{"id":14142,"date":"2017-07-07T11:32:11","date_gmt":"2017-07-07T09:32:11","guid":{"rendered":"https:\/\/reproduccionbilbao.es\/?p=9259"},"modified":"2026-04-15T11:57:04","modified_gmt":"2026-04-15T11:57:04","slug":"should-we-perform-pgs-pgt-in-all-patients","status":"publish","type":"post","link":"https:\/\/reproduccionbilbao.es\/fr\/should-we-perform-pgs-pgt-in-all-patients\/","title":{"rendered":"\u201cSHOULD WE PERFORM PGS PGT IN ALL PATIENTS?\u201d"},"content":{"rendered":"<p style=\"text-align: justify;\"><a href=\"https:\/\/reproduccionbilbao.es\/maria-de-las-heras-martinez\" target=\"_blank\" rel=\"noopener\">Por Mar\u00eda de las Heras<\/a><\/p>\n<p style=\"text-align: justify;\">Durante la celebraci\u00f3n del congreso anual de la European Society for Human Reproduction (ESHRE) que ha tenido lugar en Ginebra del 2 al 5 de Julio pudimos asistir a un interesante debate titulado \u201cSHOULD WE PERFORM PGS PGT IN ALL PATIENTS?\u201d y protagonizado por Laura Rienzi (a favor) y Sjoerd Reping (en contra) sobre un tema de actualidad en la Reproducci\u00f3n Asistida, el screening gen\u00e9tico preimplantacional (SGP).<\/p>\n<p style=\"text-align: justify;\">El <a href=\"https:\/\/reproduccionbilbao.es\/terminologia-medica\/\" target=\"_blank\" rel=\"noopener\">diagnostico gen\u00e9tico preimplantacional (DGP)<\/a> se desarroll\u00f3 inicialmente como una t\u00e9cnica para evitar la transmisi\u00f3n de enfermedades gen\u00e9ticas, monog\u00e9nicas \u00f3 estructurales, a la descendencia. Poco despu\u00e9s, apareci\u00f3 el screnning genetico preimplantacional (SGP) como una t\u00e9cnica de diagn\u00f3stico prenatal muy temprana, preimplantacional de hecho. El SGP consiste en la caracterizaci\u00f3n de la dotaci\u00f3n cromos\u00f3mica de los embriones generados por fecundaci\u00f3n in vitro (FIV) para evitar la transferencia de embriones cromos\u00f3micamente anormales (aneuploides). A d\u00eda de hoy no hay un consenso claro sobre las indicaciones del PGS, la literatura sugiere edad materna avanzada, abortos de repetici\u00f3n y fallos repetidos de FIV.<\/p>\n<p style=\"text-align: justify;\">Se sabe, que las aneuploidias cromos\u00f3micas son la principal causa de fallo de implantaci\u00f3n y abortos, tanto in vivo como in vitro, y que su prevalencia en el embri\u00f3n esta directamente relacionada con la edad materna. En teor\u00eda, todas las pacientes que se someten a un tratamiento de fecundaci\u00f3n in vitro tienen riesgo de generar embriones aneuploides y por ello, todas ellas podr\u00edan verse beneficiadas por el SGP. En sus inicios, el SGP presentaba limitaciones en cuanto al n\u00famero de cromosomas que se pod\u00edan estudiar (\u00fanicamente 9) y al momento en el que se realizaba la biopsia, en D3. Actualmente la biopsia se realiza en estadio de blastocisto (D5\/D6) y se estudia la dotaci\u00f3n cromos\u00f3mica completa mediante \u201cnext generation sequency (NGS)\u201d, lo que permite un diagn\u00f3stico m\u00e1s preciso y menor riesgo para los embriones.<\/p>\n<p style=\"text-align: justify;\">Laura Rienzi defiende que se trata de una t\u00e9cnica que deber\u00eda ser aplicada a todas las pacientes de FIV y que se deber\u00eda dejar de hablar de \u201cdiagnostico gen\u00e9tico preimplantacional (DGP)\u201d para hablar de \u201ctest gen\u00e9tico preimplantacional (TGP)\u201d. Se han llevado a cabo estudios randomizados que muestran un aumento en la tasa de implantaci\u00f3n y una disminuci\u00f3n en la tasa de aborto. Sin embargo, Sjored Reping, hizo hincapi\u00e9 en que \u00e9stos estudios muestran tambi\u00e9n que no se trata de una t\u00e9cnica que aumente la tasa de \u201cni\u00f1o vivo en casa\u201d, aunque tampoco la disminuye, como bien indico Laura Rienzi. Los pacientes, indico Sjored, deben tener claro que el SGP no aumenta sus posibilidades de tener un ni\u00f1o vivo sano, lo que permite es \u00fanicamente disminuir el n\u00famero de transferencias que hay que realizar para conseguirlo y el n\u00famero de posibles abortos (lo que no es poco). En esta l\u00ednea, Laura Rienzi defendi\u00f3 el SGP como una herramienta para la implementaci\u00f3n de la transferencia de un \u00fanico embri\u00f3n, ya que la literatura muestra que la transferencia de un \u00fanico embri\u00f3n euploide iguala la tasa de ni\u00f1o nacido vivo tras la transferencia de dos embriones no analizados, mejorando tambi\u00e9n los resultados obst\u00e9tricos.<\/p>\n<p style=\"text-align: justify;\">Las limitaciones principales presentadas por Laura Rienzi para la implantaci\u00f3n del SGP fueron por un lado la necesidad de un high-standard laboratory\u201d que asegure unas buenas tasas de cultivo hasta blastocisto, biopsia en estadio de blastocisto y superviviencia a la vitrificaci\u00f3n y por otro lado el coste econ\u00f3mico que supone a las pacientes.<\/p>\n<p style=\"text-align: justify;\">Son necesarios m\u00e1s estudios que por un lado analicen el coste-efectividad del SGP, tendiendo en cuenta tanto el coste del tratamiento como los costes obst\u00e9tricos y perinatales y por otro lado m\u00e1s estudios randomizados para determinar si el SGP debe ser realizado a todos las pacientes de FIV o a aquellas con un mayor riesgo de generar embriones aneuploides.<\/p>\n<p style=\"text-align: justify;\">En cualquier caso, los pacientes deben recibir la informaci\u00f3n correcta sobre sus posibilidades de conseguir un ni\u00f1o vivo en casa, la duraci\u00f3n y coste del tratamiento y las posibles complicaciones obst\u00e9tricas para poder tomar su propia decisi\u00f3n.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Por Mar\u00eda de las Heras Durante la celebraci\u00f3n del congreso anual de la European Society for Human Reproduction (ESHRE) que ha tenido lugar en Ginebra del 2 al 5 de Julio pudimos asistir a un interesante debate titulado \u201cSHOULD WE PERFORM PGS PGT IN ALL PATIENTS?\u201d y protagonizado por Laura Rienzi (a favor) y Sjoerd <\/p>\n<div class=\"btn-more-wrapper\"><a href=\"https:\/\/reproduccionbilbao.es\/fr\/should-we-perform-pgs-pgt-in-all-patients\/\" class=\"btn btn-sm btn-hover-fill\"><svg class=\"icon icon-right-arrow\" version=\"1.1\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"32\" height=\"32\" viewBox=\"0 0 32 32\"><title>right-arrow<\/title><path d=\"M21.548 5.088c-0.436-0.451-1.162-0.451-1.613 0-0.436 0.436-0.436 1.162 0 1.596l8.177 8.177h-26.984c-0.629 0.001-1.129 0.501-1.129 1.13s0.5 1.145 1.129 1.145h26.984l-8.177 8.162c-0.436 0.451-0.436 1.178 0 1.613 0.451 0.451 1.178 0.451 1.613 0l10.113-10.113c0.451-0.436 0.451-1.162 0-1.596l-10.113-10.114z\"><\/path><\/svg>Read More<span class=\"screen-reader-text\"> \u00ab\u00a0\u201cSHOULD WE PERFORM PGS PGT IN ALL PATIENTS?\u201d\u00a0\u00bb<\/span><svg class=\"icon icon-right-arrow\" version=\"1.1\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"32\" height=\"32\" viewBox=\"0 0 32 32\"><title>right-arrow<\/title><path d=\"M21.548 5.088c-0.436-0.451-1.162-0.451-1.613 0-0.436 0.436-0.436 1.162 0 1.596l8.177 8.177h-26.984c-0.629 0.001-1.129 0.501-1.129 1.13s0.5 1.145 1.129 1.145h26.984l-8.177 8.162c-0.436 0.451-0.436 1.178 0 1.613 0.451 0.451 1.178 0.451 1.613 0l10.113-10.113c0.451-0.436 0.451-1.162 0-1.596l-10.113-10.114z\"><\/path><\/svg><\/a><\/div>\n","protected":false},"author":9,"featured_media":8934,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[],"class_list":["post-14142","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-noticias"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - 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