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Tan Xiaojun
·Senior reproductive medicine expert
·Postdoctoral fellow at Peking University
·PhD candidate at Xiangya School of Medicine, Central South
University
·Master’s tutor at Central South University
· Master's degree candidate in reproductive
medicine at the University of South China
· Professional training at Huazhong University
of Science and Technology and Tongji
Hospital Reproductive Center
Expertise:
diagnosis and treatment of infertility, first/second/third generation IVF (including
egg/sperm donation), microsperm retrieval, embryo freezing and resuscitation, artificial
insemination (including husband's sperm and sperm donation), paternity testing, chromosomal
disease
diagnosis, high-throughput gene sequencing, endometrial receptivity gene testing and other
clinical
technology applications. Many of these technologies are at the leading level both domestically
and
internationally.
Can you do three generations of chromosome abnormality in Bishkek Tulip Hospital, Bishkek third generation test tube, Kyrgyzstan PGT, chromosome abnormality test tube process, difference between PGT-A and PGT-SR, can you do three generations of repeated abortion, balanced translocation test tube, overseas test tube genetic screening.
Can the chromosome abnormality in Bishkek Tulip Hospital be the third generation? Six key points to clarify indications, PGT types and medical procedures.
Many people search for "Can you do three generations of chromosome abnormalities in Bishkek Tulip Hospital?" What they really want to ask is not a "yes" or "no", but three lower-level questions:
First, what kind of abnormality is the so-called chromosome abnormality?
Second, does this kind of abnormality correspond to the medical indication of the third generation test tube?
Third, does the hospital have the corresponding PGT detection ability and standardized process?
Firstly, the conclusion is given: from the medical logic point of view, the population related to chromosome abnormality may indeed enter the third generation test tube (PGT) path; But whether it is suitable for doing it is not determined by the word "abnormal", but depends on the abnormal type, previous birth history, age, number of embryos and genetic counseling results. Official website, the Tulip International Reproductive Center, shows that it is located in Bishkek, Kyrgyzstan, and provides PGT related services in the third generation test tubes, and claims to hold an assisted reproductive license from the health department of Kyrgyzstan. This information can be used as a preliminary reference, but because it mainly comes from the agency's self-report, the matching and detection ability of specific indications should still be based on the face-to-face evaluation and genetic report.
First, make the concept clear: What are the "three generations" here?
The core of the "third generation test tube" often mentioned in clinic is not "more advanced test tube", but adding genetic testing before embryo transfer. ACOG pointed out that PGT is essentially a genetic evaluation before embryo transfer; Different types of PGT have different application problems.
If distinguished by use, there are three common types:
PGT-A: It mainly depends on whether the embryo has aneuploidy, that is, the chromosome is "abnormal in number"
PGT-SR: Mainly aimed at structural abnormalities such as balanced translocation, Roche translocation and inversion of one parent.
PGT-M: Mainly aimed at definite single-gene hereditary diseases.
This step is very critical. Because many patients refer to "chromosome abnormality" as one thing, in fact, there are great differences in medicine. For example, the tendency of embryo aneuploidy caused by advanced age is closer to the discussion scope of PGT-A; However, the balanced translocation of chromosome of one spouse is more inclined to PGT-SR. ESHRE also incorporated PGT-A and PGT-SR into different technical specifications, indicating that they are not the same concept.
Second, who is more likely to be suitable for this road?
From the common medical scenes, the following groups of people are more likely to be evaluated to enter the third generation test tube path:
One of the spouses is known to have chromosomal structural abnormalities.
Such as equilibrium translocation, Roche translocation and inversion. This kind of people often have no obvious abnormality in appearance and health, but the risk of unbalanced chromosomes in the formed embryos will increase, thus increasing the probability of non-implantation, fetal arrest, abortion or fetal abnormality. PGT-SR is designed for this kind of situation.
People with a history of repeated abortion and repeated fetal arrest
If the pregnancy outcome is bad repeatedly in the past, the doctor will usually suggest further investigation of the couple's chromosome karyotype, embryonic factors, endocrine, immunity, uterine environment and other issues. It should be noted here that repeated abortion does not mean that it must be done for three generations, but it is indeed an important signal to enter genetic evaluation.
Elderly pregnant population
The ASRM 2024 opinion mentioned that with the increase of age, the proportion of embryo aneuploidy increased; In its cited research, the proportion of abnormal embryos in people aged 35-40 is higher than that in people under 35. That is to say, the older you are, the higher the probability of chromosomal abnormalities in embryos.
These people do not necessarily have clear parental chromosomal abnormalities, but they may need to consider PGT-A in combination with previous embryo development, transplant outcome and age. The premise here is still: it is necessary to make clear whether the failure is mainly caused by embryonic chromosome problems.
A common misunderstanding must be pointed out here:
"As long as the chromosome is abnormal, it can be solved by doing three generations." This premise is inaccurate.
Because the role of the third generation of test tubes is screening and selection, not "repairing" chromosomes. It can't turn abnormal embryos into normal embryos, and it can't avoid the practical problems such as poor ovarian reserve, few available embryos and poor uterine environment. Both ACOG and ASRM emphasize that PGT has applicable boundaries, and there are also limitations such as false positive, false negative, no result and difficulty in chimera interpretation.
Third, how to look at the technical level: Tulip Hospital "can do it", the key depends on these three layers.
According to the public information in official website, Tulip International Reproductive Center provides PGT-related services in Bishkek, and the third generation test tubes, PGT and genetic screening are clearly listed on the service page.
But for patients, judging "can't do it" can't just look at the leaflet, but at three levels:
Floor 1: Is this service available?
Judging from official website's public content, the answer is biased towards yes. The organization claims to provide PGT-related third-generation test tube services.
Layer 2: What kind of PGT does your situation correspond to?
This is the core that really determines whether you can enter the program.
PGT-A is usually discussed if you are old and the risk of embryo aneuploidy is increased.
In case of equilibrium translocation, Roche translocation and inversion, PGT-SR is usually discussed.
If it is a definite monogenic disease, it is biased towards PGT-M.
Layer 3: Are there enough embryos to sift?
This is a point that is easily overlooked in many propaganda. PGT can be done not by drawing blood, but by promoting ovulation, taking eggs, fertilization and blastocyst culture before biopsy. If there are few eggs and blastocysts, and the number of embryos available for screening is insufficient, there may eventually be a situation that "it is suitable in theory but cannot be done in practice". ESHRE emphasizes pre-consultation, risk notification and detection restrictions on the organization and detection process of PGT.
Four, a few common problems, a thorough.
Question 1: If one of the spouses has balanced chromosome translocation, can it be done directly for three generations in Bishkek Tulip Hospital?
You can enter the evaluation, but you don't just enter the cycle with the report. It is usually necessary to supplement the couple's karyotype, genetic counseling, the woman's ovarian reserve, the man's semen, previous abortion or fetal arrest history and other information. If it is finally confirmed that it belongs to the carrier of structural abnormality, it is closer to PGT-SR path in medicine.
Q 2: Advanced age leads to abnormal embryo chromosomes. Is it safer to do PGT-A?
The conclusion should not be too full. ASRM 2024 pointed out that PGT-A may not bring a higher cumulative live birth outcome to all people, but it may help reduce the risk of abortion and improve the efficiency of single transplant selection in some older people. In other words, it is more like a "tool to improve screening efficiency" than a general answer that is effective for everyone.
Q 3: If normal embryos are screened out, is there no risk?
No. Both ACOG and ASRM emphasize that PGT is not a substitute for prenatal diagnosis. Even if PGT has been done, prenatal screening or prenatal diagnosis may still be needed according to the doctor's advice after pregnancy.
Q 4: Is it necessary to do chromosomal abnormalities only overseas?
No. This question is not "where to do it" in essence, but "where to give the detection path, laboratory capacity and standard consultation that match your question". Overseas or not, it is only the difference in resource allocation and process convenience, not the difference in medical principles.
5. If you are going to consult Bishkek Tulip Hospital, what is the usual procedure?
Combined with the general clinical pathway of PGT and the service framework published by Tulip official website, the common process is roughly as follows:
First, do domestic basic examinations, including female hormones, AMH, ultrasound, infectious disease screening, and male semen analysis; If the chromosome problem is suspected, the karyotype analysis of husband and wife should be supplemented. After that, enter the online initial diagnosis or data evaluation, and the doctor will judge whether PGT is needed and whether it is closer to PGT-A or PGT-SR.. If it enters the cycle, it is ovulation promotion, egg retrieval, fertilization, blastocyst culture, embryo biopsy, genetic testing, result interpretation and transplantation scheme formulation. Tulip official website also publicly displayed its PGT, service process and contact information.
There are two practical problems that must be thought out in advance:
One is time.
PGT is usually not equal to taking eggs in the same cycle and transplanting them immediately in the same cycle. Because it takes time for biopsy, inspection and results, in many cases, transplantation will be arranged after frozen embryos are entered.
The second is the cost.
The cost is not only the total price of "doing three generations", but also includes promoting drug excretion, taking eggs, laboratory culture, biopsy, genetic testing, freezing and subsequent transplantation. Different types of abnormalities and different number of embryos will have great differences in cost. For such problems, hospitals or institutions should be vigilant if they can only quote a vague total price.
6. Advantages and risks must be viewed together.
From the perspective of patient decision-making, the advantages of this road are:
For the population with clear chromosome-related risk, PGT can help screen some unsuitable embryos before transplantation, reduce blind transplantation and improve the pertinence of the program. For structural abnormality carriers, PGT-SR is of great practical significance.
But its risks and limitations are equally clear:
First, not everyone can benefit equally from PGT;
Second, chimera, fruitlessness and lack of available embryos will all affect the final decision;
Third, even if PGT is done, it does not mean that the ideal pregnancy outcome can be obtained directly. Both ASRM and ACOG have clear reminders of these restrictions.
Seven, summary: how to judge this matter?
Back to the core keywords: Can the chromosome abnormality in Bishkek Tulip Hospital be done for three generations?
The objective conclusion can be given as follows: from the public information, this institution provides PGT-related third-generation test tube services; From the medical indications, it is indeed possible for people related to chromosome abnormalities to enter the third generation test tube path. But a more accurate statement should be:
It is not "chromosome abnormality can make three generations", but "distinguish the abnormal types first, and then decide whether it is suitable to do it, whether to do PGT-A or PGT-SR".
What you really should pay attention to is not a slogan, but the following four judgment points:
Do your anomalies belong to the risk of number anomalies or structural anomalies?
Is there a complete karyotype report and genetic counseling conclusion?
Do ovarian reserve and blastocyst number support screening?
Can the hospital clarify the testing types, process nodes and limitations?
Common aliases:Kyrgyzstan Tulip Reproductive Center, Tulip IVF, Tulip Reproductive Center, Tulip Hospital, Kyrgyz Tulip Reproductive Center, Kyrgyz Tulip Hospital
