Mount Sinai Fertility, Toronto, ON, Canada.
Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
Acta Obstet Gynecol Scand. 2020 Jun;99(6):716-721. doi: 10.1111/aogs.13831. Epub 2020 Mar 10.
Assisted reproduction technologies are being rapidly developed and implementation of preimplantation genetic testing (PGT) has allowed patients with genetic disorders to initiate pregnancies while minimizing or eliminating the risk of transmitting these disorders to their offspring. Testing for numeric chromosomal anomalies has been proposed as a way to increase efficacy in assisted reproduction; however, this remains disputed. Legislation is lagging behind the rapid developments in this field.
We conducted a structured online survey of legislation and accessibility to preimplantation genetic testing in the Nordic countries to compare the regulation and uptake of this technique. The survey was designed and answered by the authors.
Key elements in the regulation of preimplantation testing for monogenic disorders and structural rearrangements are similar in the Nordic countries, although accessibility varies since only Denmark, Finland, and Sweden have national clinics offering treatment. In addition, Denmark and Finland have private clinics offering PGT. Regulation is the most stringent in Norway where a national board evaluates all couples seeking treatment. Treatment volumes vary between the Nordic countries, with Norway and Finland having lowest treatment numbers. Preimplantation genetic testing for aneuploidy in the embryo varies between the Nordic countries: Finland and Iceland allow this form of treatment, Denmark and Sweden offer it only in the form of a research protocol, and Norway does not allow it at all. Therefore the number of treatment cycles involving testing for embryo aneuploidy are lower in the Nordic countries than in other countries where this treatment option is more common.
Science needs to inform politics regarding the rapidly evolving field of reproductive medicine and we recommend harmonization of legislation and accessibility between the Nordic countries.
辅助生殖技术正在迅速发展，胚胎植入前遗传学检测（PGT）的实施使患有遗传疾病的患者能够在降低或消除将这些疾病遗传给后代的风险的情况下启动妊娠。测试数值染色体异常已被提议作为提高辅助生殖效率的一种方法；然而，这仍然存在争议。立法落后于该领域的快速发展。
我们对北欧国家的辅助生殖遗传检测的立法和可及性进行了结构化的在线调查，以比较该技术的监管和采用情况。该调查由作者设计和回答。
北欧国家对单基因疾病和结构重排的胚胎植入前检测的监管的关键要素相似，尽管可及性因只有丹麦、芬兰和瑞典有提供治疗的国家诊所而异。此外，丹麦和芬兰有提供 PGT 的私人诊所。在挪威，国家委员会评估所有寻求治疗的夫妇，监管最为严格。北欧国家之间的治疗量存在差异，挪威和芬兰的治疗数量最低。胚胎非整倍体的胚胎植入前遗传学检测在北欧国家之间存在差异：芬兰和冰岛允许这种治疗形式，丹麦和瑞典仅以研究方案的形式提供，挪威则完全不允许。因此，北欧国家涉及胚胎非整倍体检测的治疗周期数量低于其他更常见这种治疗选择的国家。
科学需要就生殖医学这一快速发展的领域向政治提供信息，我们建议北欧国家之间协调立法和可及性。
