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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.
Is it necessary to do the third generation test tube overseas by balanced translocation? The third generation test tube PGT technology, the overseas test tube baby process, the abnormal chromosome birth plan, the test tube in Kyrgyzstan, the chromosome screening for the pregnant elderly, the reasons for repeated abortion, and the test tube baby is suitable for the population.
Do you have to do three generations of test tubes for balanced translocation? Three key judgments tell you whether it is necessary to go overseas.
1. What is "balanced translocation"? Why does it affect pregnancy?
In genetics, the so-called "balanced translocation" refers to the fragment exchange between chromosomes, but the overall amount of genetic material has not increased or decreased significantly.
On the surface, this kind of people usually live normally without obvious physical abnormalities, so many people are discovered after pregnancy failure or repeated abortion.
But the crux of the problem is:
Unbalanced chromosomes may be produced during gamete formation.
Embryos may be deleted or duplicated.
As a result:
Abnormal embryonic development
Implantation failure
Early abortion
According to Hum Reprod Update, about 40%–70% of embryos of balanced translocation carriers may have abnormal karyotypes after natural conception (data source: review of international literature on assisted reproduction).
This is why many people will start to consider the third generation test tube (PGT).
How to solve the problems of the second and third generation test tubes (PGT)
The so-called third-generation test tubes, medically known as preimplantation genetic testing (PGT), mainly include:
PGT-A: Screening for abnormal chromosome number
PGT-SR: for structural abnormalities (such as equilibrium translocation)
PGT-M: For Monogenic Diseases
For balanced translocation population, the core technology is:
PGT-SR (structural rearrangement screening)
Its logic is:
Obtaining multiple embryos by in vitro fertilization
Take a few cells in blastocyst stage.
Perform chromosome structure analysis
Embryos with normal or balanced chromosomes were selected for transplantation.
This can reduce abnormal embryos from entering the uterus at the source.
Expert tip:
PGT technology can reduce the probability of abnormal embryo transfer, but it can't completely avoid abortion or improve the live birth rate to an absolute level, and there are still individual differences in clinic.
Third, which people are more necessary to consider the third generation of test tubes?
Not all carriers of balanced translocation have to do three generations of test tubes, and the key depends on the risk performance.
Common clinical suggestions are to consider the population.
Recurrent spontaneous abortion (≥2 times)
The test tube failed many times but the reason was not clear.
Have a history of fetal or fetal arrest with chromosomal abnormalities.
The risk of overlapping chromosomes in older people (≥35 years old)
The man or woman is clearly a balanced translocation carrier.
For the following people, it can be evaluated individually:
Not trying to conceive naturally.
No history of abortion
There is no obvious genetic problem in the family.
Medical advice is usually:
"Whether to do PGT is not to see whether there is translocation, but to see whether the birth risk has been reflected."
4. Why do some people choose to "do it overseas"?
Regarding "Is it necessary to make third-generation test tubes overseas by balanced translocation", the essence is not a technical problem, but a difference in medical environment and resources.
Common considerations include:
1. Technical accessibility
Some areas:
PGT-SR was developed late.
There are differences in laboratory experience.
And some overseas centers:
Long-term treatment of complex chromosome cases
The laboratory system is more mature.
2. Flexibility of medical process
Some countries are more flexible in the following aspects:
Single or special population policy
Embryo number and screening strategy
Transplant scheme selection
3. Cycle efficiency
In clinical practice, some overseas institutions can:
Periodic convergence is more compact.
The interval between detection and transplantation is shorter.
But it needs to be emphasized that:
Overseas does not mean a higher success rate, but adapting to different demand scenarios.
5. What is a complete three-generation test tube process?
Whether at home or overseas, the core process is basically the same:
Pre-examination and genetic counseling
Karyotype analysis
Reproductive function evaluation
Ovulation promotion and egg retrieval
Use drugs to promote the development of multiple follicles
In vitro fertilization (IVF/ICSI)
Sperm and eggs combine to form embryos.
Blastocyst culture (day 5-6)
Embryo biopsy+PGT detection
Results Analysis and Embryo Screening
Embryo transfer or cryopreservation
The whole cycle usually requires:
1–2 months (single cycle)
Accumulate enough embryos in multiple cycles (part of the population)
Expert tip:
The proportion of available embryos in patients with balanced translocation may be low, so it is sometimes necessary to take eggs many times, which is a realistic factor that must be considered when making decisions.
1. Is it necessary to make three generations of test tubes for balanced translocation?
Not necessarily.
Key judgment criteria:
Have you ever had a history of bad pregnancy?
Can you accept the risk of spontaneous abortion?
Age factor
Medically, it is "optional but not mandatory"
2. Do it overseas, will the success rate be higher?
There is no absolute conclusion.
The success rate depends on:
Egg quality
Sperm quality
Embryo number
Laboratory level
Region is only one of the influencing factors.
3. Can a healthy child be born after PGT screening?
I can't.
The reasons include:
Factors other than chromosome (uterine environment, immune factors, etc.)
Embryo self-development potential
PGT reduces risks, but it does not mean eliminating risks.
4. Are all embryos screened?
Clinically, it is usually recommended that:
Balanced translocation population → suggested screening
General population → individualized selection
VII. Summary: How to judge "Is it necessary"
From the perspective of medical decision-making, we can use a simple logical judgment:
Case 1: It is recommended to give priority to the third generation of test tubes.
abortion
Clear the history of chromosomal abnormalities
Age superposition risk
Necessity: medium-high
Case 2: You can try natural or ordinary test tubes first.
Not pregnant or just trying for a short time
No bad pregnancy history
Necessity: low-medium
Situation 3: Whether to go overseas?
Depends on:
Requirements for cycle efficiency
Preference for the choice of medical resources
Individual policy adapts to demand
Necessity: individual differences are obvious.
Final conclusion
Whether it is necessary to make a third-generation test tube overseas by balanced translocation is essentially a risk management problem, not a technical problem.
PGT can reduce the risk of abnormal embryos (evidence is sufficient)
Whether it must be done depends on previous fertility performance.
Whether to go overseas depends on resource matching and personal needs.
Common aliases:Kyrgyzstan Tulip Reproductive Center, Tulip IVF, Tulip Reproductive Center, Tulip Hospital, Kyrgyz Tulip Reproductive Center, Kyrgyz Tulip Hospital
