感染性疾病患者实施辅助生殖技术的风险与防范

Risk of Assisted Reproductive Technology in Patients with Infective Diseases,and Its Prevention

在辅助生殖技术(ART)中,临床改善内分泌措施改变了女性生殖道的微生物防御机制,体外对配子/胚胎操作和移植替代了性交,而临床操作对于女性是个风险,有可能导致病原微生物的机械传播,同时也可能被用于患性传播疾病(STD)的不育男性。应高度关注在ART实施过程中女性生殖道的微生物状况和感染问题,避免人为机械性地将病原生物植入女性盆腔深部组织。应用ART避免男性STD传播问题应当慎重。在这种情况下,安全的精子分离程序、规范的实验室操作、患者充分知情同意是必须的。对ART中传播人类免疫缺陷病毒(HIV)的风险应当从生物学、操作程序和伦理学方面再评价。规范的实验室管理是避免因实验室环节疏忽导致病原污染事件发生的必要手段。

In assistant reproductive technique（ART）,the clinical endocrinological management could change the defensive function of female reproductive tract to microorganisms,and gametes/embryos operation and transfer in vitro replaced intercourse.These clinical procedures have risks of the mechanical spread of pathogenic microorganism.Female partner could be in higher risk when ART was used in the sterility couples that husband suffered from sexual transmitted diseases（STD）.We should pay enough attention to the female reproductive tract infection in ART,to avoid contaminate of pathogenic microorganism into female.It should be assessed carefully when ART was used in those couples with male STD because STD could infect female by the clinical procedures.In that case,a safe sperm separation method and standard operating procedure should be established,and the comprehensive informed consent should be exchanged with the couples.The incidence of cross infection of HIV in ART should be re-assessed in respects of biology,laboratory procedure and ethics.The restricted laboratory operating procedure is essential for the prevention of accident contamination which be of laboratory carelessness.