SOUČINNOST GENETICKÉ PORADNY, CYTOGENETICKÉLABORATOŘE A CENTRA IVF PŘI LÉČBĚPORUCH PLODNOSTI*

Cooperation of Genetic Counselling Centre, Cytogenetic Laboratoryand in vitro Fertilization Centre in Infertility Treatment

The techniques of assisted reproduction have recently become the most effective methods of treatment of infertility;namely ICSI (intra-cytoplasmic sperm injection), MESA (microepididymal sperm aspiration), TESA (testicularsperm aspiration) and TESE (testicular sperm extraction). The techniques have been increasingly successful, evenabove the average efficiency of classical IVF (in vitro fertilization). It can be demonstrated by the percentage ofICSI - aided births percentage per 100 % of embryotransfers in ISCARE; 1996 = 21.3 %, 1997 = 26.15 %, 1998 =29.7 %. The successful use of these techniques is associated with the rise of risks which result from the selection ofcouples for assisted reproduction with genetic-based infertility and with the rise of risks involving the introductionof genetic-based defects into the next generation. Presently, a list of indications is being developed, which, whilestill not accepted officially, identifies patients for genetic counselling. Only the counselling center has the competenceto estimate genetic risks over generations. Subsequently, after selection by the center, during 1997 and 1998 thechromosomes of 731 patients were cytogenetically examined, representing 429 infertile couples from the centresISCARE, PRONATAL, FERTIMED, and CAR 1. LF UK. Within these 429 couples, belonging to four groups ofindications, the cytogenetic examination was informative in 8.15 %. This finding of a relatively high percentage (10times more than in the general population) confirms the validity of the list of indications and the necessity ofcooperation among the genetic counselling center, cytogenetic laboratory and the IVF centre.

Key words:
assisted reproduction, genetic based infertility, qenetic based risk, cytogenetic examination.