Gruber Christian J, Hengstschläger Markus, Leipold Heinz, Gruber Isabel M, Ferlitsch Kathrin, Gruber Doris M, Huber Johannes C
Division of Gynaecologic Endocrinology and Reproductive Medicine, University of Vienna Medical School, Vienna, Austria.
Wien Klin Wochenschr. 2003 Dec 15;115(23):805-11. doi: 10.1007/BF03041040.
It is still unclear whether the procedures of assisted reproduction increase the risk of congenital malformations. Thus, it remains to be clarified whether an increased risk, if any, of congenital malformations in these children is caused by the procedure of assisted reproduction itself or by the underlying maternal and paternal background. From the genetic point of view, infertility patients seeking assisted reproduction have to be classified as a high-risk group. The prevalence of numerical chromosomal abnormalities is around 10% in these patients, compared with 0.85% in the general population. The prevalence of structural chromosomal abnormalities is around 0.1% in the general population and is increased up to 1% in patients seeking assisted reproduction. In addition, patients with microdeletions of the Y-chromosome or mutations in the cystic fibrosis transmembrane-conductance regulator gene are likely to be encountered at the fertility clinic. Therefore, genetic screening and counselling should be routinely offered to infertility patients. They also need to understand that parental factors can be transferred to offspring that would most likely not have been conceived by natural means.
辅助生殖程序是否会增加先天性畸形的风险仍不清楚。因此,这些儿童先天性畸形风险(如果存在的话)增加是由辅助生殖程序本身还是由潜在的父母背景引起的,仍有待阐明。从遗传学角度来看,寻求辅助生殖的不孕患者必须被归类为高危人群。这些患者中染色体数目异常的患病率约为10%,而普通人群中这一比例为0.85%。普通人群中染色体结构异常的患病率约为0.1%,而寻求辅助生殖的患者中这一比例增加到1%。此外,在生育诊所可能会遇到Y染色体微缺失或囊性纤维化跨膜传导调节基因发生突变的患者。因此,应该常规为不孕患者提供基因筛查和咨询服务。他们还需要明白,父母的因素可能会传递给后代,而这些后代很可能不是通过自然方式受孕的。