Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, Milano 20132, Italy.
Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, Milano 20132, Italy.
Reprod Biomed Online. 2020 Apr;40(4):475-478. doi: 10.1016/j.rbmo.2020.01.015. Epub 2020 Jan 25.
Preimplantation genetic testing for aneuploidy (PGT-A) still remains controversial in clinical practice. Recently, the randomized controlled trial, 'Single Embryo TrAnsfeR of Euploid Embryo' (STAR) by Munné and coworkers showed a similar live birth rate per intention to treat in the two study groups (PGT-A and controls). A wrong diagnosis and/or biopsy-related damage to the embryo might underlie these results. To assess the impact of these factors on the efficiency of PGT-A, the live birth rate of 'euploid' embryos transferred in the PGT-A group was compared with its ideal value, namely the live birth rate of embryos with the potential to implant and to give rise to a baby in the control group. This estimate has been derived using the results of the genetic testing reported in the STAR trial. According to this model, the STAR trial has demonstrated that transferring only blastocysts classified as 'euploid' after PGT-A leads to a reduction from 82.2% to 50.0% of the live birth rate for competent embryos, thus supporting the idea that PGT-A is associated with some embryo wastage.
胚胎植入前遗传学检测（PGT-A）在临床实践中仍然存在争议。最近，Munné 及其同事进行的随机对照试验“整倍体胚胎单胚胎移植（STAR）”显示，两组研究（PGT-A 和对照组）的意向治疗活产率相似。错误的诊断和/或与活检相关的胚胎损伤可能是这些结果的基础。为了评估这些因素对 PGT-A 效率的影响，将 PGT-A 组中转运的“整倍体”胚胎的活产率与其理想值（即具有在对照组中植入和生育婴儿潜力的胚胎的活产率）进行了比较。这一估计是根据 STAR 试验中报告的遗传检测结果得出的。根据该模型，STAR 试验表明，仅将 PGT-A 后分类为“整倍体”的囊胚进行转移，会导致具有发育能力的胚胎的活产率从 82.2%降至 50.0%，从而支持 PGT-A 与一些胚胎浪费有关的观点。
