Interviewee/Dr. Lu Fan from Ive International Reproductive Medicine Center
How to define infertile patients? When should I go to the infertility clinic?
As long as one of the above elements is missing, it will lead to infertility. Theoretically, 85-90% couples with normal fertility will get pregnant within one year without deliberate contraception, and only 5- 10% couples with normal fertility fail to do so. Therefore, if a couple can't get pregnant after a year of sex, we define it as infertility. Most infertile couples just have low fertility. If medical advice and assistance can be used correctly, most of them can achieve the purpose of pregnancy.
However, with the increase of childbearing age year by year, the quality of female eggs will also decline, thus affecting the chances of pregnancy. It is suggested that older women should consider receiving examination in advance if they try to be pregnant for more than half a year. In addition, people with ovarian tumors or undergoing surgery have a higher probability of premature ovarian failure, so it is suggested to monitor ovarian function regularly in order to deal with it in time. If you have symptoms of irregular menstruation, obesity or high androgen, the probability of polycystic ovary syndrome is higher. Afraid of affecting the chances of pregnancy in the future, it is recommended to correct and improve in advance.
What is the technology of chromosome gene screening (PGS) before embryo implantation? What help does it have for infertile patients?
Due to the decline of physiological conditions of elderly women, age has become the biggest variable in artificial reproduction, because the decrease of ovarian eggs and poor egg quality will affect embryo development and lead to an increase in the probability of chromosome abnormality. Many embryos can't be implanted, or they can't continue to develop and abort after implantation, all because of abnormal embryo chromosomes. In the past, we could only judge whether an embryo was healthy from its growth rate and embryo type, and then let infertile patients implant embryos. However, when many couples are doing IVF treatment, they often fail to conceive successfully, and there are also cases where the embryo develops to half without heartbeat. It is often because of embryos with abnormal chromosomes that the pregnancy rate decreases, the abortion rate increases and the risk of birth defects increases.
In recent years, preimplantation chromosome gene screening (PGS), which is widely used in IVF treatment, can make doctors find embryos with abnormal chromosomes before implantation, thus avoiding embryo implantation failure caused by abnormal embryos chromosomes and further improving the chances of successful pregnancy. Preimplantation chromosome examination for elderly women can not only achieve excellent results, but also significantly reduce the abortion rate and shorten the time required to reach pregnancy. According to the retrospective study of Cornell University (20 16), receiving PGS can effectively improve the clinical pregnancy rate and live birth rate in elderly patients (> 37 years old). The pregnancy rate of 1 embryo increased by 3.86 times, and the pregnancy rate of two embryos increased by 9.9/kloc-0 times. The live birth rate of 1 embryo increased by 8.20 times, and the live birth rate of two embryos was as high as 8.67 times. Moreover, after receiving PGS, the number of implants required to achieve live birth is less. As long as 1.8, the abortion rate is reduced to 2.7%, the live birth rate can be as high as 36%, and the time required to reach pregnancy is as short as 7.7 weeks, all of which are significantly improved. Therefore, PGS can eliminate weeds and preserve seeds, and improve the success rate of the first implantation of elderly women.
What are the factors that affect the success of PGS?
The operation of PGS will affect the success rate of each step, such as good culture environment, good samples and sample fixation technology. In recent years, these techniques have gradually matured and stabilized, and the methods of chromosome examination have changed with each passing day. From traditional fluorescence in situ hybridization (FISH) to chip-based whole genome quantitative analysis (Array CGH) and next generation gene sequencing (NGS), the accuracy has been greatly improved, and if the huge clinical data behind it are combined, the judgment error rate will be greatly reduced.
Photo: Ive international reproductive medicine center
The treatment cycle of infertility is long and the cost is not low. How to reduce the infertility rate or reduce the burden of infertile patients?
Due to the lack of conditions for infertile patients and the plummeting quality of eggs and ovaries of elderly women, if infertility can be treated early, it is best to give birth or treat infertility before the age of 35, with a high success rate. Compared with the implantation of two embryos, the pregnancy rate of women aged 35-37 is still 40%, and by the age of 40, the pregnancy rate is only 20%, and the live birth rate is only 7%.
In addition, bad living habits, such as staying up late, frequent contact with pollution sources and taking drugs indiscriminately, will also affect the chances of pregnancy. It is suggested that infertile patients should be examined for signs such as endometriosis, myoma or adenomyosis before artificial pregnancy. In addition, due to the rising proportion of late marriage, the cryopreservation technology of oocytes provides opportunities for unmarried people of school age to have children in the future.
Do pregnant women still need to carry out chromosome correlation tests on their fetuses after infertility patients have successfully conceived by prenatal chromosome examination?
Although embryos with abnormal chromosomes can be selected by chromosome examination before implantation, there is still a very small chance of uncontrollable mutation during embryo development. At present, it is recommended that pregnant women who receive PGS treatment still need fetal chromosome confirmation examination during pregnancy. Chromosome examination, such as invasive amniocentesis or noninvasive fetal chromosome gene detection (NIFTY PLUS) screening, can be considered: common chromosome triploid, Down's disease, Edward's disease, Bartonella's disease, abnormal sex chromosome diseases, rare diseases caused by deletion or repetition of chromosome fragments, such as meowing, chubby syndrome, angel syndrome, type II Digeorge syndrome, hereditary cleft lip and palate, Jacobson's disease, etc.
Topic: 2q33. 1 deletion syndrome, NIFTY PLUS, PGS, infertility, Ji Kang in Taiwan Province Province, Down syndrome, gene detection, gene technology, angel syndrome, chubby syndrome, Bartonella's disease, sex chromosome abnormality, Edward's disease, chromosome fragment deletion, chromosome abnormality, fertility problems, prenatal screening.