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新型胚胎选择策略——寻求恰当平衡

Novel embryo selection strategies-finding the right balance.

作者信息

Polyakov Alex, Rozen Genia, Gyngell Chris, Savulescu Julian

机构信息

Faculty of Medicine and Health Sciences, The University of Melbourne, Parkville, VIC, Australia.

Reproductive Biology Unit, Royal Women's Hospital, Melbourne, VIC, Australia.

出版信息

Front Reprod Health. 2023 Dec 15;5:1287621. doi: 10.3389/frph.2023.1287621. eCollection 2023.

Abstract

The use of novel technologies in the selection of embryos during fertilisation (IVF) has the potential to improve the chances of pregnancy and birth of a healthy child. However, it is important to be aware of the potential risks and unintended consequences that may arise from the premature implementation of these technologies. This article discusses the ethical considerations surrounding the use of novel embryo selection technologies in IVF, including the growing uptake of genetic testing and others, and argues that prioritising embryos for transfer using these technologies is acceptable, but discarding embryos based on unproven advances is not. Several historical examples are provided, which demonstrate possible harms, where the overall chance of pregnancy may have been reduced, and some patients may have missed out on biological parenthood altogether. We emphasise the need for caution and a balanced approach to ensure that the benefits of these technologies outweigh any potential harm. We also highlight the primacy of patients' autonomy in reproductive decision-making, especially when information gained by utilising novel technologies is imprecise.

摘要

在体外受精(IVF)过程中使用新技术来选择胚胎,有可能提高怀孕几率以及生出健康宝宝的概率。然而,必须意识到过早应用这些技术可能带来的潜在风险和意外后果。本文讨论了围绕在体外受精中使用新型胚胎选择技术的伦理考量,包括基因检测等技术的日益普及,并认为使用这些技术优先选择用于移植的胚胎是可以接受的,但基于未经证实的进展而丢弃胚胎则不可取。文中提供了几个历史实例,这些例子表明了可能存在的危害,比如怀孕的总体几率可能降低,一些患者可能完全错失成为亲生父母的机会。我们强调需要谨慎并采取平衡的方法,以确保这些技术的益处超过任何潜在危害。我们还强调了患者在生殖决策中的自主权的首要地位,尤其是在利用新技术获得的信息不准确时。

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