The transfer of mosaic embryos in assisted reproductive technology (ART) presents both promising opportunities and significant challenges. On the positive side mosaic embryos offer increased chances of pregnancy and live birth for patients lacking euploid embryos. Studies have shown that low-level mosaic embryos can implant and develop similarly to euploid embryos, offering hope to those with limited options. The potential for embryonic self-correction, where abnormal cells are eliminated during development, supports the viability of mosaic embryos. Ethical considerations emphasize respecting patient autonomy by providing the choice to transfer mosaic embryos after thorough counseling. Advances in genetic testing have improved the detection and understanding of mosaicism, enabling more informed decision-making.
On the other hand, there are notable challenges. Mosaic embryos have reduced reproductive performance compared to euploid ones, with lower implantation and higher miscarriage rates. The inability to accurately predict reproductive outcomes or the health of resulting offspring introduces uncertainty. Mosaicism is influenced by various biological, clinical, and technical factors, including parental age and laboratory conditions, raising concerns about diagnostic accuracy. Managing mosaic embryos adds complexity to ART programs, increasing demands on genetic counseling, cryobank storage, and risk management. Ethical and legal implications arise from transferring embryos with uncertain outcomes, necessitating comprehensive patient education and consent.
In conclusion, while transferring mosaic embryos can expand reproductive options, it also introduces significant uncertainties and challenges. Careful consideration, ongoing research, and individualized patient counseling are essential to optimize outcomes and ensure ethical practice in ART.