The Center for Human Reproduction, 21 East 69th Street, New York, NY, 10021, USA.
The Foundation for Reproductive Medicine, New York, NY, USA.
Reprod Biol Endocrinol. 2021 Feb 18;19(1):23. doi: 10.1186/s12958-021-00716-1.
Two professional societies recently published opinions on the clinical management of "mosaic" results from preimplantation genetic testing for aneuploidy (PGT-A) in human blastocyst-stage embryos in associations with in vitro fertilization (IVF). We here point out three principal shortcomings: (i) Though a most recent societal opinion states that it should not be understood as an endorsement of the use of PGT-A, any discussion of how PGT-A should be clinically interpreted for all practical purposes does offer such an endorsement. (ii) The same guideline derived much of its opinion from a preceding guidance in favor of utilization of PGT-A that did not follow even minimal professional requirements for establishment of practice guidelines. (iii) Published guidelines on so-called "mosaic" embryos from both societies contradict basic biological characteristics of human preimplantation-stage embryos. They, furthermore, are clinically unvalidated and interpret results of a test, increasingly seen as harmful to IVF outcomes for many infertile women. Qualified professional organizations, therefore, should finally offer transparent guidelines about the utilization of PGT-A in association with IVF in general.
两个专业学会最近发表了关于体外受精(IVF)中人类囊胚期胚胎中胚胎植入前遗传学检测(PGT-A)“镶嵌”结果的临床管理的意见。我们在这里指出三个主要的缺点:(i)尽管最近的学会意见表示,不应将其理解为对 PGT-A 使用的认可,但任何关于如何在所有实际目的下对 PGT-A 进行临床解释的讨论实际上都提供了这种认可。(ii)该指南的同一部分意见主要来自于之前有利于使用 PGT-A 的指导意见,而该指导意见甚至没有遵循确立实践指南的最基本的专业要求。(iii)两个学会发表的关于所谓“镶嵌”胚胎的指南与人类胚胎植入前阶段胚胎的基本生物学特征相矛盾。此外,它们在临床上未经证实,并且对测试结果进行解释,越来越多地被认为对许多不孕妇女的 IVF 结果有害。因此,合格的专业组织最终应该提供关于一般情况下与 IVF 相关的 PGT-A 使用的透明指南。