Tanaka Atsushi, Watanabe Seiji
Saint Mother Obstetrics and Gynecology Clinic and Institute for ART Fukuoka Japan.
Department of Anatomical Science Hirosaki University Graduate School of Medicine Aomori Japan.
Reprod Med Biol. 2018 Oct 28;18(2):128-139. doi: 10.1002/rmb2.12252. eCollection 2019 Apr.
The pregnancy and delivery rates following assisted reproductive technology (ART) start to decrease and that the miscarriage rate increases rapidly from 35 years old. The miscarriage rate exceeds 50% at 43 years old. The number of aneuploid fetuses in miscarriages increases according to female age, reaching more than 90% when women are over 40 years old.
Different cytoplasmic donation technologies used to rescue aged oocytes with high percentage of aneuploidy were analyzed, and their efficacy compared.
Germinal vesicle transfer (GVT) might be superior to spindle chromosome transfer (ST) theoretically from the point of higher capability of rescuing the disjunction at meiosis I which cannot be helped by ST. However, actually, in vitro maturation (IVM) of oocyte after GVT has not yet been totally completed. ST among other nuclear donations showed the higher possibility to rescue them, due to the fact it does not require in vitro maturation and it has an ethical advantage over pronuclear transfer (PNT) which requires the destruction of an embryo.
Spindle chromosome transfer has the potential to rescue aged oocytes to some extent, but we have to continue the basic study further to establish the clinical application of cytoplasmic donation to rescue aged oocytes.
辅助生殖技术(ART)后的妊娠率和分娩率开始下降,且流产率从35岁起迅速上升。43岁时流产率超过50%。流产中染色体非整倍体胎儿的数量随女性年龄增加,40岁以上女性时超过90%。
分析用于挽救高比例非整倍体老龄卵母细胞的不同细胞质捐赠技术,并比较其效果。
从理论上讲,生发泡移植(GVT)在挽救减数分裂I期分离方面可能优于纺锤体染色体移植(ST),而ST对此无能为力。然而,实际上,GVT后卵母细胞的体外成熟(IVM)尚未完全完成。其他核捐赠技术中的ST显示出更高的挽救可能性,因为它不需要体外成熟,且与需要破坏胚胎的原核移植(PNT)相比具有伦理优势。
纺锤体染色体移植有一定潜力挽救老龄卵母细胞,但我们必须进一步开展基础研究以确立细胞质捐赠在挽救老龄卵母细胞方面的临床应用。