Mortimer David
Oozoa Biomedical Inc., Box 93012 Caulfield Village RPO, West Vancouver, BC, Canada V7W 3G4.
Reprod Biomed Online. 2005 Aug;11(2):162-76. doi: 10.1016/s1472-6483(10)60954-6.
The European Union's Tissues and Cells Directive (2004) establishes an extensive framework of standards for all tissue banks throughout the EU. This article considers how the requirements of the Directive might be expected to achieve the stated goals of promoting the safety of assisted conception treatments and/or facilitating the achievement of higher success rates. While there will certainly be some significant costs to implementing these systems, there are substantial benefits and returns, for example, quality improvement and risk minimization. However, there are grave problems with the feasibility, effectiveness, and probable adverse impacts of applying arbitrary clean room air quality standards to assisted conception facilities, especially IVF laboratories. This is likely to have negligible impact on the already low risks of both culture contamination and operator infection, but would severely compromise the ability to maintain gametes and embryos under optimum environmental conditions. Proper consideration must therefore be given to the particular circumstances that affect reproductive tissues (indeed, the same is true for all areas of tissue banking), to ensure that the final technical regulations are founded upon realistic expectations based on objective evidence from process-based systems. The creation of the highest quality embryos, and healthy children, must always remain the primary focus of assisted conception treatment.
欧盟的《组织与细胞指令》(2004年)为欧盟境内所有组织库建立了一个广泛的标准框架。本文探讨了该指令的各项要求有望如何实现促进辅助生殖治疗安全和/或提高成功率这一既定目标。虽然实施这些系统肯定会产生一些重大成本,但也有可观的益处和回报,例如质量提升和风险最小化。然而,将任意的洁净室空气质量标准应用于辅助生殖设施,尤其是体外受精实验室,在可行性、有效性以及可能产生的不利影响方面存在严重问题。这可能对已然很低的培养物污染和操作人员感染风险影响微乎其微,但会严重损害在最佳环境条件下保存配子和胚胎的能力。因此,必须充分考虑影响生殖组织的特殊情况(实际上,组织库的所有领域都是如此),以确保最终的技术法规基于来自基于流程的系统的客观证据所形成的现实期望。创造出最高质量的胚胎以及健康的孩子,必须始终是辅助生殖治疗的首要关注点。