The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Institute of Embryo-Fetal Original Adult Disease, Shanghai Key Laboratory for Reproductive Medicine, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Best Pract Res Clin Obstet Gynaecol. 2017 Oct;44:90-104. doi: 10.1016/j.bpobgyn.2017.07.004. Epub 2017 Aug 3.
Assisted reproductive technology (ART) is used primarily for infertility treatments to achieve pregnancy and involves procedures such as in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), and cryopreservation. Moreover, preimplantation genetic diagnosis (PGD) of ART is used in couples for genetic reasons. In ART treatments, gametes and zygotes are exposed to a series of non-physiological processes and culture media. Although the majority of children born with this treatment are healthy, some concerns remain regarding the safety of this technology. Animal studies and follow-up studies of ART-borne children suggested that ART was associated with an increased incidence of genetic, physical, or developmental abnormalities, although there are also observations that contradict these findings. As IVF, ICSI, frozen-thawed embryo transfer, and PGD manipulate gametes and embryo at a time that is important for reprogramming, they may affect epigenetic stability, leading to gamete/embryo origins of adult diseases. In fact, ART offspring have been reported to have an increased risk of gamete/embryo origins of adult diseases, such as early-onset diabetes, cardiovascular disease, and so on. In this review, we will discuss evidence related to genetic, especially epigenetic, risks of assisted reproduction.
辅助生殖技术（ART）主要用于不孕治疗以实现妊娠，涉及体外受精（IVF）、胞浆内单精子注射（ICSI）和冷冻保存等程序。此外，ART 的胚胎植入前遗传学诊断（PGD）用于有遗传原因的夫妇。在 ART 治疗中，配子和受精卵会暴露在一系列非生理过程和培养基中。尽管大多数通过这种治疗出生的儿童是健康的，但人们仍然对这项技术的安全性存在一些担忧。动物研究和对 ART 出生儿童的随访研究表明，ART 与遗传、身体或发育异常的发生率增加有关，尽管也有观察结果与这些发现相矛盾。由于 IVF、ICSI、冷冻-解冻胚胎移植和 PGD 在对配子和胚胎进行重要的重编程时进行操作，它们可能会影响表观遗传稳定性，导致配子/胚胎起源的成人疾病。事实上，已有报道称 ART 后代患配子/胚胎起源的成人疾病的风险增加，例如早发性糖尿病、心血管疾病等。在这篇综述中，我们将讨论与辅助生殖相关的遗传，特别是表观遗传风险的证据。
