Tesarik Jan, Mendoza-Tesarik Raquel
MARGen Clinic, Molecular Assisted Reproduction and Genetics, Granada, Spain.
Front Reprod Health. 2022 Jul 18;4:917159. doi: 10.3389/frph.2022.917159. eCollection 2022.
Patient-tailored reproductive health care represents an important challenge for the current practice of infertility prevention, diagnosis and treatment. This approach is based on the concept of precision medicine, taking into account genetic, epigenetic, metabolic and lifestyle characteristics of each individual patient. Even though this goal is still far from being wholly achieved, some aspects can already be put into practice nowadays. Personalization can be based on a comprehensive analysis and synthesis of the patients' personal and familial history, taking into account outcomes of previous assisted reproduction technique (ART) attempts, if available, and confronting these data with the past and the latest clinical and laboratory examination outcomes. As to the male fertility status, there is an urgent need for the inclusion of an accurate diagnostic workup of infertile men leading to the choice of the most adequate follow-up for each particular pathological condition. The follow-up of women who have become pregnant as a result of the ART attempt has also to be personalized. This should be done taking into account both the basic data extracted from the patient's file and those derived from the experience gathered during the latest attempt. Last but not least, the individual condition of each couple has to be taken into account when counseling the patients as to the urgency of the actions to be taken to resolve their fertility problem.
针对个体患者定制生殖保健是当前不孕症预防、诊断和治疗实践面临的一项重大挑战。这种方法基于精准医学的理念，考虑到每个患者的基因、表观遗传、代谢和生活方式特征。尽管这一目标仍远未完全实现，但如今已有一些方面可以付诸实践。个性化可基于对患者个人和家族病史的全面分析与综合，考虑既往辅助生殖技术（ART）尝试的结果（如有），并将这些数据与过去及最新的临床和实验室检查结果进行对比。至于男性生育状况，迫切需要对不育男性进行准确的诊断检查，以便针对每种特定病理状况选择最适当的后续措施。对因ART尝试而怀孕的女性的随访也应个性化。这应综合考虑从患者病历中提取的基本数据以及最新尝试中积累的经验数据。最后但同样重要的是，在为患者提供关于解决其生育问题所需采取行动的紧迫性的咨询时，必须考虑每对夫妇的个体情况。
