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The relevance of increased cancer risk in infertile men

机译:不育男性罹患癌症风险增加的相关性

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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.
机译:Scott等人在本期发表的一项随机对照试验(RCT)。 (1)强化了胚胎非整倍性影响人类生殖的“古老”原则。正如作者所言,尽管从理论上讲这是一项合理的原则,但在过去几年中仍被认为是极富争议的。通过荧光原位杂交(FISH)对有限数量的染色体进行分析后,除其中一个RCT以外的所有报告都产生了负面影响(2)。提出了对分析所有染色体以提供可靠,及时结果的技术的明确需求。仅在使用公认的技术进行验证后,才应将这些临床平台用于临床程序中的单细胞或滋养层活检。在Scott小组的报告中,经过微调的研究设计后,他们得出结论,与不进行非整倍性筛选的胚泡转移相比,使用定量PCR(qPCR)进行的非整倍性筛选显着提高了植入率和分娩率。他们的研究基于胚泡活检和新鲜转移,同一周期最多转移了两个胚胎。进行新鲜胚胎移植的可能性是他们研究的优势之一:他们的遗传学实验室与体外受精(IVF)实验室位于同一设施中,因此他们可以在下午对活检样本进行快速染色体分析第5天的第2天,随后进行第二天的胚胎移植。

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