中国山东网-感知山东4月24日讯

(见习记者 张秀云 通讯员 李成修 王婧)近年来,不孕不育及复发性流产的发病率逐年上升,成为为较普遍的障碍。但随着医疗技术的进步,试管婴儿也慢慢走进大众的视野,成为克服不孕不育困难的一大解决方法。本周,烟台毓璜顶医院生殖医学科张凤荣担任讲师,线上直播开展试管婴儿知识普及主题讲座,和网友双向互动,答疑解惑。

通过技术手段将卵子和丈夫的精子取出,在实验室里完成受精,体外培养三天形成胚胎后,再把胚胎放到子宫内,这个过程称为体外受精——胚胎移植,就是俗称的试管婴儿。试管婴儿经历了三代发展历程,每一代技术适用于不同的人群。张凤荣说:“我们针对不同的个体,用不同的方案,做到既省钱又省时,提高妊娠率,还可以降低流产率,实现抱婴回家的梦想。”

试管婴儿首先要抽血化验、B超检查,再进行周期前预处理,进入试管周期,进行药物促排卵,随后取精取卵,对胚胎进行培养移植,之后在第五天第七天第十四天进行抽血检查,孕妇怀孕早期进行三次B超检查,进行孕检,最后静待宝宝出生即可。

广大网友在听完试管婴儿流程介绍后,纷纷对试管婴儿的费用以及成功率的问题表现出强烈的关注。张凤荣表示:由于每个人的年龄体重和卵巢功能等存在差异,所以试管婴儿的具体费用也不同,前期化验检查费约4000元左右,在确定治疗方案后,短方案费用约1万元左右,长方案费用约2-3万元左右;而试管婴儿的成功取决于卵子精子的质量、胚胎的质量、子宫内膜的情况、患者夫妇的年龄、不孕的病因以及医疗技术等原因。此外,随着年龄的增大,卵巢功能慢慢衰退,成功率也会有所下降,因此怀孕要趁早。

在讲座的后半程,张凤荣主要讲解了试管婴儿常用药物及保存方法。降调药、促排药和夜针药是试管婴儿的常用药,要储存在2-8℃或20℃以下避光冷藏不可冷冻的环境中,在路途中可以使用保温包进行冷藏。保温包中要准备一条毛巾,两块冰块,冰块和药物之间用毛巾隔开,否则药物结冰就不能再使用。张凤荣提醒广大网友,保温包只能在路途中使用,回家后药物应立即放入冰箱保鲜层。

最后,针对排促卵过程中的常见问题,张凤荣回答道:“应用排促卵药后,不应剧烈运动,夫妻之间禁止同房,而且一般不影响月经,白带增多不一定是排卵现象,若出现腹痛的情况应及时就诊。在饮食方面,要做到营养均衡,少吃辛辣刺激的食物?!?/p>

人们都说试管婴儿是生孩子的最后一条路,其实试管婴儿只是超越了其他助孕方式,把怀孕变得简单化,把女性着床前的所有过程变为可控,生孩子的办法有很多,试管婴儿只是一条比较快捷有效的路。

往期回顾:

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如果有一天,你可以选择生育一个小“爱因斯坦”,也可以生育一个智商普通的孩子,你会做出什么样的选择?据科学家预计,未来10年内,人类将可以使用试管婴儿技术选择“最聪明”的胚胎。

Genetics research, conceptual artwork. CHINA DAILY

Couples undergoing IVF treatment could be given the option to pick the “smartest” embryo within the next 10 years, a leading US scientist has predicted.

据美国一名权威科学家预计,未来10年之内,做试管婴儿的夫妇将能够选择“最聪明”的胚胎。

IVF:in vitro fertilization 体外受精联合胚胎移植技术,又称“试管婴儿”

Stephen Hsu, senior vice president for research at Michigan State University, said scientific advances mean it will soon be feasible to reliably rank embryos according to potential IQ, posing profound ethical questions for society about whether or not the technology should be adopted.

美国密歇根州立大学主管科研的副校长徐道辉(斯蒂芬·徐)说,科学进步意味着人类不久就能够对胚胎的潜在智商给出可靠的评分,这项技术是否应该使用将是一个深刻的社会伦理问题。

Hsu’s company, Genomic Prediction, already offers a test aimed at screening out embryos with abnormally low IQ to couples being treated at fertility clinics in the US.

徐道辉的基因组预测公司已经为在美国不孕不育诊所接受治疗的夫妇提供了一项检测服务,旨在筛查出智商异常低的胚胎。

“Accurate IQ predictors will be possible, if not the next five years, the next 10 years certainly,” Hsu told the Guardian. “I predict certain countries will adopt them.”

徐道辉对《卫报》记者说:“准确的智商预测是可能的,即使不是未来5年内,那么在未来10年内也肯定可以。我预计一些国家会采纳这项技术。”

The prospect of a new generation of genetically selected babies has prompted concerns about unintended medical consequences and the potential for deepening existing social inequalities. The science underpinning the claim that intelligence can be meaningfully predicted by genetic tests is also contentious.

新一代基因选择婴儿的前景引发了人们对于意外医疗后果和现有社会不平等可能加剧的担忧?;蚣觳饽芄挥行гげ庵巧痰目蒲Ъ际跻惨⒘苏椤?/p>

contentious [kn'tens]:adj.有异议的,引起争论的

Peter Donnelly, a professor of statistical science at the University of Oxford, said any such IQ predictions should be treated with “huge caution”, adding: “I have grave misgivings about it on ethical grounds. I think it’s a really bad idea.”

牛津大学统计学教授彼得·唐纳利说,应该“十分谨慎”地对待此类智商预测。他说:“出于伦理原因,我对此非常担忧。我认为这是一个非常糟糕的想法?!?/p>

Since the 1990s, couples undergoing IVF have been able to screen their embryos for mutations in single genes that cause serious diseases such as cystic fibrosis, as well as conditions like Down’s syndrome, caused by chromosome abnormalities.

自上世纪90年代以来,接受试管受精的夫妇已经能够对他们的胚胎进行筛选,以发现单个基因的突变,这些突变会导致严重的疾病,比如囊性纤维化,以及染色体异常导致的唐氏综合征等。

chromosome ['krmsm]:n.染色体

Many other traits, including height, physical appearance, intelligence and disease susceptibility, are known to be partly heritable. But because the genetic component is spread thinly over hundreds or even thousands of DNA regions, it has previously been impossible to screen for these traits.

许多其他特征,包括身高、外貌、智力和疾病易感性,都被认为是部分遗传的。但由于遗传组分稀疏地分散在数百甚至数千个DNA区域,以前不可能对这些特征进行筛选。

In the past decade, as vast genetic databases have been established, this picture has changed. Through analyzing many genes, each making a tiny contribution, it has been possible to calculate what are called polygenic risk scores, which give a person’s likelihood of getting a particular disease or having a certain trait.

在过去的十年里,随着大量基因数据库的建立,这种情况已经发生了改变。通过分析大量基因,每个基因都做出了微小的贡献,就有可能计算出所谓的多基因风险评分,即一个人患某种特定疾病或具有某种特征的可能性。

polygenic[,pli'denik]:adj.多基因的

Genomic Prediction is the first company to take embryo screening into this grey area of risk forecasting, offering to alert couples if an embryo has an “outlier” score for risk of cancers, diabetes, heart disease, dwarfism or low IQ.

基因组预测公司是第一家将胚胎筛查纳入风险预测这一灰色地带的公司。如果胚胎在癌症、糖尿病、心脏病、侏儒症或智商低下等风险方面的评分“异?!?,它就会提醒做筛查的夫妇。

outlier ['atla]:n.(统计)异常值

Medical staff put clothes on the newborn test-tube baby at a hospital in Xi'an, Northwest China's Shaanxi province. [Photo/Xinhua]

Prediction for IQ is not good enough to give a reliable ranking, but Hsu said that knowing an embryo has a low score could still be desirable.

智商预测目前还不足以给出可靠的评分,但徐道辉表示,如果一个胚胎的智商评分较低,人们可能还是很想知道。

“Maybe the bottom 1% embryo will grow up to be a great person … even be a scientist, but the odds are against it,” he said. “I honestly feel if we can calculate that score and find a real negative outlier there’s an ethical responsibility for us to report that.”

徐道辉说:“也许评分最低的1%的胚胎长大后会成为一个优秀的人……甚至成为一名科学家,但这种可能性很小。我真的觉得,如果我们能计算出这个评分,发现它低得十分异常,那么我们就有道德责任予以告知。”

The company projects that once high-quality genetic and academic achievement data from a million individuals becomes available, expected to be within five to 10 years, it will be able to predict IQ to within about 10 points.

该公司预计,在5至10年内,一旦100万人的高质量基因和学术成就数据可用,它将能够预测智商,误差在10分以内。

Hsu is reticent about whether screening for high intelligence would be ethically justified, saying: “Let me just decline to answer that at the moment.”

徐道辉不愿评论高智商筛查是否符合伦理标准,说“目前我拒绝回答这个问题”。

reticent ['rets()nt]:adj.沉默的;有保留的

In some countries, such as Singapore, there is likely to be a high level of public acceptance and demand for such tests, he suggested. “I think the overwhelming majority would say yes, absolutely, parents should be allowed to do that,” he said. “Before you write your piece, you might just want to think that a billion people on the other side of the world might have a different view.”

徐道辉说,在一些国家,比如新加坡,公众对此类检测的接受度和需求可能会很高。他说:“我认为绝大多数人肯定会赞成允许父母这样做。在你写这篇报道之前,也许应该想想地球另外一端的10亿人可能有不同的看法?!?/p>

Whether such tests will become available in the UK would depend on approval from the Human Fertilization and Embryology Authority (HFEA).

这种检测方法能否在英国实施将取决于英国人工授精与胚胎学管理局的批准。

“If the HFEA decides that it’s not right for the UK, I will respect that,” Hsu said, but predicted that “rich people from the UK will fly to Singapore” if they are unable to get the tests locally.

他说:“如果英国人工授精与胚胎学管理局认为这对英国不合适,我会尊重这个决定?!钡げ?,如果英国富人无法在当地进行这项检测,“他们会飞到新加坡去做的?!?/p>

Some in the UK take the view that prospective parents have a right to access such tests. “I don’t think people should be deprived of that knowledge,” said Prof Simon Fishel, the founder of Care Fertility.

在英国,一些人认为未来的父母有权进行此类检测。生育关怀组织的创始人西蒙费舍尔教授说:“我认为不应该剥夺人们的这种知情权?!?/p>

Fishel questioned whether there is any ethical difference between picking an embryo ranked highest for IQ or sending a child to a private school. “What’s wrong with ranking an embryo if you can rank a child?” he said. “I think there are plenty of people who’d choose embryo Oxford [rather] than embryo A-level failure.”

费舍尔质疑挑选智商最高的胚胎和送孩子去私立学校之间是否存在伦理上的差异?!叭绻隳芨⒆悠婪?,那给胚胎评分又有什么错呢?”他说。“我认为有很多人会选择未来能考取牛津的胚胎而不是无法通过英国中学高级水平考试的胚胎?!?/p>

In practice, though, couples often have only a few embryos to choose from. And there are concerns about unintended consequences. For instance, there is some evidence linking higher polygenic scores for academic ability to higher likelihood of autism.

但实际上,夫妇们通常只有几个胚胎可供选择。此外,人们还担心会出现意想不到的后果。例如,有证据表明,学术能力的多基因得分越高,患自闭症的可能性就越大。

The technology is controversial, but that does not mean it will not gain acceptance in the future, Hsu said, drawing parallels with the reaction to IVF in its early days.

徐道辉说,这项技术存在争议,但这并不意味着它在未来不会被接受,这与早期人们对体外受精的反应类似。

“The IVF pioneers … were called monsters, Frankenstein doctors; it was predicted that these babies would have health problems,” he said. “I am actually reassured by that. IVF is completely normalized now. Everyone who is pointing their finger at [Genomic Prediction] now should go back and read those articles.”

他说:“试管婴儿的先驱被称为怪物,弗兰肯斯坦医生。当时人们预测这些婴儿会有健康问题。实际上,我对此很放心。试管受精现在已经完全正?;?。现在,所有指责(基因组预测)的人都应该回去读读那些文章?!?/p>

来源:卫报、参考消息网

翻译编辑:yaning

来源:中国日报网