective on In Vitro Fertilization and Other Assisted Reproductive Technologies.
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DOI：
10.3390/healthcare4030051
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发表时间：
2016-08-09
期刊：
影响因子：
--
通讯作者：
Rinaudo P
中科院分区：
文献类型：
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作者：
Feuer S;Rinaudo P
人类体外受精(IVF)作为一种治疗不孕不育的方法被认为是20世纪最杰出的成就之一，自20世纪70年代末以来，它的应用有了显著的增长。尽管试管受精被认为是安全的，而且大多数儿童看起来都很健康，但由于体外环境与体内环境有很大差异，生殖技术一直受到一些怀疑。这一点越来越重要，因为发育起源健康与疾病(DOHAD)假说阐明了生物体在发育的关键阶段对环境的敏感性，包括次优暴露如何特别限于配子成熟或植入前阶段影响出生后生长、葡萄糖代谢、脂肪沉积和血管功能。今天，体外受精动物模型中存在的一些生理代谢表型已经开始在人类试管受精儿童中出现，但尚不清楚体外胚胎操作是否会对后代产生持久的健康后果。我们对DOHaD领域不断扩展的知识正在推动人们在整个生命过程中看待疾病易感性的范式转变，特别强调收集详细的暴露信息、识别健康的生物标志物以及对发育脆弱时期发生的任何医疗进行纵向研究的重要性。随着试管受精使用率的持续上升，将DOHaD的概念纳入临床领域和未来的公共卫生政策方法将是非常有价值的。
Human in vitro fertilization (IVF) as a treatment for infertility is regarded as one of the most outstanding accomplishments of the 20th century, and its use has grown dramatically since the late 1970s. Although IVF is considered safe and the majority of children appear healthy, reproductive technologies have been viewed with some skepticism since the in vitro environment deviates substantially from that in vivo. This is increasingly significant because the Developmental Origins of Health and Disease (DOHaD) hypothesis has illuminated the sensitivity of an organism to its environment at critical stages during development, including how suboptimal exposures restricted specifically to gamete maturation or the preimplantation period can affect postnatal growth, glucose metabolism, fat deposition, and vascular function. Today, some of the physiological metabolic phenotypes present in animal models of IVF have begun to emerge in human IVF children, but it remains unclear whether or not in vitro embryo manipulation will have lasting health consequences in the offspring. Our expanding knowledge of the DOHaD field is fueling a paradigm shift in how disease susceptibility is viewed across the life course, with particular emphasis on the importance of collecting detailed exposure information, identifying biomarkers of health, and performing longitudinal studies for any medical treatment occurring during a developmentally vulnerable period. As IVF use continues to rise, it will be highly valuable to incorporate DOHaD concepts into the clinical arena and future approaches to public health policy.