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胚胎植入前非整倍体基因检测:你应该使用什么技术,它们有哪些差异?

Preimplantation genetic testing for aneuploidy: what technology should you use and what are the differences?

作者信息

Brezina Paul R, Anchan Raymond, Kearns William G

机构信息

Department of OB/GYN, Vanderbilt University School of Medicine, Nashville, TN, USA.

AdvaGenix, Rockville, MD, USA.

出版信息

J Assist Reprod Genet. 2016 Jul;33(7):823-32. doi: 10.1007/s10815-016-0740-2. Epub 2016 Jun 14.

Abstract

PURPOSE

The purpose of the review was to define the various diagnostic platforms currently available to perform preimplantation genetic testing for aneuploidy and describe in a clear and balanced manner the various strengths and weaknesses of these technologies.

METHODS

A systematic literature review was conducted. We used the terms "preimplantation genetic testing," "preimplantation genetic diagnosis," "preimplantation genetic screening," "preimplantation genetic diagnosis for aneuploidy," "PGD," "PGS," and "PGD-A" to search through PubMed, ScienceDirect, and Google Scholar from the year 2000 to April 2016. Bibliographies of articles were also searched for relevant studies. When possible, larger randomized controlled trials were used. However, for some emerging data, only data from meeting abstracts were available.

RESULTS

PGS is emerging as one of the most valuable tools to enhance pregnancy success with assisted reproductive technologies. While all of the current diagnostic platforms currently available have various advantages and disadvantages, some platforms, such as next-generation sequencing (NGS), are capable of evaluating far more data points than has been previously possible. The emerging complexity of different technologies, especially with the utilization of more sophisticated tools such as NGS, requires an understanding by clinicians in order to request the best test for their patients..

CONCLUSION

Ultimately, the choice of which diagnostic platform is utilized should be individualized to the needs of both the clinic and the patient. Such a decision must incorporate the risk tolerance of both the patient and provider, fiscal considerations, and other factors such as the ability to counsel patients on their testing results and how these may or may not impact clinical outcomes.

摘要

目的

本综述的目的是确定目前可用于进行非整倍体植入前基因检测的各种诊断平台,并以清晰、平衡的方式描述这些技术的各种优缺点。

方法

进行了系统的文献综述。我们使用“植入前基因检测”“植入前基因诊断”“植入前基因筛查”“非整倍体植入前基因诊断”“PGD”“PGS”和“PGD-A”等术语,在2000年至2016年4月期间搜索了PubMed、ScienceDirect和谷歌学术。还搜索了文章的参考文献以查找相关研究。可能的情况下,使用了较大规模的随机对照试验。然而,对于一些新出现的数据,仅有会议摘要中的数据可用。

结果

PGS正成为辅助生殖技术提高妊娠成功率最有价值的工具之一。虽然目前所有可用的诊断平台都有各自的优缺点,但一些平台,如下一代测序(NGS),能够评估比以前更多的数据点。不同技术日益复杂,尤其是使用如NGS等更复杂的工具时,临床医生需要了解这些情况,以便为患者选择最佳检测方法。

结论

最终,使用哪种诊断平台应根据临床和患者的需求进行个体化选择。这样的决定必须考虑患者和提供者的风险承受能力、财务因素以及其他因素,如就检测结果为患者提供咨询的能力以及这些结果可能或不可能如何影响临床结局。

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