嵌合体胚胎移植产生的可能后果及处理对策

Possible outcome and treatment strategies of mosaic embryo transfer

嵌合体胚胎是指包含两种及两种以上的遗传学不同的细胞系的胚胎,在人类植入前胚胎比较常见。在卵裂期胚胎中,嵌合体胚胎占比15%~90%,而在囊胚期胚胎中占比3%~24%,因此对嵌合体胚胎如何处置是体外受精胚胎移植治疗中重要问题之一。嵌合体胚胎的发生受多种因素的影响如遗传学检测方法、女方年龄、活检细胞种类、卵巢刺激方案等。嵌合体胚胎是否移植是需要谨慎对待。嵌合体胚胎的移植结局主要有正常活产、流产及移植妊娠失败等。虽然有文献报道移植嵌合体胚胎有正常活产,但是对于植入前遗传学检测(PGT)结果仅有嵌合体胚胎,是否可将嵌合体胚胎移植的问题,应该遵循相关伦理及共识。

Mosaic embryos are common in human pre-implantation embryos,which containing two or more genetically distinct cell lineages.It account for 15-90% of embryos in cleavage stage and 3-24% of blastocysts.Therefore,how to dispose of mosaic embryos is one of the important issues in IVF-ET treatment.The occurrence of mosaic embryos is affected by many factors,such as PGT laboratory techniques,female age,type of biopsy cells,and ovarian stimulation treatment and so on.The mosaic embryos transfer should be treated with caution.And the outcomes of mosaic embryos transplantation mainly include normal live birth,miscarriage and pregnancy failure of transplantation.Although it reported that normal live birth of mosaic embryo transplantation occurred in literatures,related ethics and consensus should be followed on the issue of whether mosaic embryos can be transferred when only mosaic embryos are detected by pre-implantation genetic test(PGT).