Araújo Sara, Paula Neto Ana, Pinho Maria João, Dória Sofia, Barros Alberto, Carvalho Filipa
Genetics Unit, Department of Pathology, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal.
Centro de Genética da Reprodução Prof. Alberto Barros, Av. do Bessa 240, 4100-012 Porto, Portugal.
JBRA Assist Reprod. 2025 Mar 12;29(1):61-66. doi: 10.5935/1518-0557.20240087.
There is a rising demand for assisted reproductive medicine, including sperm, oocyte and embryo donation. Besides medical and legal considerations, genetic testing, including carrier screening for multiple autosomal and X-linked recessive disorders plays an essential role in evaluating hereditary risk among donors and therefore exclude them from the donation process.
A retrospective study was conducted on oocyte donors from a private clinic of assisted reproduction who underwent genetic testing between June 2014 and September 2023. Pre and post-test procedures were performed at the private clinic while karyotyping and carrier screening for Cystic Fibrosis, Fragile X syndrome and Spinal Muscular Atrophy were performed at the Genetic Unit of Faculty of Medicine, University of Porto.
Among 581 donors, 81 women were excluded from the donation process since 5/563 had an alteration in karyotype, 57/581 were carriers of a Cystic Fibrosis Transmembrane conductance Regulator pathogenic variant or had a 5T allele, 11/394 had Survival of Motor Neuron 1 deletion and 8/426 had an intermediate or premutation allele in Fragile X Messenger Ribonucleoprotein gene. While recommendations from fertility societies advocate for comprehensive screening, opinions differ on the mandatory implementation of expanded carrier screening.
In conclusion, the genetic tests and the pre and post-test counseling is imperative to optimize reproductive outcomes in the oocyte donation process.
对辅助生殖医学的需求不断增加,包括精子、卵母细胞和胚胎捐赠。除了医学和法律方面的考虑外,基因检测,包括对多种常染色体和X连锁隐性疾病的携带者筛查,在评估捐赠者的遗传风险中起着至关重要的作用,因此将他们排除在捐赠过程之外。
对2014年6月至2023年9月期间在一家私立辅助生殖诊所接受基因检测的卵母细胞捐赠者进行回顾性研究。检测前和检测后的程序在私立诊所进行,而染色体核型分析以及囊性纤维化、脆性X综合征和脊髓性肌萎缩症的携带者筛查在波尔图大学医学院遗传科进行。
在581名捐赠者中,81名女性被排除在捐赠过程之外,因为5/563人的染色体核型有改变,57/581人是囊性纤维化跨膜传导调节因子致病变体的携带者或有5T等位基因,11/394人有运动神经元存活1基因缺失,8/426人在脆性X信使核糖核蛋白基因中有中间或前突变等位基因。虽然生育协会的建议主张进行全面筛查,但对于强制实施扩大的携带者筛查,意见存在分歧。
总之,基因检测以及检测前和检测后的咨询对于优化卵母细胞捐赠过程中的生殖结果至关重要。