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单基因疾病植入前基因检测(PGT-M)的遗传咨询

Genetic counseling for pre-implantation genetic testing of monogenic disorders (PGT-M).

作者信息

Parikh Firuza, Athalye Arundhati, Madon Prochi, Khandeparkar Meenal, Naik Dattatray, Sanap Rupesh, Udumudi Anuradha

机构信息

Department of Assisted Reproduction and Genetics, Jaslok-FertilTree International Fertility Centre, Jaslok Hospital and Research Centre, Mumbai, India.

GeneTech Laboratory, Banjara Hills, Hyderabad, India.

出版信息

Front Reprod Health. 2023 Dec 15;5:1213546. doi: 10.3389/frph.2023.1213546. eCollection 2023.

Abstract

Pre-implantation genetic testing (PGT) is a vital tool in preventing chromosomal aneuploidies and other genetic disorders including those that are monogenic in origin. It is performed on embryos created by intracytoplasmic sperm injection (ICSI). Genetic counseling in the area of assisted reproductive technology (ART) has also evolved along with PGT and is considered an essential and integral part of Reproductive Medicine. While PGT has the potential to prevent future progeny from being affected by genetic conditions, genetic counseling helps couples understand and adapt to the medical, psychological, familial and social implications of the genetic contribution to disease. Genetic counseling is particularly helpful for couples with recurrent miscarriages, advanced maternal age, a partner with a chromosome translocation or inversion, those in a consanguineous marriage, and those using donor gametes. Partners with a family history of genetic conditions including hereditary cancer, late onset neurological diseases and with a carrier status for monogenic disorders can benefit from genetic counseling when undergoing PGT for monogenic disorders (PGT-M). Genetic counseling for PGT is useful in cases of Mendelian disorders, autosomal dominant and recessive conditions and sex chromosome linked disorders and for the purposes of utilizing matching technology for creating a savior sibling. It also helps in understanding the importance of PGT in cases of variants of uncertain significance (VUS) and variable penetrance. The possibilities and limitations are discussed in detail during the sessions of genetic counseling.

摘要

植入前基因检测(PGT)是预防染色体非整倍体和其他遗传疾病(包括单基因起源的疾病)的重要工具。它是对通过胞浆内单精子注射(ICSI)产生的胚胎进行的检测。辅助生殖技术(ART)领域的遗传咨询也随着PGT的发展而发展,并且被认为是生殖医学的重要组成部分。虽然PGT有潜力防止未来的后代受到遗传疾病的影响,但遗传咨询有助于夫妇理解并适应遗传因素对疾病的医学、心理、家庭和社会影响。遗传咨询对反复流产、高龄产妇、有染色体易位或倒位的伴侣、近亲结婚的夫妇以及使用供体配子的夫妇特别有帮助。有遗传疾病家族史(包括遗传性癌症、迟发性神经疾病)以及单基因疾病携带者的伴侣在接受单基因疾病植入前基因检测(PGT-M)时可从遗传咨询中受益。PGT的遗传咨询在孟德尔疾病、常染色体显性和隐性疾病以及性染色体连锁疾病的情况下很有用,并且有助于利用匹配技术来孕育一个“救星同胞”。它还有助于理解PGT在意义不明确的变异(VUS)和可变外显率情况下的重要性。在遗传咨询过程中会详细讨论各种可能性和局限性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed27/10755023/bfa55e3e0751/frph-05-1213546-g001.jpg

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