Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
Hum Reprod. 2020 Mar 27;35(3):490-493. doi: 10.1093/humrep/dez280.
The utilization of preimplantation genetic testing for aneuploidy (PGT-A) has understandable intuitive appeal in reassuring the clinician that 'everything possible' has been done to assure the birth of a healthy baby. Whereas the development of the PGT-A technology is still in a relatively early stage, great strides have nevertheless been made in the understanding of the genetics of the preimplantation human embryo. The problem lies not in the progress that has been achieved, but rather, in the reality that PGT-A is being actively marketed as a mature technology. Those that market the technology overstate its benefits and underestimate the losses of potential implantations that are the consequence of the practice of PGT-A. The implication is that the PGT-A technology is accurate, has minimal errors and is ready to be applied to every case of IVF. This approach is not evidence-based. Substantial losses of potential implantations are even evident in the analysis of the numbers presented by marketing materials themselves. In order to provide accurate, evidence-based counseling for patients undergoing IVF, we need to apply an appropriate level of scientific scrutiny to the data that are available and apply PGT-A selectively to those cases in which the benefits clearly outweigh the costs.
胚胎植入前遗传学检测（PGT-A）用于非整倍体的应用具有直观的吸引力，它可以让临床医生确信已经采取了一切可能的措施来确保婴儿的健康。尽管 PGT-A 技术的发展仍处于相对早期阶段，但在理解胚胎植入前人类胚胎的遗传学方面已经取得了重大进展。问题不在于已经取得的进展，而在于 PGT-A 被积极宣传为成熟技术的现实。那些推广这项技术的人夸大了它的好处，低估了 PGT-A 实践所导致的潜在胚胎植入的损失。这意味着 PGT-A 技术是准确的，错误最小化，并且已经准备好应用于每一例试管婴儿。这种方法没有基于证据。即使在分析营销材料本身呈现的数字时，也明显存在潜在胚胎植入的大量损失。为了为接受试管婴儿治疗的患者提供准确、基于证据的咨询，我们需要对现有数据进行适当水平的科学审查，并将 PGT-A 有选择地应用于那些明显利大于弊的病例。
