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Arroja N, Binois O, Hesters L, Sonigo C, Monnot S, Steffann J, Frydman N, Mayeur A. PGT and deferred embryo transfer: Is blastocyst biopsy more effective than cleaved embryo biopsy? J Gynecol Obstet Hum Reprod 2024; 53:102718. [PMID: 38158043 DOI: 10.1016/j.jogoh.2023.102718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/11/2023] [Accepted: 12/24/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE Blastocyst biopsy has recently been implemented in our laboratory for PGT with a "freeze all" indication. The aim of this study is to compare PGT results between embryos biopsied at the cleaved and embryos biopsied at the blastocyst stage. STUDY DESIGN This is a retrospective cohort study conducted from January 2017 to December 2022 in France. All couples with a "freeze all" indication the day of hCG trigerring during the study period were included in the study. Patients were retrospectively assigned in one group of two groups based on the day of embryo biopsy: the cleavage group if a blastomere biopsy was performed on day 3/4 or the blastocyst group if a trophectoderm biopsy was performed on day 5/6. We evaluated and compared the results between the two groups for biological parameters and clinical outcomes. RESULTS In total, 325 PGT cycles (291 patients) were included in our study. Frozen-thawed embryo transfer was performed for 285 cycles, 122 in the blastocyst group and 163 in the cleavage group. The number of biopsied embryos per cycle is significantly higher in the cleavage group with a mean of 7.2 ± 4.1 embryos biopsied per cycle vs. 2.9 ± 2.8 embryos in the blastocyst group (p < 0.001). The rate of the useful embryos was similar between the two groups with 14.6 % of frozen healthy embryos among the 1352 cleaved embryos obtained in blastocyst group, compared to 17.1 % in the cleavage group. No significant differences in clinical pregnancy rate per transfer and implantation rate were observed between the blastocyst and cleavage groups (36.4% vs. 40.4 % and 33.1% vs. 33.2 % respectively). CONCLUSIONS For "freeze all" PGT cycles, the day of embryo biopsy (cleaved vs blastocyst biopsy) does not impact pregnancy outcomes. Knowing how to perform embryo biopsy at different stages helps to better organize daily laboratory activity and to rescue some undiagnosed embryos after day 3 biopsy.
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Affiliation(s)
- Nathalie Arroja
- Service de Biologie de la Reproduction-CECOS, Hôpital Antoine Béclère, AP-HP, Université Paris Saclay, cedex, F-92140 Clamart, France.
| | - Olivier Binois
- Service de Biologie de la Reproduction-CECOS, Hôpital Antoine Béclère, AP-HP, Université Paris Saclay, cedex, F-92140 Clamart, France
| | - Laetitia Hesters
- Service de Biologie de la Reproduction-CECOS, Hôpital Antoine Béclère, AP-HP, Université Paris Saclay, cedex, F-92140 Clamart, France
| | - Charlotte Sonigo
- Service de Médecine de la reproduction et Préservation de la Fertilité, Assistance Publique Hôpitaux de Paris, Hôpital Antoine Béclère, Clamart 92140, France; Univ Paris Sud, Université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France; Inserm U1185, Faculté de médecine Paris Sud, France
| | - Sophie Monnot
- Université de Paris, Institut Imagine et Service de Génétique Moléculaire, Hôpital Necker-Enfants Malades, Paris, France
| | - Julie Steffann
- Université de Paris, Institut Imagine et Service de Génétique Moléculaire, Hôpital Necker-Enfants Malades, Paris, France
| | - Nelly Frydman
- Service de Biologie de la Reproduction-CECOS, Hôpital Antoine Béclère, AP-HP, Université Paris Saclay, cedex, F-92140 Clamart, France; Univ Paris Sud, Université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France
| | - Anne Mayeur
- Service de Biologie de la Reproduction-CECOS, Hôpital Antoine Béclère, AP-HP, Université Paris Saclay, cedex, F-92140 Clamart, France; Univ Paris Sud, Université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France
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Vernimmen V, Paulussen ADC, Dreesen JCFM, van Golde RJ, Zamani Esteki M, Coonen E, van Buul-van Zwet ML, Homminga I, Derijck AAHA, Brandts L, Stumpel CTRM, de Die-Smulders CEM. Preimplantation genetic testing for Neurofibromatosis type 1: more than 20 years of clinical experience. Eur J Hum Genet 2023:10.1038/s41431-023-01404-x. [PMID: 37337089 PMCID: PMC10400537 DOI: 10.1038/s41431-023-01404-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/16/2023] [Accepted: 05/25/2023] [Indexed: 06/21/2023] Open
Abstract
Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder that affects the skin and the nervous system. The condition is completely penetrant with extreme clinical variability, resulting in unpredictable manifestations in affected offspring, complicating reproductive decision-making. One of the reproductive options to prevent the birth of affected offspring is preimplantation genetic testing (PGT). We performed a retrospective review of the medical files of all couples (n = 140) referred to the Dutch PGT expert center with the indication NF1 between January 1997 and January 2020. Of the couples considering PGT, 43 opted out and 15 were not eligible because of failure to identify the underlying genetic defect or unmet criteria for in vitro fertilization (IVF) treatment. The remaining 82 couples proceeded with PGT. Fertility assessment prior to IVF treatment showed a higher percentage of male infertility in males affected with NF1 compared to the partners of affected females. Cardiac evaluations in women with NF1 showed no contraindications for IVF treatment or pregnancy. For 67 couples, 143 PGT cycles were performed. Complications of IVF treatment were not more prevalent in affected females compared to partners of affected males. The transfer of 174 (out of 295) unaffected embryos led to 42 ongoing pregnancies with a pregnancy rate of 24.1% per embryo transfer. There are no documented cases of misdiagnosis following PGT in this cohort. With these results, we aim to provide an overview of PGT for NF1 with regard to success rate and safety, to optimize reproductive counseling and PGT treatment for NF1 patients.
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Affiliation(s)
- Vivian Vernimmen
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands.
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - Aimée D C Paulussen
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jos C F M Dreesen
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Ron J van Golde
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
- Department of Obstetrics and Gynecology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Masoud Zamani Esteki
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Edith Coonen
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Obstetrics and Gynecology, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | - Irene Homminga
- University of Groningen, University Medical Center Groningen, Department of Obstetrics and Gynecology, Section Reproductive Medicine, Groningen, The Netherlands
| | - Alwin A H A Derijck
- Amsterdam UMC location University of Amsterdam, Center for Reproductive Medicine, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, Preconception and Conception, Amsterdam, The Netherlands
| | - Lloyd Brandts
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Constance T R M Stumpel
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Christine E M de Die-Smulders
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
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Yu EJ, Park EA, Choe SA, Lee KA, Kim YS. Freeze all-first versus biopsy-first: A retrospective analysis of frozen blastocyst transfer cycles with preimplantation genetic testing for aneuploidy. PLoS One 2022; 17:e0267652. [PMID: 36156085 PMCID: PMC9512210 DOI: 10.1371/journal.pone.0267652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 04/13/2022] [Indexed: 11/28/2022] Open
Abstract
Potential use of preimplantation genetic testing for aneuploidy (PGT-A) is increasing. Patients who have excess embryos cryopreserved at the blastocyst stage may desire PGT-A but there is little data available on options for these patients. We compared the efficacy and safety of the timing on the cryopreservation and trophectoderm(TE) biopsy for preimplantation genetic testing for aneuploidy (PGT-A) program associated with the better outcomes after frozen blastocyst transfer. Retrospective analysis of patients who underwent PGT-A cycles from January 2016 to December 2019 was carried out. 2684 blastocysts from cycles were subjected to TE biopsy for performing array comparative genomic hybridization test and Next-generation sequencing. All cycles were divided into two according to the timing of biopsy: biopsy-first (n = 211 cases/ 232 transfers) versus freeze all-first (n = 327 cases/ 415 transfers). In the biopsy-first group, embryos were cultured to expanded blastocyst and proceed to TE biopsy on day 5 or day 6 followed by cryopreservation. In the freeze all-first, blastocysts were vitrified and warmed before biopsy. Rates of clinical pregnancy (52.3% vs. 38.7%, P = 0.09) and ongoing pregnancy (44.3% vs. 34.5%, P = 0.07) in biopsy-first were significantly higher than those in freeze all-first. Biopsy-first showed comparable miscarriage rate with freeze all-first (15.2% (33/217) vs.11.1% (10/90), respectively). Rate ratio (RR) for clinical pregnancy was lower in freeze all-first group (adjusted RR = 0.78, 95% confidence interval: 0.65, 0.93). The RRs for miscarriage and live birth was also lower but it did not reach statistical significance. Our result supported performing TE biopsy of blastocyst for PGT-A before vitrification and warming. This finding would contribute to more evidence-based decision in PGT-A cycles.
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Affiliation(s)
- Eun Jeong Yu
- CHA Fertility Center Seoul Station, CHA University, Seoul, Republic of Korea
| | - Eun-A. Park
- CHA Fertility Center Seoul Station, Fertility Laboratory, Seoul, Republic of Korea
- Department of Biomedical Science, College of Life Science, CHA University, Gyeonggi-do, Republic of Korea
| | - Seung-Ah Choe
- CHA Fertility Center Seoul Station, CHA University, Seoul, Republic of Korea
| | - Kyung-Ah Lee
- Department of Biomedical Science, College of Life Science, CHA University, Gyeonggi-do, Republic of Korea
| | - You Shin Kim
- CHA Fertility Center Seoul Station, CHA University, Seoul, Republic of Korea
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Dong MJ, Yang ZK, Yang J, Guo RQ, Xiao YY, Liu H. Gamma knife radiotherapy in a neurofibromatosis type 1 Chinese pedigrees with NF1 gene frameshift mutation: A case report. Medicine (Baltimore) 2022; 101:e29280. [PMID: 35801779 PMCID: PMC9259110 DOI: 10.1097/md.0000000000029280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Neurofibromatosis type 1 (NF1) is a common autosomal dominant genetic disorder. NF1 is a multisystemic disease and its pathogenesis involves mutations in the NF1 gene on chromosome 17q11.2 causing RAS overactivation to stimulate abnormal cell proliferation. In this article, a Chinese family with neurofibromatosis type 1 was reported and the relationship between the phenotype and gene mutation was analyzed. PATIENT CONCERNS The patient was a 9-year-old-male child diagnosed with right eye exophthalmos combined with right eye glioma, optic edema, and peripheral visual field defect. There were multiple cafe-au-lait spots in the whole body of the child. His mother had multiple cafe-au-lait spots, and the eye examination showed no abnormalities. DIAGNOSIS The proband was diagnosed with NF1 and a heterozygous frameshift mutation (c. 6641delG p. Arg2214Asnfs*30) in the NF1 gene was identified, and his mother also carried the same pathogenic mutation. INTERVENTIONS To protect the vision of the right eye, he was treated with gamma knife radiotherapy. OUTCOMES After therapy, his fundus optic disc edema was decreased and the best corrected visual acuity of the right eye was increased. LESSONS Gene detection is helpful to diagnose the disease and guide the treatment. Gamma knife radiotherapy can preserve better neurological function.
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Affiliation(s)
- Meng-Jie Dong
- Department of Ophthalmology, The Affiliated Hospital of Yunnan University, The Second People’s Hospital of Yunnan Province, Kunming, China
- The Eye Disease Clinical Medical Research Center of Yunnan Province, Kunming, China
- The Eye Disease Clinical Medical Center of Yunnan Province, Kunming, China
| | - Zhong-Kun Yang
- Department of Ophthalmology, The Affiliated Hospital of Yunnan University, The Second People’s Hospital of Yunnan Province, Kunming, China
- The Eye Disease Clinical Medical Research Center of Yunnan Province, Kunming, China
- The Eye Disease Clinical Medical Center of Yunnan Province, Kunming, China
| | - Ji Yang
- Department of Ophthalmology, The Affiliated Hospital of Yunnan University, The Second People’s Hospital of Yunnan Province, Kunming, China
- The Eye Disease Clinical Medical Research Center of Yunnan Province, Kunming, China
- The Eye Disease Clinical Medical Center of Yunnan Province, Kunming, China
| | - Rui-Qin Guo
- Department of Ophthalmology, The Affiliated Hospital of Yunnan University, The Second People’s Hospital of Yunnan Province, Kunming, China
- The Eye Disease Clinical Medical Research Center of Yunnan Province, Kunming, China
- The Eye Disease Clinical Medical Center of Yunnan Province, Kunming, China
| | - Yu-Yuan Xiao
- Department of Ophthalmology, The Affiliated Hospital of Yunnan University, The Second People’s Hospital of Yunnan Province, Kunming, China
- The Eye Disease Clinical Medical Research Center of Yunnan Province, Kunming, China
- The Eye Disease Clinical Medical Center of Yunnan Province, Kunming, China
| | - Hai Liu
- Department of Ophthalmology, The Affiliated Hospital of Yunnan University, The Second People’s Hospital of Yunnan Province, Kunming, China
- The Eye Disease Clinical Medical Research Center of Yunnan Province, Kunming, China
- The Eye Disease Clinical Medical Center of Yunnan Province, Kunming, China
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Next-Generation Sequencing-Based Preimplantation Genetic Testing for De Novo NF1 Mutations. BIOCHIP JOURNAL 2021. [DOI: 10.1007/s13206-021-00006-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Chen L, Diao Z, Xu Z, Zhou J, Wang W, Li J, Yan G, Sun H. The clinical application of preimplantation genetic diagnosis for the patient affected by congenital contractural arachnodactyly and spinal and bulbar muscular atrophy. J Assist Reprod Genet 2016; 33:1459-1466. [PMID: 27393415 DOI: 10.1007/s10815-016-0760-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Accepted: 06/15/2016] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To investigate the usefulness of preimplantation genetic diagnosis (PGD) for the patient affected by congenital contractural arachnodactyly (CCA) and spinal and bulbar muscular atrophy (SBMA). METHODS Multiple displacement amplification (MDA) was performed for whole genome amplification (WGA) of biopsied trophectoderm (TE) cells. Direct mutation detection by sequencing and next-generation sequencing (NGS)-based single nucleotide polymorphism (SNP) haplotyping were used for CCA diagnosis. Direct sequencing of the PCR products and sex determination by amplification of sex-determining region Y (SRY) gene were used for SBMA diagnosis. After PGD, the unaffected blastocyst (B4) was transferred in the following frozen embryo transfer (FET). RESULTS In this PGD cycle, sixteen MII oocytes were inseminated by ICSI with testicular spermatozoa. Four blastocysts (B4, B5, B10, B13) were utilized for TE cell biopsy on day 5 after ICSI. After PGD, B4 was unaffected by CCA and SBMA. B5 was affected by CCA and carried SBMA. B10 was unaffected by CCA and carried SBMA. B13 was affected by CCA and unaffected by SBMA. B4 was the only unaffected blastocyst and transferred into the uterus for the subsequent FET cycle. The accuracy of PGD was confirmed by amniocentesis at 21 weeks of gestation. A healthy boy weighing 2850 g was born by cesarean section at the 38th week of gestation. CONCLUSIONS PGD is a valid screening tool for patienst affected of CCA and SBMA to prevent transmission of these genetic diseases from parents to children.
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Affiliation(s)
- Linjun Chen
- Reproductive Medical Center, Drum Tower Hospital Affiliated to Nanjing University Medical College, Nanjing, Jiangsu, 210008, China
| | - Zhenyu Diao
- Reproductive Medical Center, Drum Tower Hospital Affiliated to Nanjing University Medical College, Nanjing, Jiangsu, 210008, China
| | - Zhipeng Xu
- Reproductive Medical Center, Drum Tower Hospital Affiliated to Nanjing University Medical College, Nanjing, Jiangsu, 210008, China
| | - Jianjun Zhou
- Reproductive Medical Center, Drum Tower Hospital Affiliated to Nanjing University Medical College, Nanjing, Jiangsu, 210008, China
| | - Wanjun Wang
- Prenatal Diagnosis Center, Drum Tower Hospital Affiliated to Nanjing University Medical College, Nanjing, Jiangsu, 210008, China
| | - Jie Li
- Prenatal Diagnosis Center, Drum Tower Hospital Affiliated to Nanjing University Medical College, Nanjing, Jiangsu, 210008, China
| | - Guijun Yan
- Reproductive Medical Center, Drum Tower Hospital Affiliated to Nanjing University Medical College, Nanjing, Jiangsu, 210008, China.
| | - Haixiang Sun
- Reproductive Medical Center, Drum Tower Hospital Affiliated to Nanjing University Medical College, Nanjing, Jiangsu, 210008, China.
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Shofty B, Constantini S, Ben-Shachar S. Advances in Molecular Diagnosis of Neurofibromatosis Type 1. Semin Pediatr Neurol 2015; 22:234-9. [PMID: 26706011 DOI: 10.1016/j.spen.2015.10.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Neurofibromatosis 1 (NF1) is a common neurocutaneous and tumor predisposing genetic disorder with an autosomal dominant mode of inheritance. NF1 is solely caused by mutations in the NF1 gene, and disease-causing mutations can be found in more than 95% of individuals with a clinical diagnosis. Although NF1 has a distinctive clinical phenotype, it has a highly variable expression, even among individuals from the same family. Identifying the specific mutation does not usually assist in determining disease course and severity, and relatively few genotype-phenotype correlations have thus far been found. This review discusses the basic clinical aspects of NF1 and the current explanations for the high phenotypic variability, and provides the recently detected genotype-phenotype correlations.
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Affiliation(s)
- Ben Shofty
- (⁎)Division of Neurosurgery, Tel-Aviv Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Gilbert Israeli Neurofibromatosis Center, Tel-Aviv Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Shlomi Constantini
- (⁎)Division of Neurosurgery, Tel-Aviv Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Department of Pediatric Neurosurgery, Tel-Aviv Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Gilbert Israeli Neurofibromatosis Center, Tel-Aviv Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Shay Ben-Shachar
- Gilbert Israeli Neurofibromatosis Center, Tel-Aviv Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Genetic Institute, Tel-Aviv Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
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Weng SPF, Surrey MW, Danzer HC, Hill DL, Chen PC, Wu TCJ. Chromosome abnormalities in embryos derived from microsurgical epididymal sperm aspiration and testicular sperm extraction. Taiwan J Obstet Gynecol 2015; 53:202-5. [PMID: 25017267 DOI: 10.1016/j.tjog.2014.04.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Accepted: 04/09/2012] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To evaluate the patterns of chromosome abnormalities in embryos derived from intracytoplasmic sperm injection (ICSI) in microsurgical epididymal sperm aspiration (MESA) or testicular sperm extraction (TESE) in comparison to embryos that are derived from naturally ejaculated (EJAC) patients. MATERIALS AND METHODS Male partners with azoospermia who required MESA or TESE for ICSI were studied for chromosomal abnormalities. The ICSI patients with EJAC sperm served as the control group. Preimplantation genetic diagnosis (PGD) was performed by fluorescence in situ hybridization (FISH). Chromosome abnormalities were categorized as polyploidy, haploidy, aneuploidy, and complex abnormality (which involves more than two chromosomes). Fertilization, embryo development, and patterns of chromosome abnormalities were accessed and evaluated. RESULTS There was no difference between the MESA, TESE, and EJAC patient groups in the rates of fertilization and pregnancy and the percentages of euploid embryos. In all three groups, less than one-half of the embryos for each group were normal (41 ± 31%, 48 ± 38%, and 48 ± 31% in MESA, TESA, and EJAC, respectively). Complex chromosomal abnormality was significantly more frequent in the MESA group than in the EJAC group (48.3% vs. 26.5%, respectively; p < 0.001). Furthermore, the overall pattern of chromosomal aneuploidy was similar among all three studied groups. CONCLUSION We suggest that MESA and TESE, followed by ICSI and PGD, appear to be acceptable approaches for treating men with severe spermatogenesis impairment.
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Affiliation(s)
- Shao-Ping Fred Weng
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan
| | | | | | | | - Pau-Chung Chen
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Tsung-Chieh Jackson Wu
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
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Outcomes of preimplantation genetic diagnosis in neurofibromatosis type 1. Fertil Steril 2015; 103:761-8.e1. [DOI: 10.1016/j.fertnstert.2014.11.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 10/30/2014] [Accepted: 11/17/2014] [Indexed: 11/19/2022]
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Zakharova EE, Zaletova VV, Krivokharchenko AS. Biopsy of human morula-stage embryos: outcome of 215 IVF/ICSI cycles with PGS. PLoS One 2014; 9:e106433. [PMID: 25191937 PMCID: PMC4156362 DOI: 10.1371/journal.pone.0106433] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 07/29/2014] [Indexed: 12/28/2022] Open
Abstract
Preimplantation genetic diagnosis (PGD) is commonly performed on biopsies from 6-8-cell-stage embryos or blastocyst trophectoderm obtained on day 3 or 5, respectively. Day 4 human embryos at the morula stage were successfully biopsied. Biopsy was performed on 709 morulae from 215 ICSI cycles with preimplantation genetic screening (PGS), and 3-7 cells were obtained from each embryo. The most common vital aneuploidies (chromosomes X/Y, 21) were screened by fluorescence in situ hybridization (FISH). No aneuploidy was observed in 72.7% of embryos, 91% of those developed to blastocysts. Embryos were transferred on days 5-6. Clinical pregnancy was obtained in 32.8% of cases, and 60 babies were born. Patients who underwent ICSI/PGS treatment were compared with those who underwent standard ICSI treatment by examining the percentage of blastocysts, pregnancy rate, gestational length, birth height and weight. No significant differences in these parameters were observed between the groups. Day 4 biopsy procedure does not adversely affect embryo development in vitro or in vivo. The increased number of cells obtained by biopsy of morulae might facilitate diagnostic screening. There is enough time after biopsy to obtain PGD results for embryo transfer on day 5-6 in the current IVF cycle.
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Affiliation(s)
- Elena E. Zakharova
- Center for Reproductive Medicine MAMA, Moscow, Russian Federation
- * E-mail:
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Chen HF, Chang SP, Wu SH, Lin WH, Lee YC, Ni YH, Chen CA, Ma GC, Ginsberg NA, You EM, Tsai FP, Chen M. Validating a rapid, real-time, PCR-based direct mutation detection assay for preimplantation genetic diagnosis. Gene 2014; 548:299-305. [PMID: 25034658 DOI: 10.1016/j.gene.2014.07.039] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 07/08/2014] [Accepted: 07/12/2014] [Indexed: 01/24/2023]
Abstract
Although co-amplification of polymorphic microsatellite markers is the current gold standard for preimplantation genetic diagnosis (PGD) of single-gene disorders (SGD), this approach can be hampered by the lack of availability of informative markers. We recently (2011) devised a novel in-house assay for PGD of aromatic L-amino acid decarboxylase deficiency, based on an amplification refractory mutation system and quantitative PCR (ARMS-qPCR). The objective of the present study was to verify ARMS-qPCR in a cohort of 20 PGD cycles with a diverse group of SGDs (15 couples at risk for 10 SGDs). Day-3 cleavage-stage embryos were subjected to biopsy and genotyping, followed by fresh embryo transfer (FET). The diagnostic rate was 82.9%; unaffected live births were achieved in 9 of 20 FET cycles (45%), with only one false negative (among 54 transferred embryos). Overall, the ARMS-qPCR had frequent allele-dropout (ADO), rendering it inappropriate as the sole diagnostic method (despite a favorable live-birth rate). Regardless, it has the potential to complement the current gold-standard methodology, especially when trophectoderm biopsy becomes a preferred option and genotyping needs to be timely enough to enable FET.
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Affiliation(s)
- Hsin-Fu Chen
- Department of Obstetrics and Gynecology, College of Medicine, and Hospital, National Taiwan University, Taipei, Taiwan; Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shun-Ping Chang
- Department of Genomic Medicine, Changhua Christian Hospital, Changhua, Taiwan; Department of Life Science, National Chung-Hsing University, Taichung, Taiwan
| | - Sheng-Hai Wu
- Department of Life Science, National Chung-Hsing University, Taichung, Taiwan
| | - Wen-Hsiang Lin
- Department of Genomic Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Yi-Chung Lee
- Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yen-Hsuan Ni
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan
| | - Chi-An Chen
- Department of Obstetrics and Gynecology, College of Medicine, and Hospital, National Taiwan University, Taipei, Taiwan
| | - Gwo-Chin Ma
- Department of Genomic Medicine, Changhua Christian Hospital, Changhua, Taiwan; Institute of Biochemistry and Biotechnology, Chung Shan Medical University, Taichung, Taiwan
| | - Norman A Ginsberg
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - En-Min You
- Department of Genomic Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | | | - Ming Chen
- Department of Obstetrics and Gynecology, College of Medicine, and Hospital, National Taiwan University, Taipei, Taiwan; Department of Genomic Medicine, Changhua Christian Hospital, Changhua, Taiwan; Department of Life Science, National Chung-Hsing University, Taichung, Taiwan; Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan; Department of Life Science, Tunghai University, Taichung, Taiwan.
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Yan L, Wei Y, Huang J, Zhu X, Shi X, Xia X, Yan J, Lu C, Lian Y, Li R, Liu P, Qiao J. Advances in preimplantation genetic diagnosis/screening. SCIENCE CHINA-LIFE SCIENCES 2014; 57:665-71. [PMID: 24907939 DOI: 10.1007/s11427-014-4683-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 04/28/2014] [Indexed: 11/30/2022]
Affiliation(s)
- LiYing Yan
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China
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Chen CK, Yu HT, Soong YK, Lee CL. New perspectives on preimplantation genetic diagnosis and preimplantation genetic screening. Taiwan J Obstet Gynecol 2014; 53:146-50. [DOI: 10.1016/j.tjog.2014.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Accepted: 08/29/2012] [Indexed: 10/25/2022] Open
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Current status of comprehensive chromosome screening for elective single-embryo transfer. Obstet Gynecol Int 2014; 2014:581783. [PMID: 24991216 PMCID: PMC4058795 DOI: 10.1155/2014/581783] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 05/12/2014] [Indexed: 12/30/2022] Open
Abstract
Most in vitro fertilization (IVF) experts and infertility patients agree that the most ideal assisted reproductive technology (ART) outcome is to have a healthy, full-term singleton born. To this end, the most reliable policy is the single-embryo transfer (SET). However, unsatisfactory results in IVF may result from plenty of factors, in which aneuploidy associated with advanced maternal age is a major hurdle. Throughout the past few years, we have got a big leap in advancement of the genetic screening of embryos on aneuploidy, translocation, or mutations. This facilitates a higher success rate in IVF accompanied by the policy of elective SET (eSET). As the cost is lowering while the scale of genome characterization continues to be up over the recent years, the contemporary technologies on trophectoderm biopsy and freezing-thaw, comprehensive chromosome screening (CCS) with eSET appear to be getting more and more popular for modern IVF centers. Furthermore, evidence has showen that, by these avant-garde techniques (trophectoderm biopsy, vitrification, and CCS), older infertile women with the help of eSET may have an opportunity to increase the success of their live birth rates approaching those reported in younger infertility patients.
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Collins SC. Preimplantation genetic diagnosis: technical advances and expanding applications. Curr Opin Obstet Gynecol 2013; 25:201-6. [PMID: 23429571 DOI: 10.1097/gco.0b013e32835faafe] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW To review the foundations, recent technical advances, and increasing number of applications for in-vitro fertilization with preimplantation genetic diagnosis (PGD). RECENT FINDINGS PGD is an important technique for reducing the burden of genetic disease. Studies have shown that the diagnostic accuracy and subsequent live-birth rate after PGD are impacted by the developmental stage at the time of biopsy, as well as the biopsy protocol used. Also essential for accurate diagnosis are refined mutation detection protocols which avoid the common problem of allele drop-out. As the technique has improved, there has been a concomitant increase in the popularity and breadth of application of PGD. A recently published 10-year dataset of worldwide PGD reveals the increasing frequency of its use and the growing number of indications for which PGD is offered. SUMMARY Technical advances from biopsy to detection of mutations have led to improved diagnostic accuracy and an increased frequency and breadth of use for PGD.
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Affiliation(s)
- Stephen C Collins
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut 06520-8063, USA.
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Short-term storage of tripronucleated human embryos. J Assist Reprod Genet 2013; 30:1043-7. [PMID: 23820799 DOI: 10.1007/s10815-013-0036-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 06/20/2013] [Indexed: 10/26/2022] Open
Abstract
PURPOSE To determine the survival and subsequent in vitro development of human cleavage stage embryos and hatched blastocysts following varying periods of short-term storage at 4 °C, using tripronucleated human embryos (TPN) as a model. METHODS TPN cleavage embryos and hatched blastocysts short-term stored at 4 °C for 0 h (control), 24 h and 48 h. The main outcome measures were: survival rates (SR) and in vitro developmental ability (blastocyst rate and blastocyst-re-expansion rate) in each of the groups after storage. RESULTS Cleavage-stage TPN survived at comparable rates to controls, regardless of storage time (average: 97.3 %). The in vitro development of cleavage-stage TPN stored for 24 h was comparable to that of controls (average 64.7 %), but was significantly impaired when storage lasted 48-h (20.8 %). After artificial shrinkage, SR was comparable in 24-h-stored and non-stored hatched blastocysts (85.7 %; p > 0.05), but was significantly impaired in the 48-h-stored group (20.0 %). Following 24-h storage, the re-expansion rate of hatched blastocysts was similar to that of controls (average: 57.1 %; p > 0.05), but was higher than that of the 48-h-stored group (15.0 %; p < 0.05). CONCLUSIONS TPN human cleavage embryos and blastocysts can be successfully stored short-term for up to 24 h at 4 °C without using cryoprotectants without any significant negative impact on survival or subsequent in vitro development.
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Establishment of an in vitro model of the human placental barrier by placenta slice culture and ussing chamber. Biosci Biotechnol Biochem 2013; 77:1030-4. [PMID: 23649265 DOI: 10.1271/bbb.120976] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Our purpose was to establish an in vitro model of the human placental barrier based on placenta slice culture and Ussing chamber. The villous morphology, beta-human chorionic gonadotropin (β-hCG), mRNA and efflux function of P-glycoprotein (P-gp), and the permeability of the fluorescent marker were confirmed. The results showed that syncytiotrophoblast cells with abundant endoplasmic reticulum and mitochondria were covered with a dense microvillus in the placenta slice. The β-hCG secretion levels in the Ussing chamber were 274.13 ± 13.52 mIU/mL at 5 h, significantly higher than that in the incubator 95.2 ± 13.14 mIU/mL, and β-hCG continued to secrete for 48 h. P-gp mRNA was expressed in the placenta slice. The Rho123 apparent permeability coefficient (Papp) value from maternal side to the fetal side was 26.34 ± 1.87 nm/s, but it was significantly increased, to 289.55 ± 6.02 nm/s after adding verapamil. The Rho123 efflux value was >2. The fluorescein Papp value was (3.42 ± 0.24) × 10(-3) nm/s. In contrast, the fluorescein isothiocyanate-dextran (FD70) Papp value was (3.93 ± 0.08) × 10(-5) nm/s. This indicates that the placenta slice in the Ussing chamber had the activity of a placenta, and can act as a valuable in vitro model of placental barrier.
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A feasible strategy of preimplantation genetic diagnosis for carriers with chromosomal translocation: Using blastocyst biopsy and array comparative genomic hybridization. J Formos Med Assoc 2013; 112:537-44. [PMID: 24079714 DOI: 10.1016/j.jfma.2013.02.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 01/23/2013] [Accepted: 02/20/2013] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND/PURPOSE Patients with chromosomal translocation are highly vulnerable to produce unbalanced gametes that result in recurrent miscarriages, affected offspring, or infertility. Preimplantation genetic diagnosis (PGD) with blastomere biopsy and fluorescent in-situ hybridization (FISH) has been used to select normal/balanced embryos for transfer. However, FISH is inherent with some technical difficulties such as cell fixation and signal reading. Here we introduce a strategy of PGD using blastocyst biopsy and array comparative genomic hybridization (aCGH) for reproductive problems of patients with chromosomal translocation. METHODS Twelve patients diagnosed as having chromosomal translocation who underwent PGD cycles were included in this single-center observational study. Blastocyst biopsy was performed and biopsied blastocysts were cryopreserved individually. Testing was performed with aCGH, and the euploid embryos were transferred in the following thawing cycles. RESULTS The overall diagnostic efficiency was 90.2% (55/61) and the euploidy rate was 32.7% (18/55). Ten cycles of thawed embryo transfer (ET) were carried out, resulting in three live births and another three ongoing pregnancies with an ongoing pregnancy rate of 60%/transfer cycle. The prenatal diagnosis with chorionic villi sampling confirmed the results of PGD/aCGH in all six pregnant women. No miscarriage happened in our case series. CONCLUSION Our study demonstrates an effective PGD strategy with promising outcomes. Blastocyst biopsy can retrieve more genetic material and may provide more reliable results, and aCGH offers not only detection of chromosomal translocation but also more comprehensive analysis of 24 chromosomes than traditional FISH. More cases are needed to verify our results and this strategy might be considered in general clinical practice.
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Chang LJ, Chen SU, Tsai YY, Hung CC, Fang MY, Su YN, Yang YS. An update of preimplantation genetic diagnosis in gene diseases, chromosomal translocation, and aneuploidy screening. Clin Exp Reprod Med 2011; 38:126-34. [PMID: 22384431 PMCID: PMC3283069 DOI: 10.5653/cerm.2011.38.3.126] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Revised: 08/23/2011] [Accepted: 08/25/2011] [Indexed: 11/06/2022] Open
Abstract
Preimplantation genetic diagnosis (PGD) is gradually widely used in prevention of gene diseases and chromosomal abnormalities. Much improvement has been achieved in biopsy technique and molecular diagnosis. Blastocyst biopsy can increase diagnostic accuracy and reduce allele dropout. It is cost-effective and currently plays an important role. Whole genome amplification permits subsequent individual detection of multiple gene loci and screening all 23 pairs of chromosomes. For PGD of chromosomal translocation, fluorescence in-situ hybridization (FISH) is traditionally used, but with technical difficulty. Array comparative genomic hybridization (CGH) can detect translocation and 23 pairs of chromosomes that may replace FISH. Single nucleotide polymorphisms array with haplotyping can further distinguish between normal chromosomes and balanced translocation. PGD may shorten time to conceive and reduce miscarriage for patients with chromosomal translocation. PGD has a potential value for mitochondrial diseases. Preimplantation genetic haplotyping has been applied for unknown mutation sites of single gene disease. Preimplantation genetic screening (PGS) using limited FISH probes in the cleavage-stage embryo did not increase live birth rates for patients with advanced maternal age, unexplained recurrent abortions, and repeated implantation failure. Polar body and blastocyst biopsy may circumvent the problem of mosaicism. PGS using blastocyst biopsy and array CGH is encouraging and merit further studies. Cryopreservation of biopsied blastocysts instead of fresh transfer permits sufficient time for transportation and genetic analysis. Cryopreservation of embryos may avoid ovarian hyperstimulation syndrome and possible suboptimal endometrium.
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Affiliation(s)
- Li-Jung Chang
- Department of Obstetrics and Gynecology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
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