Reprod Biomed Online. 2022 Jul;45(1):19-25. doi: 10.1016/j.rbmo.2022.03.013. Epub 2022 Mar 20.
Chromosome testing strategies, such as preimplantation genetic testing for aneuploidy (PGT-A), improve initial IVF outcomes by avoiding unwitting transfer of aneuploid embryos in morphology-based selection practices. Newer technologies have revealed that some embryos may appear to have intermediate whole chromosome (or parts of a chromosome termed segmental) copy number results suggesting trophectoderm mosaicism. An embryo with a trophectoderm mosaic-range result may be the only option for transfer for some patients. Recent data suggest that such mosaic embryos can be transferred without added risk of abnormal birth outcomes but may be associated with increased implantation failure and miscarriage rates, with higher values of mosaicism appearing to be less favourable for producing good outcomes. In this Position Statement, we provide guidance to laboratories, clinics, clinicians and counsellors to assist in discussions on the utility and transfer of mosaic embryos.
染色体检测策略,如胚胎植入前遗传学检测非整倍体(PGT-A),通过避免在基于形态学选择的实践中无意识地转移非整倍体胚胎,改善了初始 IVF 结局。新技术显示,一些胚胎的整体染色体(或染色体的一部分称为片段)拷贝数结果可能显示滋养外胚层嵌合体。对于一些患者来说,滋养外胚层嵌合范围的结果可能是唯一可供转移的胚胎。最近的数据表明,这样的嵌合胚胎可以转移而不会增加异常出生结局的风险,但可能与增加的着床失败和流产率相关联,较高的嵌合率似乎不利于产生良好的结局。在这份立场声明中,我们为实验室、诊所、临床医生和顾问提供指导,以协助讨论嵌合胚胎的应用和转移。