GeneraLife IVF centers, Clinica Valle Giulia, via G. de Notaris 2b, 00197, Rome, Italy.
Igenomix, Marostica, Italy.
J Assist Reprod Genet. 2021 Feb;38(2):319-331. doi: 10.1007/s10815-020-02015-x. Epub 2020 Nov 24.
A clear definition of developmentally incompetent preimplantation embryo (DIPE) in literature is still missing, while several scientific societies are discussing this challenging topic. From both a clinical and scientific perspective, the identification of embryos unfit for reproductive purpose is crucial. This aim should be pursued in light of all diagnostic technologies for embryo evaluation, encompassing also genetic analyses, of recent implementation in IVF. The Italian context is characterized by an unusual scenario: embryos can be discarded only if not viable and cannot be used for research purposes either. Therefore, thousands of embryos, diagnosed as affected and/or aneuploid as resulting from preimplantation genetic testing (PGT) and clinically not utilizable, are cryopreserved and stored indefinitely, with important psychological, legal, and financial implications. With the aim of updating the definition of DIPE, also on the basis of the embryo genetic status, the Italian Society of Embryology, Reproduction and Research (SIERR) and the Italian Society of Human Genetic (SIGU) reviewed the literature on this topic, found a consensus, and produced a list of relevant criteria.
发育能力不足的胚胎(DIPE)在文献中的明确定义仍未确定,尽管一些科学协会正在讨论这一具有挑战性的话题。从临床和科学的角度来看,识别不适合生殖目的的胚胎至关重要。这一目标应在胚胎评估的所有诊断技术的基础上追求,包括最近在 IVF 中实施的基因分析。意大利的情况具有独特的特点:只有在胚胎无法存活的情况下才能丢弃胚胎,而且也不能用于研究目的。因此,数以千计的胚胎被诊断为受影响和/或非整倍体,因为它们是通过植入前遗传学检测(PGT)得出的,且临床上无法使用,因此被冷冻保存并无限期储存,这带来了重要的心理、法律和财务影响。为了更新 DIPE 的定义,意大利胚胎学、生殖和研究学会(SIERR)和意大利人类遗传学学会(SIGU)还基于胚胎的遗传状况,回顾了这一主题的文献,达成了共识,并制定了一份相关标准清单。