1
|
Simpson JL, Rechitsky S. Preimplantation genetic testing to reduce preterm births in assisted reproductive technology. Int J Gynaecol Obstet 2020; 150:34-40. [PMID: 32524593 DOI: 10.1002/ijgo.13192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 05/06/2020] [Indexed: 11/12/2022]
Abstract
The 10% rate of preterm birth rate worldwide has not been proved amenable to reduction. Avoiding multiple embryo transfer in assisted reproductive technologies (ART) using in vitro fertilization is one unassailable method. Preimplantation genetic testing (PGT) to select only a single euploid embryo for transfer is one unequivocal way, maintaining 50%-60% pregnancy rates while avoiding twins. Contemporary methodology entails trophectoderm biopsy of a 5-6-day blastocyst, and cryopreservation of biopsied embryos while awaiting analysis by next generation sequencing. Embryo biopsy is safe, analytic validity for chromosomal analysis high, and global access to PGT high.
Collapse
Affiliation(s)
- Joe L Simpson
- Department of Obstetrics and Gynecology, Florida International University Herbert Wertheim College of Medicine, Miami, FL, USA.,Department of Human and Molecular Genetics, Florida International University Herbert Wertheim College of Medicine, Miami, FL, USA.,Reproductive Genetic Innovations, Northbrook, IL, USA
| | - Svetlana Rechitsky
- Department of Human and Molecular Genetics, Florida International University Herbert Wertheim College of Medicine, Miami, FL, USA.,Reproductive Genetic Innovations, Northbrook, IL, USA
| |
Collapse
|
2
|
Simpson JL, Kuliev A, Rechitsky S. Overview of Preimplantation Genetic Diagnosis (PGD): Historical Perspective and Future Direction. Methods Mol Biol 2019; 1885:23-43. [PMID: 30506188 DOI: 10.1007/978-1-4939-8889-1_2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Preimplantation genetic diagnosis (PGD) can be considered the earliest form of prenatal testing. It was first used in humans over 26 years ago. At its inception, PGD could only be performed for a limited number of genetic disorders. Technological advances in molecular biology and cytogenomics have been utilized in the field of PGD to greatly expand the spectrum of genetic disorders that can now be detected in early human embryos.
Collapse
Affiliation(s)
- Joe Leigh Simpson
- March of Dimes Foundation, White Plains, NY, USA. .,Florida International University, Miami, FL, USA. .,Reproductive Genetics Institute, Inc. (RGI), Northbrook, IL, USA.
| | - Anver Kuliev
- Florida International University, Miami, FL, USA.,Reproductive Genetics Institute, Inc. (RGI), Northbrook, IL, USA
| | - Svetlana Rechitsky
- Florida International University, Miami, FL, USA.,Reproductive Genetics Institute, Inc. (RGI), Northbrook, IL, USA
| |
Collapse
|
3
|
Romero R. A profile of Alan H. DeCherney, MD. Am J Obstet Gynecol 2017; 217:389.e1-389.e12. [PMID: 28692822 DOI: 10.1016/j.ajog.2017.06.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 06/26/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Roberto Romero
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services.
| |
Collapse
|
4
|
Simpson JL, Rechitsky S. Preimplantation diagnosis and other modern methods for prenatal diagnosis. J Steroid Biochem Mol Biol 2017; 165:124-130. [PMID: 27108943 DOI: 10.1016/j.jsbmb.2016.03.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 03/16/2016] [Indexed: 12/15/2022]
Abstract
Prenatal treatment of congenital adrenal hyperplasia (CAH) has long involved prenatal treatment with dexamethasone, administered to the pregnant woman to prevent genital masculinization of an affected female fetus. Although it is unnecessary to treat unaffected or affected males because their genital development would not be disturbed, there has only been incremental progress in determining fetal gender sufficiently each to avoid treating males and unaffected females. Invasive procedures were initially necessary, with first-trimester amniocentesis at 15-20 weeks and then chorionic villus sampling (CVS) at 10-12 weeks gestation. Two approaches now allow personalized treatment of affected female fetuses prior to female genital differentiation. Only preimplantation genetic diagnosis (PGD) is available prior to clinical pregnancy. Recent technological advances have further allowed both single gene diagnosis (e.g., CAH) and aneuploidy detection concomitantly, resulting in far better pregnancy rates than heretofore possible in assisted reproduction technology.
Collapse
Affiliation(s)
- Joe Leigh Simpson
- March of Dimes Foundation, 1275 Mamaroneck Avenue, White Plains, NY 10605, USA; Florida International University, Herbert Wertheim College of Medicine, 11200 SW 8th Street, AHC2 667, USA; Reproductive Genetics Innovation, 2910 MacArthur Blvd., Northbrook, IL 60062, USA.
| | - Svetlana Rechitsky
- Florida International University, Herbert Wertheim College of Medicine, 11200 SW 8th Street, AHC2 667, USA; Reproductive Genetics Innovation, 2910 MacArthur Blvd., Northbrook, IL 60062, USA
| |
Collapse
|
5
|
Early human embryos are naturally aneuploid-can that be corrected? J Assist Reprod Genet 2016; 34:15-21. [PMID: 27900612 PMCID: PMC5330987 DOI: 10.1007/s10815-016-0845-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 11/14/2016] [Indexed: 11/16/2022] Open
Abstract
Aneuploidy is common and may be a natural occurrence in early human embryos. Selecting against embryos containing aneuploid cells for embryo transfer has been reported to increase clinical pregnancies per transfer in some studies, but not others. Some aneuploidy is due to misallocation of chromosomes during meiosis, in either the egg or sperm, but most aneuploidy is due to misallocation of chromosomes during mitoses after fertilization. Big questions are as follows: Why does this happen? How much aneuploidy in a preimplantation embryo is compatible with normal fetal development? Is aneuploidy increased by in vitro culture, and/or could it be prevented or corrected in the IVF lab?
Collapse
|
6
|
Eskandarani H. Pre-implantation Genetic Diagnosis in the Gulf Cooperative Council Countries: Utilization and Ethical Attitudes. ACTA ACUST UNITED AC 2015; 15:68-74. [DOI: 10.1558/hrge.v15i2.68] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
7
|
|
8
|
Theodosiou AA, Johnson MH. The politics of human embryo research and the motivation to achieve PGD. Reprod Biomed Online 2011; 22:457-71. [PMID: 21397558 PMCID: PMC3101706 DOI: 10.1016/j.rbmo.2011.01.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Revised: 12/07/2010] [Accepted: 01/05/2011] [Indexed: 11/07/2022]
Abstract
This article reports a historical study of factors influencing the achievement of clinical preimplantation genetic diagnosis (PGD) in 1990, 22 years after its first demonstration in animals. During the 1970s, research on PGD continued in large farm animals, but serious interest in human PGD was not evident until 1986. First, interest in PGD during the 1970s waned with the advent of prenatal testing, which for gynaecologists was clinically more familiar, technically simpler and ethically less challenging than IVF. Indeed, IVF was viewed with widespread suspicion until the first IVF births in 1978. Second, interest in clinical PGD was stimulated by the UK Parliamentary reaction against human embryo research that greeted the Warnock Report in 1984. This hostility led scientists to initiate a pro-research campaign, further galvanized in 1985 by MP Enoch Powell’s bid to ban such research. However, while Powell abhorred embryo research, he approved of PGD, a stance that divided the anti-research lobby. Accordingly, the campaigners for research emphasized that it was needed to achieve PGD. Powell demanded evidence of such projects and PGD research increased from 1986. It is concluded that UK political debates on embryo research played a critical role in stimulating the achievement of clinical PGD. Human pregnancies following preimplantation genetic diagnosis (PGD) for embryo sex were announced in 1990, 22 years after the technique was pioneered in animals. PGD in humans required not only technological advances, such as IVF and sensitive diagnostic tests, but also the motivation to develop and apply them. Our historical analysis shows that, although research on PGD continued in large farm animals during the 1970s, and techniques of the required sensitivity were developed on mouse embryo models, interest in clinical PGD was not evident until 1986. Two factors stimulated this sudden change in motivation. First, interest in PGD was depressed during the 1970s by the advent of prenatal diagnostic techniques, which for gynaecologists were clinically, technically and ethically less challenging than IVF. IVF was then regarded with a suspicion that only started to wane in the early 1980s following the first IVF births. Second, the UK Parliamentary reaction against human embryo research that greeted the Warnock Report in 1984 provided a positive stimulus to clinical PGD by prompting scientists to form a pro-research lobby, which was further galvanized in early 1985 by MP Enoch Powell’s almost-successful bid to ban human embryo research. We show that while Powell abhorred embryo research, he approved of PGD, a stance that fractured the unity of the anti-research lobby. Accordingly, the pro-research lobby emphasized that embryo research was needed to achieve PGD. Powell demanded evidence of such projects, thereby, we argue, stimulating PGD research from 1986. Our evidence shows that UK political debates about PGD played a critical role in stimulating the achievement of PGD clinically.
Collapse
Affiliation(s)
- Anastasia A Theodosiou
- Anatomy School and Trophoblast Research Centre, Department of Physiology, Development and Neuroscience, Downing Street, Cambridge CB2 3DY, UK
| | | |
Collapse
|
9
|
Abstract
First reported in 1990, PGD has evolved into a complementary form of prenatal diagnosis offering novel indications. DNA for PGD can be recovered with equal safety and facility from polar bodies I and II, blastomere (8 cell embryo) and trophectoderm (5-6 day blastocyst). Diagnostic accuracy is very high (>99%) for both chromosomal abnormalities and single gene disorders. Traditional application of FISH with chromosome specific probes for detecting aneuploidy and translocations may be replaced or complemented by array comparative genome hybridization (array CGH); biopsied embryos can now be cryopreserved (vitrification) while analysis proceeds in orderly fashion. PGD has been accomplished for over 200 different single gene disorders. Novel indications for PGD not readily applicable by traditional prenatal genetic diagnosis include avoiding clinical pregnancy termination, performing preconceptional diagnosis (polar body I), obtaining prenatal diagnosis without disclosure of prenatal genotype (nondisclosure), diagnosing adult-onset disorders particularly cancer, and identifying HLA compatible embryos suitable for recovering umbilical cord blood stem cells.
Collapse
Affiliation(s)
- Joe Leigh Simpson
- Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA.
| |
Collapse
|
10
|
Kubisch HM, Johnson KM. The Effects of Blastomere Biopsy and Oxygen Tension on Bovine Embryo Development, Rate of Apoptosis and Interferon-? Secretion. Reprod Domest Anim 2007; 42:509-15. [PMID: 17845607 DOI: 10.1111/j.1439-0531.2006.00814.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A series of experiments was performed to examine the effects of blastomere biopsies on subsequent development of IVF-derived bovine embryos. The first experiment was designed to assess the optimal time for blastomere removal. One blastomere was removed either 48 or 72 h after IVF. Biopsy at 48 h resulted in 17.2% of embryos proceeding to the blastocyst stage, which was lower than when biopsies were performed at 72 h (37.5%, p < 0.05). In the second experiment, embryos were cultured either under atmospheric or 5% O(2) following blastomere removal. Biopsies had no effect on rate of blastocyst formation with 36% of controls and 33.7% of biopsied embryos proceeding to that stage. However, culture under 5% O(2) significantly increased the number of blastocysts from 29.9% to 40.3% (p < 0.05). This effect was significant in both biopsied and control embryos. In the final experiment, biopsied embryos were again cultured under different oxygen tension. Blastocysts were collected and cultured individually for 48 h in medium droplets in their respective O(2) concentration after which time the medium was assayed for concentration of interferon-tau (IFN-tau). Reduced O(2) concentration again significantly increased blastocyst formation from 24.9% to 41.9% (p < 0.05). IFN-tau secretion was not affected by biopsies, but culture under atmospheric O(2) resulted in significantly increased IFN-tau concentration in medium droplets (12274.0 +/- 2825.9 pM vs 5046.5 +/- 2562.2 pM; p < 0.05).
Collapse
Affiliation(s)
- H M Kubisch
- Unit of Reproductive Biology, Division of Veterinary Medicine, Tulane National Primate Research Center, Covington, LA 70433, USA.
| | | |
Collapse
|
11
|
Luo H, Zhu G, Liu Q, Chen W, Li Z. Establishment of a simple and useful way for preimplantation genetic diagnosis of chromosomal diseases. ACTA ACUST UNITED AC 2007; 27:315-7. [PMID: 17641851 DOI: 10.1007/s11596-007-0325-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2006] [Indexed: 11/30/2022]
Abstract
In order to establish a simple and useful way for preimplantation genetic diagnosis (PGD) of chromosomal diseases in general IVF laboratory, the methods that are most commonly used in the embryo biopsy, fixation of blastomere and fluorescence in situ hybridization were compared. The three aspects of PGD were analyzed respectively. There was no significant difference in further development capacity of embryos between mechanical (79.7%) and chemical biopsy group (78.6%) (P>0.05). In this study, more cells were successfully fixed with the Tween/HCL method (93.8%) than with the methanol/acetic acid method (80.5%, P<0.05). There was no significant difference in cytoplasm remains between methanol/acetic acid method and Tween/HCL method (P>0.05). The hybridization efficiency of fluorescence in situ hybridization was 89.5% in successive denaturation method and 90.9% in codenaturation method with the difference being not significant (P>0.05). In conclusion, the mechanical or chemical method, Tween/HCL fixation method and codenaturation fluorescence in situ hybridization method can constitute a simple and useful way for PGD of chromosomal diseases.
Collapse
Affiliation(s)
- Haining Luo
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
| | | | | | | | | |
Collapse
|
12
|
Wang CW, Yao DS, Horng SG, Chiu HC, Chen CK, Lee CL, Huang HY, Wang HS, Soong YK, Pao CC. Feasibility of human telomerase reverse transcriptase mRNA expression in individual blastomeres as an indicator of early embryo development. J Assist Reprod Genet 2005; 21:163-8. [PMID: 15279323 PMCID: PMC3455524 DOI: 10.1023/b:jarg.0000031249.37862.3a] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE The study was undertaken to test whether human telomerase reverse transcriptase (hTERT) transcripts in an individual blastomere could be used as an indicator for embryo development. METHODS Group A consisted of day 3 normal cleaving embryos at 4- to 8-cell stage, which were surplus and not allocated for uterine transfer. Group B consisted of arrested or fragmented embryos at the same stage, which were considered to be compromised. After blastomere dissociation, RNA purification, reverse transcription, and hTERT PCR amplification, the amplified product was separated by 3% gel electrophoresis. RESULTS Eighty-six (90.5%) of the 95 intact blastomeres in group A and 78 (70.9%) of the 110 blastomeres in group B demonstrated hTERT mRNA expression. The difference was statistically significant (P < 0.05, chi-square). Eight (38.1%) of the 21 embryos in group A and 22 (62.9%) of the 35 embryos in group B had at least one blastomere that did not express hTERT mRNA under this procedure. The difference was not significant (P > 0.05, chi-square). CONCLUSIONS General hTERT mRNA transcripts can be detected in most of the individual blastomeres but cannot be used as an indicator for early embryo development. Further investigations are necessary to elucidate its clinical application.
Collapse
Affiliation(s)
- Chia-Woei Wang
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Lin-Kou Medical Center, 5 Fu-Hsing Street, Kwei-Shan, Tao-Yuan, Taiwan.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Abstract
The aim was to develop a method to optimize cryopreservation of biopsied multi-celled human embryos. Human day 3 embryos that were donated to research, along with those found to be chromosomally abnormal after blastomere biopsy and fluorescence in-situ hyridization (FISH), were cryopreserved using a slow-freezing protocol in either standard embryo cryopreservation solution [embryo transfer freezing medium (ETFM), a conventional sodium-based medium] or CJ3 (a choline-based, sodium-free medium). After thawing, the number of intact cells was recorded and the previously biopsied embryos were re-analysed using FISH. Biopsied embryos had a lower proportion of intact blastomeres after cryopreservation as compared with intact embryos. However, a significantly (P < 0.05) higher proportion of blastomeres from intact and biopsied embryos cryopreserved in CJ3 (84.1 and 80.1% respectively) survived after thaw than those in ETFM (73.6 and 50.5% respectively). The proportion of aneuploid and mosaic embryos was not statistically different between the two groups. In addition, the frequency of lost cells by aneuploid and mosaic embryos was similar. This study describes a new method that improves the survival of cryopreserved biopsied embryos, and shows that it may also be beneficial for the storage of intact human multi-celled embryos.
Collapse
|
14
|
De Vos A, Van Steirteghem A. Aspects of biopsy procedures prior to preimplantation genetic diagnosis. Prenat Diagn 2001; 21:767-80. [PMID: 11559914 DOI: 10.1002/pd.172] [Citation(s) in RCA: 107] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Today, preimplantation genetic diagnosis (PGD) is offered in over 40 centres worldwide for an expanded range of genetic defects causing disease. This very early form of prenatal diagnosis involves the detection of affected embryos by fluorescent in situ hybridization (FISH) (sex determination or chromosomal defects) or by polymerase chain reaction (PCR) (monogenic diseases) prior to implantation. Genetic analysis of the embryos involves the removal of some cellular mass from the embryos (one or two blastomeres at cleavage-stage or some extra-embryonic trophectoderm cells at the blastocyst stage) by means of an embryo biopsy procedure. Genetic analysis can also be performed preconceptionally by removal of the first polar body. However, additional information is then often gained by removal of the second polar body and/or a blastomere from the embryo. Removal of polar bodies or cellular material from embryos requires an opening in the zona pellucida, which can be created in a mechanical way (partial zona dissection) or chemical way (acidic Tyrode's solution). However, the more recent introduction of laser technology has facilitated this step enormously. Different biopsy procedures at different preimplantation stages are reviewed here, including their pros and cons and their clinical applications. The following aspects will also be discussed: safety of zona drilling by laser, use of Ca2+/Mg2+-free medium for decompaction, and removal of one or two cells from cleavage-stage embryos.
Collapse
Affiliation(s)
- A De Vos
- Centre for Reproductive Medicine, University Hospital, Dutch-speaking Brussels Free University (Vrije Universiteit Brussel), Brussels, Belgium.
| | | |
Collapse
|
15
|
Kahraman S, Bahçe M, Samli H, Imirzalioğlu N, Yakisn K, Cengiz G, Dönmez E. Healthy births and ongoing pregnancies obtained by preimplantation genetic diagnosis in patients with advanced maternal age and recurrent implantation failure. Hum Reprod 2000; 15:2003-7. [PMID: 10967004 DOI: 10.1093/humrep/15.9.2003] [Citation(s) in RCA: 115] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Preimplantation genetic diagnosis (PGD) and subsequent embryo development was evaluated in 72 couples presenting at our centre for intracytoplasmic sperm injection (ICSI) due to severe male factor. The embryo biopsies were performed in Ca(2+)/Mg(2+)-free medium. These patients were further divided into those with advanced maternal age (AMA, n = 49) and those with recurrent implantation failure (RIF, n = 23). Fluorescence in-situ hybridization (FISH) was carried out on 329 blastomeres (91.3%) with probes for the X, Y, 13, 18 and 21 chromosomes. The chromosomal abnormality rate was 41.3% with no significant difference between the AMA and RIF groups. Aneuploidy accounted for the majority (72.8%) of chromosomal abnormalities. Out of 329 embryos, 84.2% had cleaved after 24 h and 15.1% had arrested. Embryos were transferred in 70 patients and 22 pregnancies were achieved (31.4% with an ongoing pregnancy rate of 28.5%). There were no significant differences between the pregnancy rates of the AMA and RIF groups (32.5 and 30% respectively). Therefore PGD should be offered to patients with AMA and RIF. Furthermore, the use of Ca(2+)/Mg(2+)-free medium during the blastomere biopsy facilitates the procedure, while further embryo cleavage, ongoing pregnancies and healthy births are possible.
Collapse
Affiliation(s)
- S Kahraman
- Sevgi Hospital, Assisted Reproductive Technologies and Reproductive Endocrinology Unit, G.A.T.A., Genetic Division and Sevgi Hospital, Genetic Division, Ankara, Turkey.
| | | | | | | | | | | | | |
Collapse
|
16
|
Chen SU, Chao KH, Wu MY, Chen CD, Ho HN, Yang YS. The simplified two-pipette technique is more efficient than the conventional three-pipette method for blastomere biopsy in human embryos. Fertil Steril 1998; 69:569-75. [PMID: 9531901 DOI: 10.1016/s0015-0282(97)00535-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate the efficiency and efficacy of a simplified two-pipette technique in comparison to the conventional three-pipette method; in the two-pipette method, a single, larger drilling/biopsy pipette is used to perform zona pellucida (ZP) drilling and blastomere aspiration for embryo biopsy. DESIGN A preclinical, prospective, randomized, in vitro experiment. SETTING The reproductive unit of a university teaching hospital. PATIENT(S) Ninety-five excess embryos at the two- to four-cell stage were obtained from 35 patients undergoing IVF. INTERVENTION(S) At the six- to eight-cell stage, 88 embryos were allocated randomly to three groups: group I for the conventional method (n = 29), group II for the simplified technique (n = 30), and group III for controls (n = 29). The embryos then were cultured in vitro. The retrieved blastomeres were fixed and examined with fluorescence in situ hybridization using X and Y probes simultaneously. MAIN OUTCOME MEASURE(S) Biopsy time, successful retrieval of a blastomere, fixation of the cell, signals developed from fluorescence in situ hybridization, and growth potential and hatching capacity of the biopsied embryos were evaluated. RESULT(S) The mean time (+/- SD) for biopsy of each embryo in group I (435 +/- 137 seconds) was significantly longer than that in group II (126 +/- 32 seconds). The success rates for obtaining an intact blastomere were not different between group I (93%) and group II (97%). The growth capacity to the blastocyst stage was similar among the three groups (34%, 37%, and 38%, respectively). However, the ZP-drilled and biopsied embryos of groups I and II had higher percentages of hatching (34% and 37%, respectively) and complete hatching (17% and 20%, respectively) than did those of group III (10% and 0, respectively). The blastomeres obtained by biopsy in groups I and II were equally fixed (90% vs. 90%, respectively) and shown in fluorescence in situ hybridization (79% vs. 80%, respectively). CONCLUSION(S) Compared with the conventional method, the simplified technique is more efficient and equally efficacious for blastomere biopsy in preimplantation genetic diagnosis.
Collapse
Affiliation(s)
- S U Chen
- Department of Obstetrics and Gynecology, College of Medicine, Taipei, Taiwan
| | | | | | | | | | | |
Collapse
|
17
|
Hossain AM, Barik S, Rizk B, Thorneycroft IH. Preconceptional sex selection: past, present, and future. ARCHIVES OF ANDROLOGY 1998; 40:3-14. [PMID: 9465998 DOI: 10.3109/01485019808987923] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Predetermination of sex in human and in farm animals is reviewed. Preconceptional sex selection has generated great interest and controversy over the years. Medical and commercial benefits outweigh the ethical issues. Technology has not yet provided a routine method for separating the X- and Y-chromosome-bearing sperm. Flow cytometry is the only technique that produces a clinically significant enrichment of X- or Y-bearing spermatozoa However, concern has been raised about the methodological implications of the flow technique because of the use of DNA stains and UV light. Some other techniques, such as gradient columns, appear to produce a slight enrichment of one type of sperm over the other, but this level of enrichment appears unlikely to affect the sex ratio at birth. It thus remains speculative whether 100% pure preparation of X or Y sperm can be obtained unless a major improvement in methodology is achieved. Fluorescence in situ hybridization (FISH) and polymerase chain reaction (PCR) are currently the methods of choice for evaluating the validity of the sex selection procedure. In view of the extraordinary pace of the technological and scientific progress, it can be expected that the clinical and commercial application of the technology of preconceptional sex selection by X and Y sperm separation will be a reality in near future.
Collapse
Affiliation(s)
- A M Hossain
- Department of Obstetrics and Gynecology, University of South Alabama, Mobile 36688, USA
| | | | | | | |
Collapse
|
18
|
Chen SU, Ho HN, Chen HF, Chao KH, Huang SC, Lee TY, Yang YS. A simplified technique for embryo biopsy: use of the same micropipette for zona drilling and blastomere aspiration. J Assist Reprod Genet 1997; 14:157-61. [PMID: 9090559 PMCID: PMC3454670 DOI: 10.1007/bf02766133] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Using different micropipettes for zona drilling and blastomere aspiration for embryo biopsy is prevalent at centers of preimplantation genetic diagnosis. The purpose of our study was to simplify the technique by using only one micropipette. METHODS In this animal model, ICR mouse embryos at the four-cell stage (n = 446) were randomly allocated into two groups; a biopsied group (n = 224) for blastomere aspiration and a control group (n = 222) without micromanipulation. We used a drilling/biopsy micropipette to drill a hole in the zona by expulsion of acidified Tyrode's solution and to aspirate the blastomere by gentle suction with the same micropipette and pull it out of the zona. One blastomere was biopsied from each embryo. RESULTS In all, 222 (99.1%) intact blastomeres were successfully biopsied from 224 embryos. Only two blastomeres were damaged during aspiration. The capacity for blastocyst development (92.4 vs 93.7%) was not different between the two groups, but the percentages of embryos hatching (51.8 vs 18.0%) and hatched (29.9 vs 8.1%) were significantly higher in the biopsied group than in the control group. CONCLUSIONS This simplified technique of embryo biopsy is safe and highly efficient for obtaining blastomeres for preimplantation genetic diagnosis and may also facilitate hatching of the blastocysts.
Collapse
Affiliation(s)
- S U Chen
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei
| | | | | | | | | | | | | |
Collapse
|
19
|
Rojas FJ, Garner C, Schiewe M, Asch RH, Balmaceda JP, Moretti-Rojas I. Enzymatic amplification of specific deoxyribonucleic acid sequences from single cells: evaluation of a simplified and rapid method for use in preimplantation genetic diagnosis. Fertil Steril 1995; 64:255-60. [PMID: 7615099 DOI: 10.1016/s0015-0282(16)57719-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To develop a simplified polymerase chain reaction (PCR) protocol on single cells for the purpose of preimplantation genetic diagnosis. Also to evaluate a new thermal cycler, RoboCycler 40 (Stratagene, La Jolla, CA), for reducing the time to complete PCR amplification. DESIGN PCR amplification without DNA purification or reamplification of a 149 base pair (bp) segment of the human Y chromosome was used as a model. The assay was tested in human fetal cells, single lymphocytes and single human blastomeres. RESULTS Amplification of the 149 bp segment using fetal cells was 100% correct. Results on single lymphocytes were concordant in all but one of the 15 male cases. However, 2 of the 25 female cases were identified as male suggesting the occurrence of DNA contamination. Analysis of 61 blastomeres were concordant in 57 cases (93%); results for male blastomeres showed 12% of false negatives. No false positives were detected for female cells. Amplification using the simplified PCR protocol in combination with the RoboCycler was completed in 2 hours. CONCLUSION These data show that this PCR assay performed directly, without DNA extraction or purification and without re-amplification is a practical and effective approach for amplification of specific DNA sequences in single cells. Furthermore, the simplified PCR protocol significantly reduced the time to complete DNA amplification. The reduced time is expected to facilitate the management of a routine program for preimplantation genetic diagnosis.
Collapse
Affiliation(s)
- F J Rojas
- Department of Obstetrics and Gynecology, University of California, Irvine, Orange, USA
| | | | | | | | | | | |
Collapse
|
20
|
Liu J, Lissens W, Van Broeckhoven C, Löfgren A, Camus M, Liebaers I, Van Steirteghem A. Normal pregnancy after preimplantation DNA diagnosis of a dystrophin gene deletion. Prenat Diagn 1995; 15:351-8. [PMID: 7617576 DOI: 10.1002/pd.1970150409] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
To perform preimplantation DNA diagnosis for Duchenne muscular dystrophy (DMD) in a female carrier of a dystrophin gene deletion of exons 3-18, we developed a polymerase chain reaction (PCR)-based assay of exon 17 sequences. Exon 17 was efficiently amplified in all 50 single blastomeres of normal control embryos and in five blastomeres of one male embryo of the DMD carrier obtained after a first preimplantation diagnosis (PID) for gender determination. In ten blastomeres of another two male embryos of the DMD carrier, no PCR signals were observed, probably as a result of the deletion. After intracytoplasmic sperm injection, embryos were analysed for exon 17 and three of the four embryos showing normal PCR signals were replaced, resulting in a singleton pregnancy. Prenatal diagnosis showed a female karyotype and DNA analysis indicated that the fetus was not a DMD carrier.
Collapse
Affiliation(s)
- J Liu
- Centre for Reproductive Medicine, University Hospital, Dutch-speaking Brussels Free University (Vrije Universiteit Brussel), Belgium
| | | | | | | | | | | | | |
Collapse
|
21
|
Bibliography. Fertil Steril 1994. [DOI: 10.1016/s0015-0282(16)57141-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
22
|
Abstract
Germ-line gene therapy, in which genetic flaws are corrected in the DNA of externally fertilized human embryos, lies in the distant yet foreseeable future. Worries about germ-line therapy have prompted international bodies to craft guidelines that are unusual for their anticipatory nature. Motivating these guidelines is the idea that a “transnational harmonization” of principles should be reached before national policies are developed. This article reviews selected national policies and international recommendations, and it concludes that national policies should be precedents for, rather than descendants of, international normative codes. The inclination to develop morally-based codes, which is implicit in transnational harmonization, will be more useful if grounded in empirically-based medical technologies and politically-tested policies rather than on abstract principles developed well in advance of technological feasibility.
Collapse
|
23
|
Muggleton-Harris AL. Inherited genetic defects: analysis and diagnosis at the cellular level in preimplantation embryos. INTERNATIONAL REVIEW OF CYTOLOGY 1994; 151:1-27. [PMID: 8014020 DOI: 10.1016/s0074-7696(08)62629-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
24
|
Griffin DK. Fluorescent in situ hybridization for the diagnosis of genetic disease at postnatal, prenatal, and preimplantation stages. INTERNATIONAL REVIEW OF CYTOLOGY 1994; 153:1-40. [PMID: 8045699 DOI: 10.1016/s0074-7696(08)62187-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- D K Griffin
- Department of Genetics and Biometry, University College London, United Kingdom
| |
Collapse
|
25
|
|
26
|
Abstract
OBJECTIVE To analyze different biopsy methods, embryo stages, and cellular masses that can be removed for preimplantation diagnosis of genetic diseases to find optimal biopsy conditions compatible with the subsequent development of the conceptus, the acquisition of intact viable blastomeres, and the reliability of the genetic analysis. DATA IDENTIFICATION The most important published studies have been identified through a computerized bibliographical search (MEDLINE; Dialog, Palo Alto, CA). STUDY SELECTION Studies reporting different embryo biopsy methods practiced at different stages have been selected. RESULTS The analysis carried out in the current review shows, at the present time, the following: [1] the displacement and push methods may be more suitable than the stitch and pull and aspiration (puncturing the zona pellucida) approaches at cleavages stages; [2] the aspiration and stitch and pull procedures may assure higher success rates than the herniation procedure at the blastocyst stage; [3] the mechanical division method and the use of acid Tyrode's solution would not be advisable before the eight-cell stage; [4] human embryos at the two-cell and blastocyst stages may not be suitable for preimplantation diagnosis because of an excessive reduction of cellular mass at the two-cell stage and a low or zero pregnancy rate after transfer at the blastocyst stage; and [5] biopsy of a quarter of the embryonic cellular mass on day 2 after insemination may increase biochemical pregnancies if the cleavage rate is not preserved. CONCLUSIONS At the present time, biopsy of a quarter of the embryo on day 3 after insemination may be the most feasible approach for preimplantation diagnosis.
Collapse
Affiliation(s)
- J J Tarín
- Institute of Obstetrics and Gynaecology, Royal Postgraduate Medical School, Hammersmith Hospital, London, United Kingdom
| | | |
Collapse
|
27
|
Munné S, Weier HU, Stein J, Grifo J, Cohen J. A fast and efficient method for simultaneous X and Y in situ hybridization of human blastomeres. J Assist Reprod Genet 1993; 10:82-90. [PMID: 8499685 DOI: 10.1007/bf01204446] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
PURPOSE To use a 6-hr fluorescence in situ hybridization (FISH) procedure involving fluorochrome-labeled probes to determine the gender of blastomeres from arrested biopsied human embryos. RESULTS Simultaneous detection of X and Y chromosomes was performed on 68 blastomeres with this technique. The FISH efficiency for gender determination was 95.5% (65/68). In addition, rehybridization with chromosome 8-specific probes was performed to determine the ploidy of blastomeres with more than two sex chromosomes. CONCLUSION This technique offers an alternative to polymerase chain reaction for the preimplantation diagnosis of X-linked diseases and can also be used for ploidy assessment.
Collapse
Affiliation(s)
- S Munné
- Gamete and Embryo Research Laboratory, New York Hospital-Cornell University Medical Center, New York 10021
| | | | | | | | | |
Collapse
|
28
|
Abstract
Only about 10% of embryos obtained after in vitro fertilization (IVF) are able to implant after transfer in utero. Detecting the viable embryos is therefore the prerequisite condition to increase the overall efficiency of the technique. Zygote and embryo morphology is partly related to their viability. Indeed, fertilized oocytes with a timely fertilization and pronuclear growth, leading to embryos with equally sized blastomeres reaching at least the 4-cell stage about 42 h after insemination, have the best chance of implanting. The metabolic approach, although requiring sensitive microassays, seems promising. Indeed, in a small series 100% of the pregnancies were predicted when the level of interleukin 1-alpha was > 60 pg/ml and the suppressive level (antiproliferative activity using tumour cell lines) was > 20% in the supernatant of transferred embryos. Lastly, invasive assessment of the chromosome status of embryos should allow us in future to discard severely abnormal embryos, thus increasing the success rate of IVF.
Collapse
|
29
|
Giacalone J, Friedes J, Francke U. A novel GC-rich human macrosatellite VNTR in Xq24 is differentially methylated on active and inactive X chromosomes. Nat Genet 1992; 1:137-43. [PMID: 1302007 DOI: 10.1038/ng0592-137] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
A new X chromosome-specific repetitive sequence, a 3 kilobase HindIII clone with a base composition of 63% C+G, has been isolated. The sequence is organized as a hypervariable tandem repeat cluster ranging in size from 150-350 kilobases, with outlying single copies. This locus, designated DXZ4 and mapped to chromosome band Xq24, may consist of as many as 50 variable-length alleles. It represents a class of variable number of tandem repeat polymorphism which may be termed 'macrosatellite'. The cluster is highly methylated on the active X chromosome and hypomethylated on the inactive X.
Collapse
Affiliation(s)
- J Giacalone
- Department of Genetics, Howard Hughes Medical Institute, Stanford University School of Medicine, California 94305
| | | | | |
Collapse
|
30
|
Griffin DK, Wilton LJ, Handyside AH, Winston RM, Delhanty JD. Dual fluorescent in situ hybridisation for simultaneous detection of X and Y chromosome-specific probes for the sexing of human preimplantation embryonic nuclei. Hum Genet 1992; 89:18-22. [PMID: 1577462 DOI: 10.1007/bf00207035] [Citation(s) in RCA: 120] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Dual fluorescent in situ hybridisation has been used for the simultaneous detection of X and Y chromosome-specific probes in single cleavage nuclei from disaggregated 4- to 7-cell human embryos. Based on the presence of a Y signal or 2 X signals in the absence of a Y, 89% of poor quality metaphases and 72% of interphase nuclei could be classified as male or female. With further refinements, this technique will offer a credible alternative to the polymerase chain reaction for the diagnosis of sex in human preimplantation embryos in families segregating for X-linked genetic disease.
Collapse
Affiliation(s)
- D K Griffin
- Department of Genetics and Biometry, University College London, UK
| | | | | | | | | |
Collapse
|