关键词:
Bioethics
GCC
PGT
FISH
PCR
A-CGH
NGS,
摘要:
Introduction Pre- implantation Genetic Testing (PGT), including Pre- Implantation Genetic Screening (PGS) and Pre-Implantation Genetic Diagnosis (PGD) is defined as a group of genetic analysis applied to embryos produced through IVF programs. In Bahrain, these investigations were introduced since 2007, by referring embryo biopsy samples to PGD labs outside the country. Most of the tests were initially implemented using the techniques of FISH and PCR, while a-CGH and NGS emerged later. Genetic testing of embryos is laborious, costly, stressful and psychologically harsh on families. It should be organized and protected to ensure safety of testing and authenticity of outcome. Currently, the PGT practices in Bahrain and some of GCC countries lack many elements of quality management and require strategies for transformation of commercially oriented business to a patient-welfare oriented service. This study will present PGT data collected in the last 10 years from three major IVF centres in Bahrain. It will basically emphasize on the problems and the weaknesses encountered in our system through analysis of the data and treatment outcome in terms of pregnancy success rates. Also, in an endeavour to improve the quality of PGT services and to overcome some of the implementation-related issues observed, bioethical standards helping in improvement of the system and regulation of PGT practices will be proposed and discussed. Materials and Methods This study will present the findings of 500 infertility/ PGT cases treated in three major IVF centres in Bahrain from 2007 until present. All the centres refer their samples to satellite PGD laboratories. The tests were initially focussed on aneuploidy screening for 5 chromosomes by the technique of FISH, which was gradually shifted to 24-chromosome screening by A-CGH in 2013 through 2015 and later substituted with NGS when the technique was made available. The number of cases, the types of PGT tests performed, justifications of testin