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[法国的胚胎捐赠:实践与困难。斯特拉斯堡的经验]

[Embryo donation in France: practice and difficulties. Strasbourg's experience].

作者信息

Bettahar-Lebugle K, Wittemer C, Firtion C, Rongières C, Ohl J, Nisand I, Viville S, Favre R

机构信息

Service d'Aide Médicale à la Procréation, CMCO-SIHCUS, 19, rue Louis-Pasteur, BP 120, 67300 Schiltigheim, France.

出版信息

Gynecol Obstet Fertil. 2007 Feb;35(2):114-20. doi: 10.1016/j.gyobfe.2006.10.033. Epub 2007 Jan 12.

Abstract

OBJECTIVE

The aim of this study was to present the situation of embryo donation in France and around the world, to expound the difficulties of its practice and the results obtained in our centre 3 years after the introduction of this procedure.

PATIENTS AND METHODS

Embryo donation in France is controlled by implemented decrees published between 1999 and 2004. The couples, who have stored frozen embryos since at least two years, were contacted for a pluridisciplinary medical consultation. The indication of embryo donation was evaluated for the recipients through a pluridisciplinary approach.

RESULTS

Among the interviewed couples, 16.7% have chosen embryo donation but only half of them have completed the procedure (6% of the couples with frozen embryos). The main indications for embryo donation were a double sterility, unexplained genetic disease, ART failures (poor fertilization or bad embryo quality) and oocyte donation when the delay was too long for the couples. The pregnancy rate was 28.6% after the 21 first embryo transfers.

DISCUSSION AND CONCLUSION

The results of embryo donation confirm the international experience both considering the poor number of donated embryos, medical indications and results. Embryo donation has its place among ART techniques, but one should not ignore the general debate on ethical questions raised by this procedure.

摘要

目的

本研究旨在介绍法国及全球胚胎捐赠的情况,阐述其实施过程中的困难以及该程序引入3年后我们中心所取得的成果。

患者与方法

法国的胚胎捐赠受1999年至2004年发布的实施法令管控。对至少已冷冻胚胎两年的夫妇进行多学科医学咨询。通过多学科方法对接受者的胚胎捐赠指征进行评估。

结果

在接受访谈的夫妇中,16.7%选择了胚胎捐赠,但其中只有一半完成了该程序(占冷冻胚胎夫妇的6%)。胚胎捐赠的主要指征为双侧不育、不明原因的遗传疾病、辅助生殖技术失败(受精不良或胚胎质量差)以及夫妇等待时间过长时的卵母细胞捐赠。首次进行21次胚胎移植后的妊娠率为28.6%。

讨论与结论

胚胎捐赠的结果在捐赠胚胎数量少、医学指征及成果方面均证实了国际经验。胚胎捐赠在辅助生殖技术中占有一席之地,但不应忽视该程序引发的伦理问题的总体辩论。

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