The relevance of increased cancer risk in infertile men

摘要

The publication in this issue of a randomized, controlled trial (RCT) by Scott et al. (1) reinforces the "old" principle of the impact of embryo aneuploidy in human reproduction. As the authors stated, this principle, despite being theoretically sound, was considered highly controversial in past years. All except one of the RCTs reported a negative impact after the analysis of a limited number of chromosomes by fluorescence in situ hybridization (FISH) (2). The clear need for a technique to analyze all chromosomes that would offer reliable, timely results was postulated. These clinical platforms should be employed for single cells or trophectoderm biopsies in a clinical program only after validation with a well-established technique. In the report by Scott's group, after a finely tuned study design, they concluded that aneuploidy screening using quantitative PCR (qPCR) meaningfully improves implantation and delivery rates compared with blastocyst transfer without aneuploidy screening. Their study was based on blastocyst biopsy and fresh transfer with a maximum of two embryos transferred in the same cycle. The possibility of performing fresh embryo transfer was one of the strengths of their study: their genetics laboratory was located in the same facility as their in vitro fertilization (IVF) laboratory, so they could perform a rapid chromosome analysis of the biopsy samples on the afternoon of day 5 with subsequent next-day embryo transfer.