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Tan H, Huang Q, Liu D, Huang L, Chen C, Wang F, Dong M, Weng H, Zhu X, Zhang X, Liu F. Effects of Carrier's sex on the outcome of embryos and pregnancies in 412 couples undergoing preimplantation genetic testing for structural rearrangements. Gene 2024:148989. [PMID: 39384107 DOI: 10.1016/j.gene.2024.148989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 09/16/2024] [Accepted: 10/04/2024] [Indexed: 10/11/2024]
Abstract
STUDY DESIGN To ascertain whether the carrier's sex affects the outcome of embryos and pregnancies in couples undergoing preimplantation genetic testing for structural rearrangements (PGT-SR). METHODS This retrospective study comprised 412 couples with reciprocal translocations (RecT), Robertsonian translocations (RobT), or inversions (INV) between January 2017 and October 2022. We applied next-generation sequencing (NGS) on 2588 embryos after trophectoderm (TE) biopsy. RESULTS Genetically transferable blastocyst rate was higher in the male carrier group (34.0 % vs 31.7 %, P = 0.013) relative to the female carrier group whereas other embryo and pregnancy outcomes remained similar. Further analysis revealed that this result was primarily due to the alteration of segregation patterns in the RobT subgroup, in which the proportion of alternate segregation was higher (84.3 % vs 66.4 %, P < 0.001) in male carriers compared with female carriers. In the RecT subgroup, the genetically transferable blastocyst rate between male and female carriers was similar although the segregation models also changed, such that the frequency of the adjacent-1 segregation pattern was higher in male carriers than in female carriers (42.5 % vs 34.7 %, P = 0.002). In addition, interchromosomal effect (ICE) did not differ between male and female carriers although ICE was lower in male carriers of the RobT subgroup (pure ICE: 35.50 % vs 44.30 %, P = 0.14; total ICE: 35.50 % vs 40.30 %, P = 0.32) and higher in male carriers of the INV subgroup (pure ICE: 42.3 % vs 37.20 %, P = 0.33; total ICE: 40.90 % vs 36.00 %, P = 0.36). CONCLUSIONS The carrier's sex was closely associated with the genetically transferable embryo rate in couples undergoing PGT-SR, principally resulted from the change in segregation pattern in the RobT subgroup but not in the RecT and INV subgroups.
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Affiliation(s)
- Hu Tan
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong Province 511400, China
| | - Qianwen Huang
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong Province 511400, China
| | - Dun Liu
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong Province 511400, China
| | - Li Huang
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong Province 511400, China
| | - Chuangqi Chen
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong Province 511400, China
| | - Fang Wang
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong Province 511400, China
| | - Mei Dong
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong Province 511400, China
| | - Huinan Weng
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong Province 511400, China
| | - Xiulan Zhu
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong Province 511400, China
| | - Xiqian Zhang
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong Province 511400, China.
| | - Fenghua Liu
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong Province 511400, China.
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Tian Z, Lian W, Xu L, Long Y, Tang L, Wang H. Robust evidence reveals the reliable rate of normal/balanced embryos for identifying reciprocal translocation and Robertsonian translocation carriers. ZYGOTE 2024; 32:58-65. [PMID: 38083872 DOI: 10.1017/s0967199423000606] [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] [Indexed: 01/16/2024]
Abstract
We aimed to evaluate the reliable rate of normal/balanced embryos for reciprocal translocation and Robertsonian translocation carriers and to provide convincing evidence for clinical staff to conduct genetic counselling regarding common structural rearrangements to alleviate patient anxiety. The characteristics of 39,459 embryos that were sourced from unpublished data and literature were analyzed. The samples consisted of 17,536 embryo karyotypes that were not published and 21,923 embryo karyotypes obtained from the literature. Using the PubMed, Cochrane Library, Web of Science, and Embase databases, specific keywords were used to screen the literature for reciprocal translocation and Robertsonian translocation. The ratio of normal/balanced embryos in the overall data was calculated and analyzed, and we grouped the results according to gender to confirm if there were gender differences. We also divided the data into the cleavage stage and blastocyst stage according to the biopsy period to verify if there was a difference in the ratio of normal/balanced embryos. By combining the unpublished data and data derived from the literature, the average rates of normal/balanced embryos for reciprocal translocation and Robertsonian translocation carriers were observed to be 26.96% (7953/29,495) and 41.59% (4144/9964), respectively. Reciprocal translocation and Robertson translocation exhibited higher rates in male carriers than they did in female carriers (49.60% vs. 37.44%; 29.84% vs. 27.67%). Additionally, the data for both translocations exhibited differences in the normal/balanced embryo ratios between the cleavage and blastocyst stages of carriers for both Robertsonian translocation and reciprocal translocation (36.07% vs 43.43%; 24.88% vs 27.67%). The differences between the two location types were statistically significant (P < 0.05). The normal/balanced ratio of embryos in carriers of reciprocal and RobT was higher than the theoretical ratio, and the values ranged from 26.96% to 41.59%. Moreover, the male carriers possessed a higher number of embryos that were normal or balanced. The ratio of normal/balanced embryos in the blastocyst stage was higher than that in the cleavage stage. The results of this study provide a reliable suggestion for future clinic genetic consulting regarding the rate of normal/balanced embryos of reciprocal translocation and Robertsonian translocation carriers.
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Affiliation(s)
- Zhihua Tian
- Department of Reproduction and Genetics, the First Affiliated Hospital of Kunming Medical University, Kunming650032, China
| | - Wenchang Lian
- Department of Medical Genetics, Yikon Genomics Company, Ltd, Jiangsu Suzhou215021, China
| | - Li Xu
- Department of Reproduction and Genetics, the First Affiliated Hospital of Kunming Medical University, Kunming650032, China
| | - Yanxi Long
- Department of Reproduction and Genetics, the First Affiliated Hospital of Kunming Medical University, Kunming650032, China
| | - Li Tang
- Department of Reproduction and Genetics, the First Affiliated Hospital of Kunming Medical University, Kunming650032, China
| | - Huawei Wang
- Department of Reproduction and Genetics, the First Affiliated Hospital of Kunming Medical University, Kunming650032, China
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Zhou F, Ren J, Li Y, Keqie Y, Peng C, Chen H, Chen X, Liu S. Preimplantation genetic testing in couples with balanced chromosome rearrangement: a four-year period real world retrospective cohort study. BMC Pregnancy Childbirth 2024; 24:86. [PMID: 38280990 PMCID: PMC10821259 DOI: 10.1186/s12884-023-06237-6] [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: 09/11/2023] [Accepted: 12/29/2023] [Indexed: 01/29/2024] Open
Abstract
BACKGROUND Couples with balanced chromosome rearrangement (BCR) are at high risk of recurrent miscarriages or birth defects due to chromosomally abnormal embryos. This study aimed to provide real-world evidence of the euploidy rate of blastocysts from couples with BCR using preimplantation genetic testing (PGT) and to guide pretesting genetic counselling. METHODS A continuous four-year PGT data from couples with BCR were retrospectively analyzed. Biopsied trophectoderm cells were amplified using whole genome amplification, and next-generation sequencing was performed to detect the chromosomal numerical and segmental aberrations. Clinical data and molecular genetic testing results were analyzed and compared among the subgroups. RESULTS A total of 1571 PGT cycles with 5942 blastocysts were performed chromosomal numerical and segmental aberrations detection during the four years. Of them, 1034 PGT cycles with 4129 blastocysts for BCR couples were included; 68.96% (713/1034) PGT cycles had transferable euploid embryos. The total euploidy rate of blastocysts in couples carrying the BCR was 35.29% (1457/4129). Couples with complex BCR had euploid blastocyst rates similar to those of couples with non-complex BCR (46.15% vs. 35.18%, P > 0.05). Chromosome inversion had the highest chance of obtaining a euploid blastocyst (57.27%), followed by Robertsonian translocation (RobT) (46.06%), and the lowest in reciprocal translocation (RecT) (30.11%) (P < 0.05). Couples with males carrying RobT had higher rates of euploid embryo both in each PGT cycles and total blastocysts than female RobT carriers did, despite the female age in male RobT is significant older than those with female RobT (P < 0.05). The proportions of non-carrier embryos were 52.78% (95/180) and 47.06% (40/85) in euploid blastocysts from couples with RecT and RobT, respectively (P > 0.05). RecT had the highest proportion of blastocysts with translocated chromosome-associated abnormalities (74.23%, 1527/2057), followed by RobT (54.60%, 273/500) and inversion (30.85%, 29/94) (P < 0.05). CONCLUSIONS In couples carrying BCR, the total euploidy rate of blastocysts was 35.29%, with the highest in inversion, followed by RobT and RecT. Even in couples carrying complex BCR, the probability of having a transferable blastocyst was 46.15%. Among the euploid blastocysts, the non-carrier ratios in RecT and RobT were 52.78% and 47.06%, respectively. RecT had the highest proportion of blastocysts with translocated chromosome-associated abnormalities.
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Affiliation(s)
- Fan Zhou
- Department of Medical Genetics/Prenatal Diagnostic Center, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, Sichuan, China
| | - Jun Ren
- Department of Medical Genetics/Prenatal Diagnostic Center, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, Sichuan, China
| | - Yutong Li
- Department of Medical Genetics/Prenatal Diagnostic Center, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, Sichuan, China
| | - Yuezhi Keqie
- Department of Medical Genetics/Prenatal Diagnostic Center, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, Sichuan, China
| | - Cuiting Peng
- Department of Medical Genetics/Prenatal Diagnostic Center, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, Sichuan, China
| | - Han Chen
- Department of Medical Genetics/Prenatal Diagnostic Center, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, Sichuan, China
| | - Xinlian Chen
- Department of Medical Genetics/Prenatal Diagnostic Center, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, Sichuan, China.
| | - Shanling Liu
- Department of Medical Genetics/Prenatal Diagnostic Center, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, Sichuan, China.
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Wang S, Liu L, Ma M, Wang H, Han Y, Guo X, Yeung WSB, Cheng Y, Zhang H, Dong F, Zhang B, Tian Y, Song J, Peng H, Yao Y. Preimplantation genetic testing for aneuploidy helps to achieve a live birth with fewer transfer cycles for the blastocyst FET patients with unexplained recurrent implantation failure. Arch Gynecol Obstet 2023; 308:599-610. [PMID: 37246978 DOI: 10.1007/s00404-023-07041-5] [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: 10/18/2022] [Accepted: 04/06/2023] [Indexed: 05/30/2023]
Abstract
PURPOSE This retrospective cohort study aimed to investigate the value of preimplantation genetic testing for aneuploidy (PGT-A) as a screening test for patients suffering from unexplained recurrent implantation failure (RIF). METHODS After screening patients in one reproductive medicine center, twenty-nine, forty-nine and thirty-eight women (< 40 years old) who had suffered unexplained RIF with PGT-A, or RIF without PGT-A, or no RIF with PGT-A were included. The clinical pregnancy rate and live birth rate per transfer, the conservative and optimal cumulative clinical pregnancy rates (CCPR) and live birth rates (CLBR) after three blastocyst FETs were analyzed. RESULTS The live birth rate per transfer was significantly higher in the RIF + PGT-A group than that in the RIF + NO PGT-A group (47.6% vs. 24.6%, p = 0.014). After 3 cycles of FET, RIF + PGT-A group had significantly higher conservative CLBR and optimal CLBR compared to the RIF + NO PGT-A group (69.0% vs. 32.7%, p = 0.002 and 73.7% vs. 57.5%, p = 0.016), but had similar conservative and optimal CLBRs compared to the NO RIF + PGT-A group. The number of FET cycles required when half women achieved a live birth was 1 in the PGT-A group and 3 in RIF + NO PGT-A group. The miscarriage rates were not different between the RIF + PGT-A and RIF + NO PGT-A, RIF + PGT-A and NO RIF + PGT-A groups. CONCLUSION PGT-A did be superior in reducing the number of transfer cycles required to achieve a similar live birth rate. Further studies to identify the RIF patients who would benefit most from PGT-A are necessary.
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Affiliation(s)
- Sidong Wang
- Department of Obstetrics and Gynecology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Luochuan Liu
- College of Medicine, Nankai University, Tianjin, 300071, China
| | - Minyue Ma
- Department of Obstetrics and Gynecology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Hui Wang
- Department of Obstetrics and Gynecology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Yibing Han
- Kiang Wu Hospital, Macau SAR, 999078, China
| | - Xinmeng Guo
- College of Medicine, Nankai University, Tianjin, 300071, China
| | - William S B Yeung
- Shenzhen Key Laboratory of Fertility Regulation, Reproductive Medicine Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, 518053, China
| | - Yanfei Cheng
- Shenzhen Key Laboratory of Fertility Regulation, Reproductive Medicine Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, 518053, China
| | - Huiting Zhang
- Department of Obstetrics and Gynecology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Fengming Dong
- Department of Obstetrics and Gynecology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Bolun Zhang
- College of Medicine, Nankai University, Tianjin, 300071, China
| | - Ye Tian
- Department of Obstetrics and Gynecology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Jiangnan Song
- Department of Obstetrics and Gynecology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Hongmei Peng
- Department of Obstetrics and Gynecology, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Yuanqing Yao
- Department of Obstetrics and Gynecology, Chinese PLA General Hospital, Beijing, 100853, China.
- Shenzhen Key Laboratory of Fertility Regulation, Reproductive Medicine Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, 518053, China.
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Mo F, Hu X, Ma Q, Zhang L, Xing L. Self-reported effects of perceived social support on marital quality in balanced translocation patients and their spouses undergoing preimplantation genetic testing in China: actor-partner interdependence model. J OBSTET GYNAECOL 2022; 42:3248-3253. [PMID: 35983680 DOI: 10.1080/01443615.2022.2112020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
This study aimed to analyse the relationship between perceived social support and marital quality in balanced translocation patients and their spouses undergoing a preimplantation genetic testing (PGT) treatment cycle in China. The authors assessed the actor and partner effects of perceived social support on marital quality in patient-spouse dyads using a dyadic analysis approach. In total, 59 couples were assessed using self-report questionnaires for marital quality and perceived social support. There were significant differences in marital quality between patients and their spouses (p=.0025) based on the APIM (actor-partner interdependence model) analyses. The perceived social support of both patients (p=.0076) and spouses (p<.001) had a significant effect on individual marital quality for actor effects. Partner effects showed that patients' perceived social support had a significant effect on spouses' marital quality (p=.0156) and the spouses' perceived social support had a significant effect on patients' marital quality (p=.0084). The findings indicate that the level of perceived social support affected both his/her own marital quality and that of his/her spouse.Impact StatementWhat is already known on this subject? Infertility and reproductive treatments affect both partners, that is, the couple as a unit and have a negative impact on an individual's marital satisfaction and social relationships.What do the results of this study add? There are significant differences in marital quality between balanced translocation patients and their spouses. Perceived social support significantly correlated with marital quality in both the actor and partner effects.What are the implications of these findings for clinical practice and/or further research? Health professionals should provide couple-based interventions involving both patients and spouses throughout the PGT treatment to improve perceived social support, thereby improving their marital quality.
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Affiliation(s)
- Fengyi Mo
- Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, People's Republic of China
| | - Xiaorui Hu
- Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, People's Republic of China
| | - Qing Ma
- Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, People's Republic of China
| | - Li Zhang
- Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, People's Republic of China
| | - Lanfeng Xing
- Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, People's Republic of China
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Nakano T, Ammae M, Satoh M, Mizuno S, Nakaoka Y, Morimoto Y. Analysis of clinical outcomes and meiotic segregation modes following preimplantation genetic testing for structural rearrangements using aCGH/NGS in couples with balanced chromosome rearrangement. Reprod Med Biol 2022; 21:e12476. [PMID: 35781920 PMCID: PMC9243298 DOI: 10.1002/rmb2.12476] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 06/13/2022] [Accepted: 06/13/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To retrospectively evaluate the effectiveness of PGT-SR by array comparative genomic hybridization (aCGH) or next-generation sequencing (NGS) in preventing recurrent miscarriages. Methods Thirty one couples with balanced translocation who underwent 68 PGT-SR cycles between 2012 and 2020 were evaluated. A total of 242 blastocysts were biopsied for aCGH or NGS. The genetically transferable blastocysts were transferred in the subsequent frozen-thawed single embryo transfer cycle. Results The genetically transferable blastocyst rate was 21.2% (51/241). Thirty five genetically transferable blastocysts were transferred into the uterine cavity. The clinical pregnancy rate was 57.1% (20/35), and the ongoing pregnancy rate was 100.0% (20/20). The incidence of interchromosomal effect (ICE) was influenced by ovarian stimulation protocol, female age, and carrier's gender, but dependent on the types of balanced translocation carriers. Furthermore, there was no significant difference in meiotic segregation modes in ovarian stimulation protocols and carrier's gender. Interestingly, the incidence of adjacent-1 segregation in ≧40 years group increased significantly compared with <35 years group. Conclusions For the first time in Japan, we show the effectiveness of PGT-SR using aCGH or NGS, which enables comprehensive analysis of chromosomes, in the prevention of recurrent miscarriages. Furthermore, our results may support better genetic counseling of balanced translocation carriers for PGT-SR cycles.
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Perinatal Outcomes of Singleton Live Births Following Preimplantation Genetic Testing for Chromosomal Structural Rearrangements in Single Frozen-Thawed Blastocyst Transfer Cycles: a Retrospective Cohort Study. Reprod Sci 2021; 29:3039-3046. [PMID: 34716537 DOI: 10.1007/s43032-021-00732-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/26/2021] [Indexed: 10/20/2022]
Abstract
This study investigated whether singleton pregnancies conceived after preimplantation genetic testing for chromosomal structural rearrangements (PGT-SR) are associated with a higher risk of adverse perinatal outcomes than singleton pregnancies conceived after intracytoplasmic sperm injection (ICSI). We collected data on singleton live births after PGT-SR (n = 107) and ICSI (n = 585) in our hospital from January 2017 to August 2020. Multivariable analyses were used to adjust for maternal age, body mass index, gravidity and parity, paternal age, ovulatory disorder, and recurrent spontaneous abortion. The unadjusted results showed a significantly higher risk of hypertensive disorders of pregnancy (HDP) (odds ratio (OR) = 2.47; 95% confidence interval (CI): 1.10-5.54; P = 0.029) associated with PGT-SR singleton pregnancies than with ICSI singleton pregnancies. However, after adjusting for potential confounders, there were no longer any significant differences in the risk of HDP (adjusted OR = 2.24; 95% CI: 0.92-5.48; P = 0.077) between PGT-SR and ICSI singleton pregnancies. There were no significant differences between PGT-SR and ICSI singleton pregnancies in terms of gestational diabetes, preterm premature rupture of membranes, placenta previa, cesarean delivery, gestational age (weeks), preterm delivery (< 37 weeks), very preterm delivery (≥ 28 weeks and < 32 weeks), birth weight (g), low birth weight (< 2500 g), very low birth weight (< 1500 g), birth height (cm), birth defects, and 1-min and 5-min Apgar scores. In conclusion, for single frozen-thawed blastocyst cycles, there were no significant differences in adverse perinatal outcomes between PGT-SR and ICSI singleton pregnancies. However, due to the limited sample size, these conclusions need to be confirmed by further studies.
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Cai Y, Ding M, Zhang Y, Sun Y, Lin F, Diao Z, Zhou J. A mathematical model for predicting the number of transferable blastocysts in next-generation sequencing-based preimplantation genetic testing. Arch Gynecol Obstet 2021; 305:241-249. [PMID: 34218301 DOI: 10.1007/s00404-021-06050-6] [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: 08/16/2020] [Accepted: 03/27/2021] [Indexed: 12/23/2022]
Abstract
PURPOSE To investigate the clinical factors that could be used predict the number of transferable blastocysts in preimplantation genetic testing (PGT) cycles based on next-generation sequencing (NGS) and formed form a mathematical model to predict the chance likelihood of obtaining one transferable blastocyst, which is helpful for genetic counseling. METHODS This retrospective study enrolled couples undergoing PGT cycles for chromosomal structural rearrangement (PGT-SR, n = 363, 202 with reciprocal translocation carriers, 131 with Robertsonian translocation carriers, 30 with inversion carriers), monogenic diseases (PGT-M, n = 47), and for Aneuploidies (PGT-A, n = 132) from January 2015 to October 2018. Stepwise multiple linear regression analysis was used to identify the factors relevant for obtaining at least one transferable blastocyst. The factors that predict the number of biopsied blastocysts were further analyzed. RESULTS The transferable blastocyst rates were 29.94, 41.99, 49.09, 41.42, and 44.37% in the reciprocal translocation carrier, Robertsonian translocation carrier, inversion carrier, PGT-M, and PGT-A cycles, respectively. The number of transferable blastocysts in these cycles were 0.3004 × the number of biopsied blastocysts (NBB) - 0.0031, 0.4063 × NBB + 0.0460, 0.5762 × NBB - 0.3128, 0.3611 × NBB + 0.1910, and 0.4831 × NBB - 0.0970, respectively. Furthermore, the number of MII oocytes and female age were clinical predictors of NBB in reciprocal translocation and PGT-A couples, while the number of MII oocytes was the only clinical predictor in Robertsonian translocation carriers, inversion carriers, and PGT-M couples. CONCLUSIONS The number of biopsied blastocysts was the only clinical predictor of the ability to obtain a transferable blastocyst in PGT cycles; therefore, for clinical practice, theoretically the minimum numbers of biopsied blastocysts is 4 in reciprocal translocation carrier and 3 in couples undergoing PGT for other reasons. The number of MII oocytes and female age were clinical predictors of the number of biopsied blastocysts. With the mathematical models in our study as a reference, in clinical practice, clinicians will be able to conduct a more targeted genetic consultation for different kinds of PGT patients.
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Affiliation(s)
- Yunni Cai
- Reproductive Medicine Center, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321#, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Min Ding
- Reproductive Medicine Center, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321#, Nanjing, 210008, Jiangsu, People's Republic of China
| | - YuTing Zhang
- Reproductive Medicine Center, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321#, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Yanxin Sun
- Reproductive Medicine Center, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321#, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Fei Lin
- Reproductive Medicine Center, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321#, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Zhenyu Diao
- Reproductive Medicine Center, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321#, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Jianjun Zhou
- Reproductive Medicine Center, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321#, Nanjing, 210008, Jiangsu, People's Republic of China.
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Li X, Zhu X, Hao Y, Ji D, Zhang Z, Wei Z, Cao Y, Zhou P. Comprehensive assessment of a clinic's experience of preimplantation genetic testing by a cumulative rate. Taiwan J Obstet Gynecol 2021; 60:225-231. [PMID: 33678320 DOI: 10.1016/j.tjog.2020.11.034] [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] [Accepted: 08/31/2020] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the outcomes of patients who had preimplantation genetic testing for chromosomal structural rearrangement (PGT-SR) or for aneuploidy screening (PGT-A) with different indications. METHODS This was a retrospective study at a single center. Pregnancy outcomes of all couples who had PGT from 2014 to 2018 were retrospectively analyzed, and the cumulative pregnancy rates (CPR) and the cumulative live birth/ongoing pregnancy rate (CLB/OPR) per patient with at least one transfer cycle were calculated. RESULTS A total of 313 PGT-SR cycles of 255 patients, 22 PGT-sexing cycles of 20 patients, and 190 PGT-A cycles of 168 patients were performed during the period. In PGT-SR, the overall CPR and the CLB/OPR were 68.04% and 59.79%, respectively. In PGT-A, the CPR and CLB/OPR were 67.52% and 58.12%, respectively. We also found that the CPR (93.75%) and CLB/OPR (87.50%) were highest in patients for PGT-sexing with a diagnosis of Y chromosomal microdeletion. In addition, we discovered a significant trend that aneuploidy rate significantly increased with maternal age (p = 0.000) in PGT-A population. No significant difference was found in the mosaicism rate or clinical outcomes among the age groups. Similarly, the significance was absent in the PGT-SR population. CONCLUSION We reviewed the CPR and CLB/OPR for different indications since the 24-chromosome technique has been applied in the clinical setting for 4 years in our center. We hope that our results will provide some pointed guidance and a new perspective on outcomes for PGT in certain patients and clinicians.
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Affiliation(s)
- Xinyuan Li
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No 218 Jixi Road, Hefei, 230022, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, Hefei, 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xiaoqian Zhu
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No 218 Jixi Road, Hefei, 230022, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, Hefei, 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yan Hao
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No 218 Jixi Road, Hefei, 230022, Anhui, China; Anhui Province Key Laboratory of Reproductive Health and Genetics, No 81 Meishan Road, Hefei, 230032, Anhui, China; Biopreservation and Artificial Organs, Anhui Provincial Engineering Research Center, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Dongmei Ji
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No 218 Jixi Road, Hefei, 230022, Anhui, China; Anhui Province Key Laboratory of Reproductive Health and Genetics, No 81 Meishan Road, Hefei, 230032, Anhui, China; Biopreservation and Artificial Organs, Anhui Provincial Engineering Research Center, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Zhiguo Zhang
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No 218 Jixi Road, Hefei, 230022, Anhui, China; Anhui Province Key Laboratory of Reproductive Health and Genetics, No 81 Meishan Road, Hefei, 230032, Anhui, China; Biopreservation and Artificial Organs, Anhui Provincial Engineering Research Center, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Zhaolian Wei
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No 218 Jixi Road, Hefei, 230022, Anhui, China; Anhui Province Key Laboratory of Reproductive Health and Genetics, No 81 Meishan Road, Hefei, 230032, Anhui, China; Biopreservation and Artificial Organs, Anhui Provincial Engineering Research Center, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yunxia Cao
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No 218 Jixi Road, Hefei, 230022, Anhui, China; Anhui Province Key Laboratory of Reproductive Health and Genetics, No 81 Meishan Road, Hefei, 230032, Anhui, China; Biopreservation and Artificial Organs, Anhui Provincial Engineering Research Center, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Ping Zhou
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No 218 Jixi Road, Hefei, 230022, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, Hefei, 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.
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10
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Blastocyst conversion rate and ploidy in patients with structural rearrangements. J Assist Reprod Genet 2021; 38:1143-1151. [PMID: 33656620 DOI: 10.1007/s10815-021-02131-2] [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: 10/28/2020] [Accepted: 02/24/2021] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The primary objective of this study was to test the hypotheses that compared to IVF cycles undergoing preimplantation genetic testing for aneuploidy (PGT-A) with or without testing for monogenic disorders (PGT-M), IVF cycles undergoing PGT for structural rearrangements (PGT-SR) will have (1) a poorer blastocyst conversion rate and (2) fewer usable blastocysts available for transfer. Secondarily, the study aimed to compare pregnancy outcomes among PGT groups. PATIENTS Retrospective cohort study including cycles started from January 1, 2012, to March 30, 2020, with the intent of pursuing PGT-A, PGT-A with PGT-M, and PGT-SR, with trophectoderm biopsy on days 5 or 6. RESULTS A total of 658 women underwent 902 cycles, including 607 PGT-A, 216 PGT-A&M, and 79 PGT-SR cycles. When compared with the blastocyst conversion rate for the PGT-A group (59.4%), and after adjustment for patient age, total number of mature oocytes, BMI, and ICSI, there were no significant differences for either the PGT-A&M (69.7%, aRR 1.03, 95% CI 0.96-1.10) or PGT-SR (63.2%, aRR1.04, 95% CI 0.96-1.13) groups. Compared to the PGT-A group, the proportion of usable blastocysts was statistically significantly lower in the PGT-SR group: 35.1% versus 24.4% (aRR 0.57, 95% CI 0.46-0.71) and the PGT-A&M group: 35.1% versus 31.5% (aRR 0.68, 95% CI 0.58-0.81). Implantation, pregnancy, and miscarriage rates were equivalent for all groups. CONCLUSION Patients with structural rearrangements have similar blastocyst development but significantly fewer usable blastocysts available for transfer compared to PGT-A testers. Nevertheless, with the transfer of a usable embryo, PGT-SR testers perform as well as those testing for PGT-A.
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11
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Boynukalin FK, Gultomruk M, Turgut NE, Rubio C, Rodrigo L, Yarkiner Z, Ecemis S, Karlikaya G, Findikli N, Bahceci M. The impact of patient, embryo, and translocation characteristics on the ploidy status of young couples undergoing preimplantation genetic testing for structural rearrangements (PGT-SR) by next generation sequencing (NGS). J Assist Reprod Genet 2021; 38:387-396. [PMID: 33398513 PMCID: PMC7884505 DOI: 10.1007/s10815-020-02054-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 12/28/2020] [Indexed: 10/22/2022] Open
Abstract
PURPOSE To evaluate the factors that affect the incidence of euploid balanced embryos and interchromosomal effect (ICE) in carriers of different structural rearrangements. METHODS This retrospective study includes 95 couples with reciprocal translocations (RecT) and 36 couples with Robertsonian translocations (RobT) undergoing Preimplantation Genetic Testing for Structural Rearrangements (PGT-SR) between March 2016 and July 2019. Next-generation sequencing (NGS) was the technique used coupled with trophectoderm (TE) biopsy. Only cases with females under 38 years were included. A total of 532 blastocysts were evaluated. RESULTS The euploidy rate was similar in RobT when compared with RecT carriers [57/156 (36.5%) vs. 112/376 (29.8%), p = 0.127]. The pure ICE rate was significantly higher in RobT carriers [48/156 (30.8%) vs. 53/376 (14.1%), p < 0.001] than it was in RecT carriers. Female age was the independent factor for the probability of obtaining a euploid embryo in RecT and RobT carriers, and increasing female age decreases the probability of obtaining a euploid embryo. In RecT carriers, no significant differences were observed in euploidy rates, pure ICE, or combined ICE according to the length of the translocated fragment and the chromosome group. However, total ICE was significantly lower when there was a breakpoint in the short chromosome arm together with a breakpoint in the long arm [(44/158 (27.8%) for pq or qp, 51/155 (32.9%) for pp and 30/63 (47.6%) for qq; p = 0.02]. CONCLUSION The incidence of euploid/balanced blastocysts was similar in both types of translocations. However, there was a significant increase in pure ICE in RobT compared to RecT carriers. In RecT carriers, the presence of the breakpoints in the long arm of the chromosomes involved in the rearrangement resulted in a higher total ICE.
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Affiliation(s)
| | - Meral Gultomruk
- Bahceci Health Group, Hakki Yeten cad. No: 11 Terrace Fulya, Fulya, Istanbul, Turkey
| | - Niyazi Emre Turgut
- Bahceci Health Group, Hakki Yeten cad. No: 11 Terrace Fulya, Fulya, Istanbul, Turkey
| | - Carmen Rubio
- IGENOMIX, Calle Narcís Monturiol Estarriol no. 11 Parcela B, Edificio Europark, Parque Tecnológico de Paterna, 46980, Paterna, Valencia, Spain
| | - Lorena Rodrigo
- IGENOMIX, Calle Narcís Monturiol Estarriol no. 11 Parcela B, Edificio Europark, Parque Tecnológico de Paterna, 46980, Paterna, Valencia, Spain
| | - Zalihe Yarkiner
- Department of Statistics, Cyprus Science University, Dr. Fazil Kucuk Cad., 99320, Ozankoy, Cyprus
| | - Selen Ecemis
- Bahceci Health Group, Hakki Yeten cad. No: 11 Terrace Fulya, Fulya, Istanbul, Turkey
| | - Guvenc Karlikaya
- Bahceci Health Group, Hakki Yeten cad. No: 11 Terrace Fulya, Fulya, Istanbul, Turkey
| | - Necati Findikli
- Bahceci Health Group, Hakki Yeten cad. No: 11 Terrace Fulya, Fulya, Istanbul, Turkey
| | - Mustafa Bahceci
- Bahceci Health Group, Hakki Yeten cad. No: 11 Terrace Fulya, Fulya, Istanbul, Turkey
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12
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In vitro fertilization outcomes after preimplantation genetic testing for chromosomal structural rearrangements comparing fluorescence in-situ hybridization, microarray comparative genomic hybridization, and next-generation sequencing. F S Rep 2020; 1:249-256. [PMID: 34223252 PMCID: PMC8244371 DOI: 10.1016/j.xfre.2020.09.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/18/2020] [Accepted: 09/21/2020] [Indexed: 12/22/2022] Open
Abstract
Objective To compare in vitro fertilization (IVF) outcomes for preimplantation genetic testing for chromosomal structural rearrangements (PGT-SR) using various testing platforms. Design Retrospective cohort. Setting Large academic IVF center. Patient(s) Fifty-one balanced translocation carriers undergoing IVF with PGT-SR who completed a total of 91 cycles, including 31 fluorescence in-situ hybridization (FISH), 24 microarray comparative genomic hybridization (aCGH), and 36 next-generation sequencing (NGS) testing cycles. Intervention(s) PGT-SR. Main Outcome Measure(s) Primary outcome of live-birth rate and secondary outcomes including implantation rate, clinical loss rate, and percentages of normal or balanced, unbalanced, and aneuploid embryos detected. Result(s) There was no statistically significant difference in LBR, though there was a tendency toward a higher LBR for NGS testing (14 of 19, 73.7%) compared with FISH (8 of 18, 44.4%) and aCGH (10 of 20, 50.0%). The implantation rate was statistically significantly higher for NGS (16 of 20, 80.0%) compared with FISH (11 of 25, 44.0%) and aCGH (16 of 30, 53.3%). There was no statistically significant difference in clinical pregnancy losses. There was a lower percentage of normal or balanced embryos with FISH (12.5%) compared with aCGH (23.7%) and with NGS (20.7%). Conclusion(s) This is the first report of PGT-SR outcomes for translocation carriers directly comparing PGT-SR using FISH, aCGH, and NGS. Our findings suggest an improvement in pregnancy outcomes parallel to the advancement in technology and are reassuring for continued use of NGS for this population.
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13
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Mahdavi M, Sharafi SM, Daniali SS, Riahi R, Kheirollahi M. The Clinical Effectiveness of Preimplantation Genetic Diagnosis for Chromosomal Translocation Carriers: A Meta-analysis. Glob Med Genet 2020; 7:14-21. [PMID: 32879919 PMCID: PMC7410090 DOI: 10.1055/s-0040-1712455] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Published data on the relationship between pregnancy outcomes of preimplantation genetic diagnosis (PGD) in translocation carriers have implicated inconclusive results. To identify potentially eligible reports, an electronic search was conducted in several databases, including PubMed, Scopus, Web of Knowledge, and Cochrane. Pooled odd ratios (ORs) and 95% confidence intervals (Cis) were estimated based on a random-effect model to evaluate the strength of association between PGD and successful pregnancy outcome in translocation carriers. A total of six cohort studies were included in the current study. The meta-analysis of these studies revealed that the PGD method was associated with an increased successful pregnancy outcome of translocation carriers (OR = 8.58; 95%CI: 1.40–52.76). In subgroup analysis, there was no significant association according to the chromosomal translocation carrier origin and the type of translocated chromosomes, as well as country. In developed countries, the pregnancy outcome of PGD was significantly improved in translocation carriers (OR = 21.79; 95%CI: 1.93–245.52). The current meta-analysis demonstrated that the PGD method is associated with successful pregnancy outcome in both types of reciprocal and Robertsonian translocation carriers, especially in developed countries.
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Affiliation(s)
- Manijeh Mahdavi
- Pediatric Inherited Diseases Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyedeh M Sharafi
- Environment Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyede S Daniali
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Riahi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Majid Kheirollahi
- Department of Genetics and Molecular Biology, School of Medicine, Pediatric Inherited Diseases Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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14
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Madjunkova S, Sundaravadanam Y, Antes R, Abramov R, Chen S, Yin Y, Zuzarte PC, Moskovtsev SI, Jorgensen LGT, Baratz A, Simpson JT, Librach C. Detection of Structural Rearrangements in Embryos. N Engl J Med 2020; 382:2472-2474. [PMID: 32558475 DOI: 10.1056/nejmc1913370] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
| | | | - Ran Antes
- CReATe Fertility Centre, Toronto, ON, Canada
| | | | - Siwei Chen
- CReATe Fertility Centre, Toronto, ON, Canada
| | - Yin Yin
- CReATe Fertility Centre, Toronto, ON, Canada
| | | | | | | | - Ari Baratz
- University of Toronto, Toronto, ON, Canada
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15
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Does the prognosis after PGT for structural rearrangement differ between female and male translocation carriers? Reprod Biomed Online 2020; 40:684-692. [PMID: 32334941 DOI: 10.1016/j.rbmo.2020.01.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 12/18/2019] [Accepted: 01/23/2020] [Indexed: 11/20/2022]
Abstract
RESEARCH QUESTION Chromosomal translocations are known genetic causes of premature ovarian insufficiency syndrome. Are certain translocations associated with decreased capacity of small antral follicles to respond to exogenous FSH? Does the prognosis after preimplantation genetic testing for structural rearrangements differ in couples with female or male translocation carriers and according to the type of translocation? DESIGN A single-centre, retrospective, observational study covering a 10-year period. One hundred and thirty-nine females carrying a translocation were compared with 192 partners of male translocation carriers. To evaluate ovarian response to FSH, the follicular output rate was used, defined by ratio between the pre-ovulatory follicle count on day of HCG x 100/antral follicle count (AFC). To determine a cut-off of metaphase II oocytes and biopsied embryos as predictor of obtaining a balanced embryo transfer, receiver operator characteristic curves were plotted. RESULT A decreased capacity of small antral follicles to respond to exogenous FSH in female translocation carriers was found. The number of metaphase II oocytes in both groups was weakly informative as a predictor of obtaining an embryo transfer. The number of biopsied embryos had some clinical value, however, and allowed a cut-off of 6.5 to be determined for female translocation carriers versus 5.5 for the partners of male translocation carriers. Live birth rates, however, were not different between female and male translocations carriers. CONCLUSIONS Female translocation carriers may respond poorly to ovarian stimulation, and present a higher rate of unbalanced embryos, which means that higher gonadotrophin doses may be required to increase the number of biopsied embryos.
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16
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Interchromosomal effect in carriers of translocations and inversions assessed by preimplantation genetic testing for structural rearrangements (PGT-SR). J Assist Reprod Genet 2019; 36:2547-2555. [PMID: 31696386 DOI: 10.1007/s10815-019-01593-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 09/24/2019] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Balanced carriers of structural rearrangements have an increased risk of unbalanced embryos mainly due to the production of unbalanced gametes during meiosis. Aneuploidy for other chromosomes not involved in the rearrangements has also been described. The purpose of this work is to know if the incidence of unbalanced embryos, interchromosomal effect (ICE) and clinical outcomes differ in carriers of different structural rearrangements. METHODS Cohort retrospective study including 359 preimplantation genetic testing cycles for structural rearrangements from 304 couples was performed. Comparative genomic hybridisation arrays were used for chromosomal analysis. The results were stratified and compared according to female age and carrier sex. The impact of different cytogenetic features of chromosomal rearrangements was evaluated. RESULTS In carriers of translocations, we observed a higher percentage of abnormal embryos from day 3 biopsies compared with day 5/6 biopsies and for reciprocal translocations compared with other rearrangements. We observed a high percentage of embryos with aneuploidies for chromosomes not involved in the rearrangement that could be attributed to total ICE (aneuploid balanced and unbalanced embryos). No significant differences were observed in these percentages between types of rearrangements. Pure ICE (aneuploid balanced embyos) was independent of female age only for Robertsonian translocations, and significantly increased in day 3 biopsies for all types of abnormalities. Furthermore, total ICE for carriers of Robertsonian translocations and biopsy on day 3 was independent of female age too. High ongoing pregnancy rates were observed for all studied groups, with higher pregnancy rate for male carriers. CONCLUSION We observed a higher percentage of abnormal embryos for reciprocal translocations. No significant differences for total ICE was found among the different types of rearrangements, with higher pure ICE only for Robertsonian translocations. There was a sex effect for clinical outcome for carriers of translocations, with higher pregnancy rate for male carriers. The higher incidence of unbalanced and aneuploid embryos should be considered for reproductive counselling in carriers of structural rearrangements.
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17
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Zhang L, Jiang W, Zhu Y, Chen H, Yan J, Chen ZJ. Effects of a carrier's sex and age on the segregation patterns of the trivalent of Robertsonian translocations. J Assist Reprod Genet 2019; 36:1963-1969. [PMID: 31392661 DOI: 10.1007/s10815-019-01534-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 07/15/2019] [Indexed: 10/26/2022] Open
Abstract
PURPOSE To investigate the effects of a carrier's sex and age on the segregation patterns of the trivalent of Robertsonian translocations. METHODS This retrospective study was designed to analyze the segregation patterns of the trivalent and euploidy rates of blastocysts. Data were collected from 154 couples with Robertsonian translocation (77 with a female carrier and 77 with a male carrier). Embryos were diagnosed via array comparative genomic hybridization between January 2013 and July 2017. The segregation patterns of the trivalent of 604 blastocysts were analyzed according to the carrier's sex and age. RESULTS The proportion of alternate segregation was significantly higher (82.9% vs. 55.2%) in the male carriers than in the female carriers of Robertsonian translocation, and the proportion of adjacent segregation was significantly lower (16.8% vs. 42.6%), with no difference in 3:0 segregation. The segregation patterns were similar in same-sex carriers when analyzed according to the type of translocation. The carrier's age had no influence on the segregation patterns of the trivalent. CONCLUSIONS The proportions of the trivalent's meiotic segregation pattern differ significantly according to the carrier's sex in Robertsonian translocations and are independent of the carrier's age. A significantly higher proportion of alternate segregation for normal or balanced chromosome contents was observed in the blastocysts of the male carriers than in those of the female carriers.
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Affiliation(s)
- Lei Zhang
- Center for Reproductive Medicine, Shandong University, 157 Jingliu Road, Jinan, 250021, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, China.,Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, China
| | - Wenjie Jiang
- Center for Reproductive Medicine, Shandong University, 157 Jingliu Road, Jinan, 250021, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, China.,Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, China
| | - Yueting Zhu
- Center for Reproductive Medicine, Shandong University, 157 Jingliu Road, Jinan, 250021, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, China.,Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, China
| | - Hong Chen
- Center for Reproductive Medicine, Shandong University, 157 Jingliu Road, Jinan, 250021, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, China.,Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, China
| | - Junhao Yan
- Center for Reproductive Medicine, Shandong University, 157 Jingliu Road, Jinan, 250021, China. .,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, China. .,Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, China.
| | - Zi-Jiang Chen
- Center for Reproductive Medicine, Shandong University, 157 Jingliu Road, Jinan, 250021, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, China.,Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, China.,Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
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18
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Tšuiko O, Dmitrijeva T, Kask K, Tammur P, Tõnisson N, Salumets A, Jatsenko T. Detection of a balanced translocation carrier through trophectoderm biopsy analysis: a case report. Mol Cytogenet 2019; 12:28. [PMID: 31244893 PMCID: PMC6582470 DOI: 10.1186/s13039-019-0444-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 06/11/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Balanced translocation carriers are burdened with fertility issues due to improper chromosome segregation in gametes, resulting in either implantation failure, miscarriage or birth of a child with chromosomal disorders. At the same time, these individuals are typically healthy with no signs of developmental problems, hence they often are unaware of their condition. Yet, because of difficulties in conceiving, balanced translocation carriers often turn to assisted reproduction, some of whom may also undergo preimplantation genetic testing for aneuploidy (PGT-A) to improve the likelihood of achieving a successful pregnancy. CASE REPORT We describe a female patient, who pursued in vitro fertilization (IVF) treatment coupled with PGT-A following two consecutive miscarriages, unaware of her genetic condition. PGT-A was performed on blastocyst-stage embryos and the results of comprehensive chromosome screening from a first IVF cycle demonstrated reciprocal segmental aberrations on chromosome 7 and chromosome 10 in two out of four embryos. Due to distinct embryo profiles, the couple was then referred for genetic counselling and subsequent parental karyotyping revealed the presence of a previously undetected balanced translocation in the mother. CONCLUSIONS These results confirm previous reports that genome-wide PGT-A can facilitate the identification of balanced translocation carriers in IVF patients, providing explanation for poor reproductive outcome and allowing adjustments in treatment strategies.
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Affiliation(s)
- Olga Tšuiko
- Competence Centre on Health Technologies, Tiigi 61b, 50410 Tartu, Estonia
| | - Tuuli Dmitrijeva
- BioEximi OÜ, Sõle 23, 10614 Tallinn, Estonia
- Women’s Clinic, West-Tallinn Central Hospital, Sõle 23, 10614 Tallinn, Estonia
| | - Katrin Kask
- Women’s Clinic, West-Tallinn Central Hospital, Sõle 23, 10614 Tallinn, Estonia
| | - Pille Tammur
- Department of Clinical Genetics, United Laboratories, Tartu University Hospital, L. Puusepa 2, 51014 Tartu, Estonia
| | - Neeme Tõnisson
- Department of Clinical Genetics in Tallinn, United Laboratories, Tartu University Hospital, L. Puusepa 2, 51014 Tartu, Estonia
- Estonian Genome Center, University of Tartu, Riia 23b, 51010 Tartu, Estonia
| | - Andres Salumets
- Competence Centre on Health Technologies, Tiigi 61b, 50410 Tartu, Estonia
- Institute of Bio- and Translational Medicine, University of Tartu, Ravila 19, 50411 Tartu, Estonia
- Department of Obstetrics and Gynaecology, University of Tartu, L. Puusepa 8, 50406 Tartu, Estonia
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2, 00029 Helsinki, Finland
| | - Tatjana Jatsenko
- Competence Centre on Health Technologies, Tiigi 61b, 50410 Tartu, Estonia
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19
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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.
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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
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20
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El Fekih S, Tous C, Gueganic N, Brugnon F, Ali HB, Bujan L, Moinard N, Caire-Tetauru E, Ajina M, Douet-Guilbert N, Morel F, Perrin A. Decrease of spermatozoa with an unbalanced chromosome content after cell sorting in men carrying a structural chromosomal abnormality. Andrology 2019; 8:181-190. [PMID: 31116011 DOI: 10.1111/andr.12643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/03/2019] [Accepted: 04/04/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND We showed that in men with a constitutional chromosomal abnormality, DNA fragmentation was significantly higher in chromosomally unbalanced spermatozoa than in spermatozoa with a normal or balanced chromosomal content. These results could be explained by a phenomenon already described in infertile men: abortive apoptosis. OBJECTIVES To determine whether magnetic-activated cell separation could select spermatozoa with lower levels of DNA fragmentation and unbalanced chromosome content in men carrying a structural chromosomal abnormality. MATERIALS AND METHODS The spermatozoa of ten males with a chromosomal rearrangement were separated into two populations using magnetic-activated cell separation (annexin V (-) and annexin V (+) fractions), in order to study meiotic segregation by fluorescence in situ hybridization, the percentage of spermatozoa with an externalization of phosphatidylserine by annexin V staining and DNA fragmentation by TdT-mediated dUTP nick-end labeling on the whole ejaculate and on selected spermatozoa in the same patient. RESULTS For all patients, the percentage of spermatozoa with externalization of phosphatidylserine decreased in the annexin V (-) fraction and increased in the annexin V (+) fraction as compared to the frozen-thawed semen sample. The rates of DNA fragmentation were statistically much lower in the annexin V (-) fraction when compared to the rate before magnetic-activated cell separation for all but one patient. Conversely, we observed a statistically significantly higher rate of DNA fragmentation in the annexin V (+) fraction for six patients. After magnetic-activated cell separation, there was a significant increase of normal/balanced spermatozoa in the fraction of annexin V (-) for all patients. Conversely, we observed a significant decrease in the fraction of annexin V (+) for seven patients. DISCUSSION AND CONCLUSIONS Magnetic-activated cell separation is a promising tool for increasing the selection of healthy spermatozoa, with a decrease in the number of spermatozoa with externalization of phosphatidylserine, DNA fragmentation, and chromosome unbalance, for use in assisted reproductive technologies such as intracytoplasmic sperm injection for males with a chromosomal structural abnormality.
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Affiliation(s)
- S El Fekih
- Laboratoire d'histologie, Embryologie et Cytogénétique, INSERM U1078, Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale, Brest, France.,Laboratoire de Cytogénétique, Génétique Moléculaire et Biologie de la Reproduction Humaines, CHU Farhat Hached Sousse et Université de Monastir, Monastir, Tunisie
| | - C Tous
- Service de Cytogénétique et Biologie de la Reproduction, CHRU Morvan, Brest, France
| | - N Gueganic
- Laboratoire d'histologie, Embryologie et Cytogénétique, INSERM U1078, Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale, Brest, France
| | - F Brugnon
- CHU Clermont-Ferrand, AMP, CECOS, Clermont-Ferrand, France.,Faculté de Médecine, IMOST, INSERM 1240, Clermont-Ferrand, France
| | - H Ben Ali
- Laboratoire de Cytogénétique, Génétique Moléculaire et Biologie de la Reproduction Humaines, CHU Farhat Hached Sousse et Université de Monastir, Monastir, Tunisie
| | - L Bujan
- Groupe de Recherche en Fertilité Humaine, EA 3694, Groupe d'activité de Médecine de la Reproduction, Université Paul Sabatier et CECOS, CHU Toulouse, France
| | - N Moinard
- Groupe de Recherche en Fertilité Humaine, EA 3694, Groupe d'activité de Médecine de la Reproduction, Université Paul Sabatier et CECOS, CHU Toulouse, France
| | - E Caire-Tetauru
- Service de Cytogénétique et Biologie de la Reproduction, CHRU Morvan, Brest, France
| | - M Ajina
- Unité de Médecine de la Reproduction, CHU Farhat Hached, Sousse, Tunisie
| | - N Douet-Guilbert
- Laboratoire d'histologie, Embryologie et Cytogénétique, INSERM U1078, Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale, Brest, France.,Service de Cytogénétique et Biologie de la Reproduction, CHRU Morvan, Brest, France
| | - F Morel
- Laboratoire d'histologie, Embryologie et Cytogénétique, INSERM U1078, Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale, Brest, France.,Service de Cytogénétique et Biologie de la Reproduction, CHRU Morvan, Brest, France
| | - A Perrin
- Laboratoire d'histologie, Embryologie et Cytogénétique, INSERM U1078, Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale, Brest, France.,Service de Cytogénétique et Biologie de la Reproduction, CHRU Morvan, Brest, France
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21
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Inheritance of imbalances in recurrent chromosomal translocation t(11;22): clarification by PGT-SR and sperm-FISH analysis. Reprod Biomed Online 2019; 39:40-48. [PMID: 31097322 DOI: 10.1016/j.rbmo.2019.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 02/19/2019] [Accepted: 02/28/2019] [Indexed: 10/27/2022]
Abstract
RESEARCH QUESTION To analyse why unbalanced viable offspring are derived mainly from the 3:1 segregation mode in t(11;22)(q23;q11.2) reciprocal translocation. DESIGN Retrospective analysis of 24 pre-implantation genetic testing for chromosomal structural re-arrangements (PGT-SR) cycles was performed on seven male and five female carriers of t(11;22) translocation. Sperm analysis was performed on each male carrier. These patients were directed to the study centre after several years of miscarriages and/or abortions, primary infertility for male carriers or birth of an affected child. RESULTS Twenty-four PGT-SR cycles were performed to exclude imbalances in both male and female carriers. The unbalanced embryos derived from the adjacent-1 segregation mode were the most represented in both male and female carriers (68.4% and 50%, respectively). These results were positively related with meiotic segregation analysis of reciprocal translocation in spermatozoa. A thorough analysis of the unbalanced embryo karyotypes determined that the expected viable +der22 karyotype resulting from 3:1 malsegregation was less represented at 5.3%. CONCLUSIONS These findings highlight the divergence that may exist between meiotic segregation and post-zygotic selection. Post-zygotic selection would be responsible for the elimination of unbalanced embryos derived from the adjacent-1 segregation mode. The combined action of several factors occurs at the beginning of post-zygotic selection. Genetic counselling must consider the risk of a birth related to the adjacent-1 segregation mode, irrespective of the sex of the translocation carrier. These results will allow deeper understanding of the PGT results of t(11;22) carriers, which often include a high number of aneuploid embryos.
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22
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Romanski PA, James KE, Sabatini ME. Women's health providers' perspectives on preimplantation genetic testing. Reprod Biomed Online 2019; 39:530-537. [PMID: 31300204 DOI: 10.1016/j.rbmo.2019.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/25/2019] [Accepted: 05/05/2019] [Indexed: 02/08/2023]
Abstract
RESEARCH QUESTION What are the perspectives of women's health providers on the use of preimplantation genetic testing (PGT) for common medical disorders? DESIGN A cross-sectional 15-question online anonymous survey was conducted of women's health providers specializing in general obstetrics/gynaecology, gynaecologic oncology and infertility at a tertiary care academic institution in Massachusetts, USA. Respondents could answer 'yes', 'no' or 'unsure' to each thematic question. RESULTS The survey was sent to 1060 providers and 240 providers responded (response rate 22.6%). Overall, 93% of respondents supported the use of PGT for the identification of genetic mutations which lead to childhood-onset disease, 83% supported the use of PGT for chromosomal aneuploidy screening, and 76% supported the use of PGT for cancer-related genetic disorders. Only 1.7% of respondents supported the use of PGT for non-disease-related indications, including sex selection and physical traits. Compared with general obstetrics/gynaecology providers, infertility specialists were more supportive of PGT. In total, 22.5% of respondents reported no prior knowledge of PGT. CONCLUSIONS In a sample of women's health providers across multiple different obstetrics/gynaecology specialties, there was overall support for the use of PGT for a variety of common indications. Infertility specialists were the most supportive, which may reflect the familiarity that these providers have with this procedure. There was an overwhelmingly non-supportive response for the use of PGT for non-disease-related indications. The percentage of medical professionals working in women's health without prior knowledge of PGT (22.5%) was higher than expected, identifying the need for more education regarding the availability and potential indications for this procedure.
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Affiliation(s)
- Phillip A Romanski
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Massachusetts General Hospital and Harvard Medical School, Boston MA, USA.
| | - Kaitlyn E James
- Deborah Kelly Center for Outcomes Research, Department of Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston MA, USA
| | - Mary E Sabatini
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Massachusetts General Hospital and Harvard Medical School, Boston MA, USA
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23
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Peregrino PFM, Gomes A, Fujii M, Bonetti TCS, Riboldi M, Monteleone PAA. The impact of balanced reciprocal translocation - 46,XX,t(7;17) (p13;q24) probably involving the SOX9 gene in the in vitro fertilization with own oocytes evaluated by preimplantation genetic testing or donated oocytes. JBRA Assist Reprod 2019; 23:68-71. [PMID: 30264949 PMCID: PMC6364276 DOI: 10.5935/1518-0557.20180066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Preimplantation genetic testing (PGT) for in vitro fertilization
(IVF) - also known as PGT for Structural Rearrangements (PGT-SR) - has emerged
as an option for at-risk couples carrying balanced translocations. The female in
the couple featured in this case report is a carrier of a balanced reciprocal
translocation who underwent IVF. PGT showed all her embryos were aneuploid. She
subsequently had two cycles using donor oocytes, which ended in miscarriages.
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Affiliation(s)
- Pedro F M Peregrino
- Monteleone - Centro de Reprodução Humana. São Paulo, Brasil.,Centro de Reprodução Humana Governador Mario Covas, Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo (FMUSP). São Paulo, Brasil
| | | | - Mariana Fujii
- Monteleone - Centro de Reprodução Humana. São Paulo, Brasil
| | - Tatiana C S Bonetti
- Departamento de Ginecologia, Universidade Federal de São Paulo - Escola Paulista de Medicina (UNIFESP-EPM). São Paulo, Brasil
| | - Marcia Riboldi
- Igenomix Brasil, Laboratório de Medicina Genética Ltda. São Paulo, Brasil
| | - Pedro A A Monteleone
- Monteleone - Centro de Reprodução Humana. São Paulo, Brasil.,Centro de Reprodução Humana Governador Mario Covas, Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo (FMUSP). São Paulo, Brasil
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24
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Zhou S, Cheng D, Ouyang Q, Xie P, Lu C, Gong F, Hu L, Tan Y, Lu G, Lin G. Prevalence and authenticity of de-novo segmental aneuploidy (>16 Mb) in human blastocysts as detected by next-generation sequencing. Reprod Biomed Online 2018; 37:511-520. [PMID: 30228073 DOI: 10.1016/j.rbmo.2018.08.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 08/10/2018] [Accepted: 08/10/2018] [Indexed: 01/09/2023]
Abstract
RESEARCH QUESTION What is the prevalence and authenticity of de-novo segmental aneuploidies (>16 Mb) detected by next-generation sequencing (NGS) in human preimplantation blastocysts? DESIGN Between April 2013 and June 2016, 5735 blastocysts from 1854 couples (average age 33.11 ± 5.65 years) underwent preimplantation genetic testing for chromosomal structural rearrangement (PGT-SR) or for aneuploidy (PGT-A) using NGS on trophectoderm (TE) biopsy samples. The prevalence of de-novo segmental aneuploidy was calculated from these results. Forty blastocysts with de-novo segmental aneuploidy detected by NGS, which had been donated for research, were warmed for further fluorescence in-situ hybridization (FISH) analysis to confirm their authenticity. RESULTS The frequency of de-novo segmental aneuploidies in blastocysts was 10.13% (581/5735); the phenomenon was not related to maternal age and occurred on all chromosomes. Of the 40 donated blastocysts, 39 were successfully warmed and fixed for FISH analysis at the single-cell level. The de-novo segmental aneuploidies identified by NGS were confirmed by FISH in all 39 blastocysts. However, the de-novo segmental aneuploidies in these blastocysts were not all pure patterns, with 66.67% (26/39) of blastocysts exhibiting mosaic patterns varying from 8.30% to 92.86% of cells with de-novo segmental aneuploidy. The concordance rate between NGS and FISH in TE and inner cell mass (ICM) samples was 47.69% (31/65). CONCLUSIONS De-novo segmental aneuploidy above 16 Mb occurred in blastocysts and could be detected by NGS, while some aneuploidies existed as mosaics in both TE and ICM.
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Affiliation(s)
- Shuang Zhou
- National Engineering and Research Center of Human Stem Cells, Changsha, China; Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha, China
| | - Dehua Cheng
- Reproductive & Genetic Hospital of CITIC-Xiangya, Changsha, China; Key Laboratory of Reproductive and Stem Cell Engineering, Ministry of Health, Changsha, China; Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha, China
| | - Qi Ouyang
- National Engineering and Research Center of Human Stem Cells, Changsha, China; Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha, China
| | - Pingyuan Xie
- National Engineering and Research Center of Human Stem Cells, Changsha, China; Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha, China
| | - Changfu Lu
- Reproductive & Genetic Hospital of CITIC-Xiangya, Changsha, China; Key Laboratory of Reproductive and Stem Cell Engineering, Ministry of Health, Changsha, China; Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha, China
| | - Fei Gong
- Reproductive & Genetic Hospital of CITIC-Xiangya, Changsha, China; Key Laboratory of Reproductive and Stem Cell Engineering, Ministry of Health, Changsha, China; Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha, China
| | - Liang Hu
- National Engineering and Research Center of Human Stem Cells, Changsha, China; Reproductive & Genetic Hospital of CITIC-Xiangya, Changsha, China; Key Laboratory of Reproductive and Stem Cell Engineering, Ministry of Health, Changsha, China; Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha, China
| | - Yueqiu Tan
- Reproductive & Genetic Hospital of CITIC-Xiangya, Changsha, China; Key Laboratory of Reproductive and Stem Cell Engineering, Ministry of Health, Changsha, China; Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha, China
| | - Guangxiu Lu
- National Engineering and Research Center of Human Stem Cells, Changsha, China; Reproductive & Genetic Hospital of CITIC-Xiangya, Changsha, China; Key Laboratory of Reproductive and Stem Cell Engineering, Ministry of Health, Changsha, China
| | - Ge Lin
- National Engineering and Research Center of Human Stem Cells, Changsha, China; Reproductive & Genetic Hospital of CITIC-Xiangya, Changsha, China; Key Laboratory of Reproductive and Stem Cell Engineering, Ministry of Health, Changsha, China; Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha, China.
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25
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Brunet BCFK, Shen J, Cai L, Xie J, Cui Y, Liu J, Wu W. Preimplantation genetic testing for complex chromosomal rearrangement carriers by next-generation sequencing. Reprod Biomed Online 2018; 37:375-382. [PMID: 30314889 DOI: 10.1016/j.rbmo.2018.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 07/03/2018] [Accepted: 07/03/2018] [Indexed: 02/06/2023]
Abstract
RESEARCH QUESTION Can preimplantation genetic testing (PGT) with next-generation sequencing (NGS) increase the chance of achieving a balanced euploid pregnancy in complex chromosome rearrangement (CCR) carriers? DESIGN Six couples underwent PGT at the Clinical Centre of Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University. The CCR carriers in the six couples were: Case A: 46,XY,t(1;4;11)(p31;p16;q22); Case B: 46,XY,t(3;13;5)(p14;q21;p14); Case C: 46,XX,t(6;11;21)(q21;q21;q13); Case D: 46,XX,inv(9)(p12; q13),t(13;15)(q14;q24); Case E: 46,XX,inv(9)(p12;q13),t(7;9)(q22;p22); and Case F: 46,XX,t(2;7)(q21;q36),t(2;4)(p10;q10),t(2;4)(q15;q10). After ovarian stimulation followed by oocyte retrieval and embryo culture, PGT was performed on day 5 or 6 blastocyst biopsies using NGS to identify normal/balanced euploid embryos. Vitrified-warmed single embryo transfers were performed using normal/balanced euploid embryos. RESULTS After seven cycles, 84 oocytes were retrieved. Whole genome sequencing by NGS was performed on 25 trophectoderm biosies. Six (24%) embryos were identified as normal/balanced euploid, four were transferred resulting in four live births. Case A, C, D and E each gave birth to a healthy baby after their first cycle. There was no transferable embryo after two cycles for Case B and one cycle for Case F. The implantation rate per transfer was 4/4 and the live birth rate was 4/4. CONCLUSION These results strongly support the use of NGS for CCR carriers.
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Affiliation(s)
- Beatrice Chung Fat King Brunet
- The State Key Laboratory of Reproductive MedicineClinical Centre of Reproductive MedicineFirst Affiliated Hospital of Nanjing Medical UniversityNanjing210029PR China
| | - Jiandong Shen
- The State Key Laboratory of Reproductive MedicineClinical Centre of Reproductive MedicineFirst Affiliated Hospital of Nanjing Medical UniversityNanjing210029PR China
| | - Lingbo Cai
- The State Key Laboratory of Reproductive MedicineClinical Centre of Reproductive MedicineFirst Affiliated Hospital of Nanjing Medical UniversityNanjing210029PR China
| | - Jiazhi Xie
- The State Key Laboratory of Reproductive MedicineClinical Centre of Reproductive MedicineFirst Affiliated Hospital of Nanjing Medical UniversityNanjing210029PR China
| | - Yugui Cui
- The State Key Laboratory of Reproductive MedicineClinical Centre of Reproductive MedicineFirst Affiliated Hospital of Nanjing Medical UniversityNanjing210029PR China
| | - Jiayin Liu
- The State Key Laboratory of Reproductive MedicineClinical Centre of Reproductive MedicineFirst Affiliated Hospital of Nanjing Medical UniversityNanjing210029PR China.
| | - Wei Wu
- The State Key Laboratory of Reproductive MedicineClinical Centre of Reproductive MedicineFirst Affiliated Hospital of Nanjing Medical UniversityNanjing210029PR China.
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Iews M, Tan J, Taskin O, Alfaraj S, AbdelHafez FF, Abdellah AH, Bedaiwy MA. Does preimplantation genetic diagnosis improve reproductive outcome in couples with recurrent pregnancy loss owing to structural chromosomal rearrangement? A systematic review. Reprod Biomed Online 2018; 36:677-685. [PMID: 29627226 DOI: 10.1016/j.rbmo.2018.03.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Revised: 03/08/2018] [Accepted: 03/08/2018] [Indexed: 01/18/2023]
Abstract
Recurrent pregnancy loss (RPL) is a common, yet elusive, complication of pregnancy. Among couples at high risk of RPL, such as those carrying a structural chromosomal rearrangement, preimplantation genetic diagnosis (PGD) has been proposed as a tool to improve live birth rates and reduce the incidence of miscarriage; however, no clear consensus has been reached on its benefits in this population. This systematic review summarizes existing published research on the effect of PGD on pregnancy outcomes among carriers of chromosomal abnormalities with RPL. A comprehensive search of common databases was conducted, which yielded 20 studies. Meta-analysis was precluded owing to significant heterogeneity between studies. The primary outcome of interest was live birth rate (LBR), and a pooled total of 847 couples who conceived naturally had a LBR ranging from 25-71% compared with 26.7-87% among 562 couples who underwent IVF and PGD. Limitations of the study include lack of large comparative or randomized control studies. Patients experiencing RPL with structural chromosomal rearrangement should be counselled that good reproductive outcomes can be achieved through natural conception, and that IVF-PGD should not be offered first-line, given the unproven benefits, additional cost and potential complications associated with assisted reproductive technology.
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Affiliation(s)
- Mahmoud Iews
- Department of Obstetrics and Gynecology, The University of British Columbia, D415A-4500 Oak Street, Vancouver, BC, V6H 3N1, Canada; Department of Obstetrics and Gynecology, South Valley University, 83523 Qena, Egypt
| | - Justin Tan
- Department of Obstetrics and Gynecology, The University of British Columbia, D415A-4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
| | - Omur Taskin
- Department of Obstetrics and Gynecology, The University of British Columbia, D415A-4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
| | - Sukainah Alfaraj
- Department of Obstetrics and Gynecology, The University of British Columbia, D415A-4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
| | - Faten F AbdelHafez
- Department of Obstetrics and Gynecology, Assiut University, Kornish Al Ibrahimeya, Al Walideyah Al Qebleyah, Qesm Than Asyut, Assiut Governorate, Egypt
| | - Ahmed H Abdellah
- Department of Obstetrics and Gynecology, South Valley University, 83523 Qena, Egypt
| | - Mohamed A Bedaiwy
- Department of Obstetrics and Gynecology, The University of British Columbia, D415A-4500 Oak Street, Vancouver, BC, V6H 3N1, Canada.
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27
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Kuliev A, Rechitsky S. Preimplantation genetic testing: current challenges and future prospects. Expert Rev Mol Diagn 2017; 17:1071-1088. [DOI: 10.1080/14737159.2017.1394186] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Anver Kuliev
- Reproductive Genetics Innovations, Chicago, IL, USA
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28
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Diagnosis of parental balanced reciprocal translocations by trophectoderm biopsy and comprehensive chromosomal screening. J Assist Reprod Genet 2017; 35:165-169. [PMID: 28900794 DOI: 10.1007/s10815-017-1042-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 09/05/2017] [Indexed: 10/18/2022] Open
Abstract
PURPOSE This study investigates a case series of eight couples who underwent trophectoderm (TE) biopsy and comprehensive chromosomal screening (CCS) for routine aneuploidy screening and were found to have CCS results concerning for previously undetected parental balanced reciprocal translocations. METHODS In each case, controlled ovarian hyperstimulation and in vitro fertilization (IVF) yielded multiple blastocysts that each underwent CCS with high-density oligonucleotide microarray comparative genomic hybridization (aCGH). RESULTS Parental translocations were suspected based on the finding of identical break point mutations in multiple embryos from each couple. Confirmation of these suspected translocations within blastocysts was performed with next-generation sequencing (NGS). Subsequent parental karyotypic evaluation resulted in a diagnosis of parental balanced reciprocal translocation in each case. CONCLUSIONS We demonstrated that high-resolution aCGH and NGS on TE biopsies can accurately detect parental reciprocal translocations when previously unrecognized.
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29
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Preferential selection and transfer of euploid noncarrier embryos in preimplantation genetic diagnosis cycles for reciprocal translocations. Fertil Steril 2017; 108:620-627.e4. [PMID: 28863935 DOI: 10.1016/j.fertnstert.2017.07.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 06/16/2017] [Accepted: 07/12/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To develop and validate a new strategy to distinguish between balanced/euploid carrier and noncarrier embryos in preimplantation genetic diagnosis (PGD) cycles for reciprocal translocations and to successfully achieve a live birth after selective transfer of a noncarrier embryo. DESIGN Retrospective and prospective study. SETTING In vitro fertilization (IVF) units. PATIENT(S) Eleven patients undergoing mate pair sequencing for identification of translocation breakpoints, followed by clinical PGD cycles. INTERVENTION(S) Embryo biopsy with 24-chromosome testing to determine carrier status of balanced/euploid embryos. MAIN OUTCOME MEASURE(S) Definition of translocation breakpoints and polymerase chain reaction (PCR) diagnostic primers, correct diagnosis of euploid embryos for carrier status, and a live birth with a normal karyotype after transfer of a noncarrier embryo. RESULT(S) In 9 of 11 patients (82%), translocation breakpoints were successfully identified. In four patients with a term PGD pregnancy established with a balanced/euploid embryo of unknown carrier status, the correct carrier status was retrospectively determined, matching with the cytogenetic karyotype of the resulting newborns. In a prospective PGD cycle undertaken by a patient with a 46,XY,t(7;14)(q22;q24.3) translocation, the four balanced/euploid embryos identified comprised three carriers and one noncarrier. Transfer of the noncarrier embryo resulted in birth of a healthy girl who was subsequently confirmed with a normal 46,XX karyotype. CONCLUSION(S) The combination of mate pair sequencing and PCR breakpoint analysis of balanced reciprocal translocation derivatives is a novel, reliable, and accurate strategy for distinguishing between carrier and noncarrier balanced/euploid embryos. The method has potential application in clinical PGD cycles for patients with reciprocal translocations or other structural rearrangements.
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30
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Kong GWS, Ma Y, Ou J, Kwok YKY, Wang W, Yeung QSY, Wong CKM, Li Q, Xu W, Lu W, Li H, Li TC, Choy KW. Validation of a high-throughput and robust technique: BACs-on-beads assay (KaryoLite BoBs) for pre-implantation aneuploidy screening. Taiwan J Obstet Gynecol 2017; 56:514-520. [DOI: 10.1016/j.tjog.2017.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2017] [Indexed: 11/28/2022] Open
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31
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Haapaniemi Kouru K, Malmgren H, White I, Rodriguez Sanchez A, Syk Lundberg E. Meiotic segregation analyses of reciprocal translocations in spermatozoa and embryos: no support for predictive value regarding PGD outcome. Reprod Biomed Online 2017; 34:645-652. [PMID: 28336162 DOI: 10.1016/j.rbmo.2017.02.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 02/24/2017] [Accepted: 02/28/2017] [Indexed: 11/28/2022]
Abstract
Translocation heterozygotes have an increased risk of producing gametes with unbalanced chromosome content. This often leads to reproductive problems such as infertility, repeated miscarriages or birth of an affected child. To increase the chances of having a healthy live-born child, translocation heterozygotes often opt for preimplantation genetic diagnosis (PGD). The aim of this study was to investigate whether there is a correlation between chromosome segregation in spermatozoa from translocation heterozygotes and the number of balanced embryos produced during PGD that may be used to predict the PGD outcome. Ten male reciprocal translocation heterozygotes that went through PGD at a Stockholm PGD centre were included. We analysed 1000 spermatozoa from each patient and between 3 and 29 embryos from the total of PGD cycles that the couples went through. Fluorescence in-situ hybridization (FISH) analysis of spermatozoa and embryos was performed with the same DNA probes. We found that the proportion of balanced spermatozoa was much higher than the proportion of balanced embryos during PGD. Our results indicate that a sperm FISH analysis prior to PGD is not a reliable predictor of the PGD outcome. PGD is a valuable reproductive alternative for translocation heterozygotes with reproductive problems and should be offered to these couples.
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Affiliation(s)
- Katarina Haapaniemi Kouru
- Department of Molecular Medicine and Surgery, Clinical Genetics Unit, Karolinska Institutet, Stockholm SE 17176, Sweden; Fertility Centre Stockholm, Storangsvagen 10, Stockholm SE 11541, Sweden.
| | - Helena Malmgren
- Department of Molecular Medicine and Surgery, Clinical Genetics Unit, Karolinska Institutet, Stockholm SE 17176, Sweden
| | - Irene White
- Department of Molecular Medicine and Surgery, Clinical Genetics Unit, Karolinska Institutet, Stockholm SE 17176, Sweden
| | - Ana Rodriguez Sanchez
- Department of Molecular Medicine and Surgery, Clinical Genetics Unit, Karolinska Institutet, Stockholm SE 17176, Sweden
| | - Elisabeth Syk Lundberg
- Department of Molecular Medicine and Surgery, Clinical Genetics Unit, Karolinska Institutet, Stockholm SE 17176, Sweden
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Christodoulou C, Dheedene A, Heindryckx B, van Nieuwerburgh F, Deforce D, De Sutter P, Menten B, Van den Abbeel E. Preimplantation genetic diagnosis for chromosomal rearrangements with the use of array comparative genomic hybridization at the blastocyst stage. Fertil Steril 2017; 107:212-219.e3. [PMID: 27793373 DOI: 10.1016/j.fertnstert.2016.09.045] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 09/09/2016] [Accepted: 09/27/2016] [Indexed: 02/02/2023]
Affiliation(s)
- Christodoulos Christodoulou
- Ghent Fertility and Stem Cell Team, Department for Reproductive Medicine, Ghent University Hospital, Ghent, Belgium.
| | - Annelies Dheedene
- Center for Medical Genetics, Ghent University and Ghent University Hospital, Ghent, Belgium
| | - Björn Heindryckx
- Ghent Fertility and Stem Cell Team, Department for Reproductive Medicine, Ghent University Hospital, Ghent, Belgium
| | - Filip van Nieuwerburgh
- Laboratory of Pharmaceutical Biotechnology, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Dieter Deforce
- Laboratory of Pharmaceutical Biotechnology, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Petra De Sutter
- Ghent Fertility and Stem Cell Team, Department for Reproductive Medicine, Ghent University Hospital, Ghent, Belgium
| | - Björn Menten
- Center for Medical Genetics, Ghent University and Ghent University Hospital, Ghent, Belgium
| | - Etienne Van den Abbeel
- Ghent Fertility and Stem Cell Team, Department for Reproductive Medicine, Ghent University Hospital, Ghent, Belgium
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Translocations, inversions and other chromosome rearrangements. Fertil Steril 2016; 107:19-26. [PMID: 27793378 DOI: 10.1016/j.fertnstert.2016.10.013] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 10/06/2016] [Accepted: 10/07/2016] [Indexed: 01/14/2023]
Abstract
Chromosomal rearrangements have long been known to significantly impact fertility and miscarriage risk. Advancements in molecular diagnostics are challenging contemporary clinicians and patients in accurately characterizing the reproductive risk of a given abnormality. Initial attempts at preimplantation genetic diagnosis were limited by the inability to simultaneously evaluate aneuploidy and missed up to 70% of aneuploidy in chromosomes unrelated to the rearrangement. Contemporary platforms are more accurate and less susceptible to technical errors. These techniques also offer the ability to improve outcomes through diagnosis of uniparental disomy and may soon be able to consistently distinguish between normal and balanced translocation karyotypes. Although an accurate projection of the anticipated number of unbalanced embryos is not possible at present, confirmation of normal/balanced status results in high pregnancy rates (PRs) and diagnostic accuracy.
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Kato K, Aoyama N, Kawasaki N, Hayashi H, Xiaohui T, Abe T, Kuroda T. Reproductive outcomes following preimplantation genetic diagnosis using fluorescence in situ hybridization for 52 translocation carrier couples with a history of recurrent pregnancy loss. J Hum Genet 2016; 61:687-92. [DOI: 10.1038/jhg.2016.39] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 01/28/2016] [Accepted: 03/28/2016] [Indexed: 01/02/2023]
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Clinical application of next-generation sequencing in preimplantation genetic diagnosis cycles for Robertsonian and reciprocal translocations. J Assist Reprod Genet 2016; 33:899-906. [PMID: 27167073 DOI: 10.1007/s10815-016-0724-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 04/28/2016] [Indexed: 10/21/2022] Open
Abstract
PURPOSE The purpose of this study was to apply next-generation sequencing (NGS) technology to identify chromosomally normal embryos for transfer in preimplantation genetic diagnosis (PGD) cycles for translocations. METHODS A total of 21 translocation couples with a history of infertility and repeated miscarriage presented at our PGD clinic for 24-chromosome embryo testing using copy number variation sequencing (CNV-Seq). RESULTS Testing of 98 embryo samples identified 68 aneuploid (69.4 %) and 30 (30.6 %) euploid embryos. Among the aneuploid embryos, the most common abnormalities were segmental translocation imbalances, followed by whole autosomal trisomies and monosomies, segmental imbalances of non-translocation chromosomes, and mosaicism. In all unbalanced embryos resulting from reciprocal translocations, CNV-Seq precisely identified both segmental imbalances, extending from the predicted breakpoints to the chromosome termini. From the 21 PGD cycles, eight patients had all abnormal embryos and 13 patients had at least one normal/balanced and euploid embryo available for transfer. In nine intrauterine transfer cycles, seven healthy babies have been born. In four of the seven children tested at 18 weeks gestation, the karyotypes matched with the original PGD results. CONCLUSION In clinical PGD translocation cycles, CNV-Seq displayed the hallmarks of a comprehensive diagnostic technology for high-resolution 24-chromosome testing of embryos, capable of identifying true euploid embryos for transfer.
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Kohn TP, Kohn JR, Darilek S, Ramasamy R, Lipshultz L. Genetic counseling for men with recurrent pregnancy loss or recurrent implantation failure due to abnormal sperm chromosomal aneuploidy. J Assist Reprod Genet 2016; 33:571-576. [PMID: 27020275 DOI: 10.1007/s10815-016-0702-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 03/10/2016] [Indexed: 10/22/2022] Open
Abstract
PURPOSE The purpose of this study is to review recurrent pregnancy loss (RPL) due to sperm chromosomal abnormalities and discuss the genetic counseling that is required for men with sperm chromosomal abnormalities. METHOD The literature was reviewed, and a genetic counselor lends her expertise as to how couples with RPL and sperm chromosomal abnormalities ought to be counseled. The review of the literature was performed using MEDLINE. RESULTS Sperm fluorescence in situ hybridization (FISH) can be used to determine if disomy or unbalanced chromosomal translocations are present. In men with aneuploidy in sperm or who carry a chromosomal translocation, pre-implantation genetic screening (PGS) combined with in vitro fertilization (IVF) and intra-cytoplasmic sperm injection (ICSI) can increase chances of live birth. In men with abnormal sperm FISH results, the degree of increased risk of abnormal pregnancy remains unclear. Genetic counselors can provide information to couples about the risk for potential trisomies and sex chromosome aneuploidies and discuss their reproductive and testing options such as PGS, use of donor sperm, and adoption. The provision of genetic counseling also allows a couple to be educated about recommended prenatal testing since pregnancies conceived with a partner who has had abnormal sperm FISH are considered to be at increased risk for aneuploidy. CONCLUSION We review the literature and discuss genetic counseling for couples with RPL or recurrent implantation failure due to increased sperm aneuploidy.
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Affiliation(s)
| | | | - Sandra Darilek
- Molecular and Human Genetics Clinical Program, Baylor College of Medicine, Houston, TX, USA
| | - Ranjith Ramasamy
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Larry Lipshultz
- Scott Department of Urology, Baylor College of Medicine, 6624 Fannin Street Suite 1700, Houston, TX, 77030, USA.
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Ferfouri F, Bernicot I, Schneider A, Haquet E, Hédon B, Anahory T. Is the resulting phenotype of an embryo with balanced X-autosome translocation, obtained by means of preimplantation genetic diagnosis, linked to the X inactivation pattern? Fertil Steril 2016; 105:1035-46. [PMID: 26772789 DOI: 10.1016/j.fertnstert.2015.12.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 11/07/2015] [Accepted: 12/08/2015] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To examine if a balanced female embryo with X-autosome translocation could, during its subsequent development, express an abnormal phenotype. DESIGN Preimplantation genetic diagnosis (PGD) analysis on two female carriers with maternal inherited X-autosome translocations. SETTING Infertility center and genetic laboratory in a public hospital. PATIENT(S) Two female patients carriers undergoing PGD for a balanced X-autosome translocations: patient 1 with 46,X,t(X;2)(q27;p15) and patient 2 with 46,X,t(X;22)(q28;q12.3). INTERVENTION(S) PGD for balanced X-autosome translocations. MAIN OUTCOME MEASURE(S) PGD outcomes, fluorescence in situ hybridization in biopsied embryos and meiotic segregation patterns analysis of embryos providing from X-autosome translocation carriers. RESULT(S) Controlled ovarian stimulation facilitated retrieval of a correct number of oocytes. One balanced embryo per patient was transferred and one developed, but the patient miscarried after 6 weeks of amenorrhea. In X-autosome translocation carriers, balanced Y-bearing embryos are most often phenotypically normal and viable. An ambiguous phenotype exists in balanced X-bearing embryos owing to the X inactivation mechanism. In 46,XX embryos issued from an alternate segregation, der(X) may be inactivated and partially spread transcriptional silencing into a translocated autosomal segment. Thus, the structural unbalanced genotype could be turned into a viable functional balanced one. It is relevant that a discontinuous silencing is observed with a partial and unpredictable inactivation of autosomal regions. Consequently, the resulting phenotype remains a mystery and is considered to be at risk of being an abnormal phenotype in the field of PGD. CONCLUSION(S) It is necessary to be cautious regarding to PGD management for this type of translocation, particularly in transferred female embryos.
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Affiliation(s)
- Fatma Ferfouri
- Cytogenetic PGD Department, CHU Montpellier University Hospital, Montpellier, France
| | - Izabel Bernicot
- Cytogenetic PGD Department, CHU Montpellier University Hospital, Montpellier, France
| | - Anouck Schneider
- Cytogenetic PGD Department, CHU Montpellier University Hospital, Montpellier, France
| | - Emmanuelle Haquet
- ART-PGD Department, CHU Montpellier University Hospital, Montpellier, France
| | - Bernard Hédon
- ART-PGD Department, CHU Montpellier University Hospital, Montpellier, France
| | - Tal Anahory
- Cytogenetic PGD Department, CHU Montpellier University Hospital, Montpellier, France; ART-PGD Department, CHU Montpellier University Hospital, Montpellier, France; INSERM U487, Saint Eloi Hospital, Montpellier, France.
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39
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Kohn TP, Clavijo R, Ramasamy R, Hakky T, Candrashekar A, Lamb DJ, Lipshultz LI. Reproductive outcomes in men with karyotype abnormalities: Case report and review of the literature. Can Urol Assoc J 2015; 9:E667-70. [PMID: 26425238 DOI: 10.5489/cuaj.2902] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Reciprocal translocations of autosomal chromosomes are present in about 1/625 men, yet often there are no symptoms except primary infertility. Abnormal segregation during meiosis often produces sperm and subsequent embryos with unbalanced translocations that often ultimately result in spontaneous abortions. We report on a 37-year-old man and his 39-year-old wife who complained of primary infertility. Previous in vitro fertilization (IVF) had resulted in pregnancy, but two spontaneous abortions. Upon chromosomal testing, the man was diagnosed with a reciprocal translocation and his wife was diagnosed with mosaic Turner's syndrome. Through testicular sperm extraction (TESE) and IVF with preimplantation genetic screening (PGS), they succeeded in having two healthy children. Since men with different karyotype abnormalities can have male infertility, we reviewed the literature and summarized the reproductive outcomes for men with both autosome and sex chromosomal karyotype abnormalities.
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Affiliation(s)
- Taylor P Kohn
- Department of Urology, Baylor College of Medicine, Houston, TX
| | - Raul Clavijo
- Department of Urology, University of California, Los Angeles, CA
| | | | - Tariq Hakky
- Department of Urology, Baylor College of Medicine, Houston, TX
| | | | - Dolores J Lamb
- Department of Urology, Baylor College of Medicine, Houston, TX
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Bono S, Biricik A, Spizzichino L, Nuccitelli A, Minasi MG, Greco E, Spinella F, Fiorentino F. Validation of a semiconductor next-generation sequencing-based protocol for preimplantation genetic diagnosis of reciprocal translocations. Prenat Diagn 2015; 35:938-44. [PMID: 26243475 DOI: 10.1002/pd.4665] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 07/30/2015] [Accepted: 07/31/2015] [Indexed: 11/07/2022]
Abstract
OBJECTIVE We aim to validate a semiconductor next-generation sequencing (NGS)-based method to detect unbalanced chromosome translocation in preimplantation embryos. METHODS The study consisted of a blinded retrospective evaluation with NGS of 145 whole-genome amplification products obtained from biopsy of cleavage-stage embryos or blastocysts, derived from 33 couples carrying different balanced translocations. Consistency of NGS-based copy number assignments was evaluated and compared with the results obtained by array-comparative genomic hybridization. RESULTS Reliably identified with the NGS-based protocol were 162 segmental imbalances derived from 33 different chromosomal translocations, with the smallest detectable chromosomal segment being 5 Mb in size. Of the 145 embryos analysed, 20 (13.8%) were balanced, 43 (29.6%) were unbalanced, 53 (36.5%) were unbalanced and aneuploid, and 29 (20%) were balanced but aneuploid. NGS sensitivity for unbalanced/aneuploid chromosomal call (consistency of chromosome copy number assignment) was 99.75% (402/403), with a specificity of 100% (3077/3077). NGS specificity and sensitivity for unbalanced/aneuploid embryo call were 100%. CONCLUSIONS Next-generation sequencing can detect chromosome imbalances in embryos with the added benefit of simultaneous comprehensive aneuploidy screening. Given the high level of consistency with array-comparative genomic hybridization, NGS has been demonstrated to be a robust high-throughput technique ready for clinical application in preimplantation genetic diagnosis for chromosomal translocations, with potential advantages of automation, increased throughput and reduced cost.
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Affiliation(s)
- S Bono
- GENOMA, Molecular Genetics Laboratory, Rome, Italy
| | - A Biricik
- GENOMA, Molecular Genetics Laboratory, Rome, Italy
| | | | - A Nuccitelli
- GENOMA, Molecular Genetics Laboratory, Rome, Italy
| | - M G Minasi
- Centre for Reproductive Medicine, European Hospital, Rome, Italy
| | - E Greco
- Centre for Reproductive Medicine, European Hospital, Rome, Italy
| | - F Spinella
- GENOMA, Molecular Genetics Laboratory, Rome, Italy
| | - F Fiorentino
- GENOMA, Molecular Genetics Laboratory, Rome, Italy
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Pylyp LY, Spinenko LO, Verhoglyad NV, Kashevarova OO, Zukin VD. Chromosomal abnormalities in patients with infertility. CYTOL GENET+ 2015. [DOI: 10.3103/s009545271503010x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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42
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Idowu D, Merrion K, Wemmer N, Mash JG, Pettersen B, Kijacic D, Lathi RB. Pregnancy outcomes following 24-chromosome preimplantation genetic diagnosis in couples with balanced reciprocal or Robertsonian translocations. Fertil Steril 2015; 103:1037-42. [DOI: 10.1016/j.fertnstert.2014.12.118] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 12/18/2014] [Accepted: 12/18/2014] [Indexed: 12/01/2022]
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43
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Kim JY, Lee HS, Kang IS. Preimplantation genetic diagnosis. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2015. [DOI: 10.5124/jkma.2015.58.11.979] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Jin Young Kim
- Department of Obstetrics and Gynecology of Fertility Center, CHA University, Seoul, Korea
| | - Hyoung-Song Lee
- Genetics Laboratory of Fertility Center, CHA Gangnam Medical Center, CHA University, Seoul, Korea
| | - Inn Soo Kang
- Department of Obstetrics and Gynecology of Fertility Center, CHA University, Seoul, Korea
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Tan Y, Yin X, Zhang S, Jiang H, Tan K, Li J, Xiong B, Gong F, Zhang C, Pan X, Chen F, Chen S, Gong C, Lu C, Luo K, Gu Y, Zhang X, Wang W, Xu X, Vajta G, Bolund L, Yang H, Lu G, Du Y, Lin G. Clinical outcome of preimplantation genetic diagnosis and screening using next generation sequencing. Gigascience 2014; 3:30. [PMID: 25685330 PMCID: PMC4326468 DOI: 10.1186/2047-217x-3-30] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Accepted: 11/11/2014] [Indexed: 12/20/2022] Open
Abstract
Background Next generation sequencing (NGS) is now being used for detecting chromosomal abnormalities in blastocyst trophectoderm (TE) cells from in vitro fertilized embryos. However, few data are available regarding the clinical outcome, which provides vital reference for further application of the methodology. Here, we present a clinical evaluation of NGS-based preimplantation genetic diagnosis/screening (PGD/PGS) compared with single nucleotide polymorphism (SNP) array-based PGD/PGS as a control. Results A total of 395 couples participated. They were carriers of either translocation or inversion mutations, or were patients with recurrent miscarriage and/or advanced maternal age. A total of 1,512 blastocysts were biopsied on D5 after fertilization, with 1,058 blastocysts set aside for SNP array testing and 454 blastocysts for NGS testing. In the NGS cycles group, the implantation, clinical pregnancy and miscarriage rates were 52.6% (60/114), 61.3% (49/80) and 14.3% (7/49), respectively. In the SNP array cycles group, the implantation, clinical pregnancy and miscarriage rates were 47.6% (139/292), 56.7% (115/203) and 14.8% (17/115), respectively. The outcome measures of both the NGS and SNP array cycles were the same with insignificant differences. There were 150 blastocysts that underwent both NGS and SNP array analysis, of which seven blastocysts were found with inconsistent signals. All other signals obtained from NGS analysis were confirmed to be accurate by validation with qPCR. The relative copy number of mitochondrial DNA (mtDNA) for each blastocyst that underwent NGS testing was evaluated, and a significant difference was found between the copy number of mtDNA for the euploid and the chromosomally abnormal blastocysts. So far, out of 42 ongoing pregnancies, 24 babies were born in NGS cycles; all of these babies are healthy and free of any developmental problems. Conclusions This study provides the first evaluation of the clinical outcomes of NGS-based pre-implantation genetic diagnosis/screening, and shows the reliability of this method in a clinical and array-based laboratory setting. NGS provides an accurate approach to detect embryonic imbalanced segmental rearrangements, to avoid the potential risks of false signals from SNP array in this study. Electronic supplementary material The online version of this article (doi:10.1186/2047-217X-3-30) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yueqiu Tan
- Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha, China ; National Engineering and Research Center of Human Stem Cell, Changsha, China ; Reproductive & Genetic Hospital of CITIC Xiangya, Changsha, China
| | - Xuyang Yin
- BGI-Health, BGI-Shenzhen, Shenzhen, China ; Shenzhen Municipal Birth Defect Screening Project Lab, BGI-Shenzhen, Shenzhen, China ; Guangdong Enterprise Key Laboratory of Human Disease Genomics, BGI-Shenzhen, Shenzhen, China
| | - Shuoping Zhang
- Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha, China ; Reproductive & Genetic Hospital of CITIC Xiangya, Changsha, China ; Key Laboratory of Stem Cell and Reproductive Engineering, Ministry of Health, Changsha, China
| | - Hui Jiang
- Shenzhen Municipal Birth Defect Screening Project Lab, BGI-Shenzhen, Shenzhen, China ; Guangdong Enterprise Key Laboratory of Human Disease Genomics, BGI-Shenzhen, Shenzhen, China ; Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Ke Tan
- Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha, China ; National Engineering and Research Center of Human Stem Cell, Changsha, China
| | - Jian Li
- BGI-ShenZhen, ShenZhen, China
| | - Bo Xiong
- Reproductive & Genetic Hospital of CITIC Xiangya, Changsha, China
| | - Fei Gong
- Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha, China ; Reproductive & Genetic Hospital of CITIC Xiangya, Changsha, China
| | - Chunlei Zhang
- Shenzhen Municipal Birth Defect Screening Project Lab, BGI-Shenzhen, Shenzhen, China ; Guangdong Enterprise Key Laboratory of Human Disease Genomics, BGI-Shenzhen, Shenzhen, China
| | - Xiaoyu Pan
- Shenzhen Municipal Birth Defect Screening Project Lab, BGI-Shenzhen, Shenzhen, China ; Guangdong Enterprise Key Laboratory of Human Disease Genomics, BGI-Shenzhen, Shenzhen, China ; School of Bioscience and Bioengineering, South China University of Technology, Guangzhou, China
| | - Fang Chen
- Shenzhen Municipal Birth Defect Screening Project Lab, BGI-Shenzhen, Shenzhen, China ; Guangdong Enterprise Key Laboratory of Human Disease Genomics, BGI-Shenzhen, Shenzhen, China ; Section of Molecular Disease Biology, Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Shengpei Chen
- Shenzhen Municipal Birth Defect Screening Project Lab, BGI-Shenzhen, Shenzhen, China ; Guangdong Enterprise Key Laboratory of Human Disease Genomics, BGI-Shenzhen, Shenzhen, China ; State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | | | - Changfu Lu
- Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha, China ; Reproductive & Genetic Hospital of CITIC Xiangya, Changsha, China
| | - Keli Luo
- Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha, China ; Reproductive & Genetic Hospital of CITIC Xiangya, Changsha, China
| | - Yifan Gu
- Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha, China ; Reproductive & Genetic Hospital of CITIC Xiangya, Changsha, China
| | - Xiuqing Zhang
- Guangdong Enterprise Key Laboratory of Human Disease Genomics, BGI-Shenzhen, Shenzhen, China
| | - Wei Wang
- BGI-Health, BGI-Shenzhen, Shenzhen, China ; Shenzhen Municipal Birth Defect Screening Project Lab, BGI-Shenzhen, Shenzhen, China
| | - Xun Xu
- BGI-ShenZhen, ShenZhen, China
| | - Gábor Vajta
- BGI-ShenZhen, ShenZhen, China ; Central Queensland University, Rockhampton, Queensland Australia
| | - Lars Bolund
- BGI-ShenZhen, ShenZhen, China ; Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Huanming Yang
- BGI-ShenZhen, ShenZhen, China ; Prince Aljawhra Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia ; James D Watson Institute of Genome Science, Hangzhou, China
| | - Guangxiu Lu
- Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha, China ; National Engineering and Research Center of Human Stem Cell, Changsha, China ; Reproductive & Genetic Hospital of CITIC Xiangya, Changsha, China ; Key Laboratory of Stem Cell and Reproductive Engineering, Ministry of Health, Changsha, China
| | - Yutao Du
- BGI-Health, BGI-Shenzhen, Shenzhen, China
| | - Ge Lin
- Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha, China ; National Engineering and Research Center of Human Stem Cell, Changsha, China ; Reproductive & Genetic Hospital of CITIC Xiangya, Changsha, China ; Key Laboratory of Stem Cell and Reproductive Engineering, Ministry of Health, Changsha, China
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Wang L, Cram DS, Shen J, Wang X, Zhang J, Song Z, Xu G, Li N, Fan J, Wang S, Luo Y, Wang J, Yu L, Liu J, Yao Y. Validation of Copy Number Variation Sequencing for Detecting Chromosome Imbalances in Human Preimplantation Embryos1. Biol Reprod 2014; 91:37. [DOI: 10.1095/biolreprod.114.120576] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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Two different microarray technologies for preimplantation genetic diagnosis and screening, due to reciprocal translocation imbalances, demonstrate equivalent euploidy and clinical pregnancy rates. J Assist Reprod Genet 2014; 31:843-50. [PMID: 24771116 DOI: 10.1007/s10815-014-0230-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Accepted: 04/02/2014] [Indexed: 12/25/2022] Open
Abstract
PURPOSE To compare single nucleotide polymorphism (SNP) and comparative genomic hybridization (aCGH) microarray platforms to evaluate embryos for parental translocation imbalances and aneuploidy. METHODS A retrospective review of preimplantation genetic diagnosis and screening (PGD/PGS) results of 498 embryos from 63 couples undergoing 75 in vitro fertilization cycles due to parental carriers of a reciprocal translocation. RESULTS There was no significant difference between SNP and aCGH microarrays when comparing the prevalence of embryos that were euploid with no translocation imbalance, euploidy with a parental translocation imbalance or aneuploid with or without the parental chromosome imbalance. The clinical pregnancy rates were also equivalent for SNP (60 %) versus aCGH (65 %) microarrays. Of 498 diagnosed embryos, 45 % (226/498) were chromosomally normal without translocation errors or aneuploidy, 22 % (112/498) were euploid but had a parentally derived unbalanced chromosomal segregant, 8 % (42/498) harbored both a translocation imbalance and aneuploidy and 24 % (118/498) of embryos were genetically balanced for the parental reciprocal translocation but were aneuploid for other chromosomes. The overall clinical pregnancy rate per IVF cycle following SNP or aCGH microarray analysis was 61 % and was higher if the biopsy was done on blastocysts (65 %) versus cleavage stage embryos (59 %), although not statistically significant. CONCLUSIONS SNP or aCGH microarray technologies demonstrate equivalent clinical findings that maximize the pregnancy potential in patients with known parental reciprocal chromosomal translocations.
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Dul E, van Echten-Arends J, Groen H, Kastrop P, Wissen LAV, Engelen J, Land J, Coonen E, van Ravenswaaij-Arts C. Can Characteristics of Reciprocal Translocations Predict the Chance of Transferable Embryos in PGD Cycles? J Clin Med 2014; 3:348-58. [PMID: 26237378 PMCID: PMC4449682 DOI: 10.3390/jcm3020348] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 02/26/2014] [Accepted: 03/10/2014] [Indexed: 11/16/2022] Open
Abstract
Translocation carriers have an increased risk of miscarriage or the birth of a child with congenital anomalies. Preimplantation genetic diagnosis (PGD) is performed in translocation carriers to select for balanced embryos and, thus, increase the chance of an ongoing pregnancy. However, a common experience is that reciprocal translocation carriers produce a high percentage of unbalanced embryos, which cannot be transferred. Therefore, the pregnancy rates in PGD in this patient group are low. In a cohort of 85 reciprocal translocation carriers undergoing PGD we have searched for cytogenetic characteristics of the translocations that can predict the percentage of balanced embryos. Using shape algorithms, the most likely segregation mode per translocation was determined. Shape algorithm, breakpoint location, and relative chromosome segment sizes proved not to be independent predictors of the percentage of balanced embryos. The ratio of the relative sizes of the translocated segments of both translocation chromosomes can give some insight into the chance of transferable embryos: Very asymmetrical translocations have a higher risk of unbalanced products (p = 0.048). Counseling of the couples on the pros and cons of all their reproductive options remains very important.
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Affiliation(s)
- Elsbeth Dul
- Department of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, GZ Groningen 9713, The Netherlands.
| | - Jannie van Echten-Arends
- Department of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, GZ Groningen 9713, The Netherlands.
| | - Henk Groen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, GZ Groningen 9713, The Netherlands.
| | - Peter Kastrop
- Department of Reproductive Medicine, University Medical Center Utrecht, Heidelberglaan 100, CX Utrecht 3584, The Netherlands.
| | - Lucie Amory-van Wissen
- Department of Obstetrics & Gynaecology, Academic Hospital Maastricht, P. Debyelaan 25, HX Maastricht 6229, The Netherlands.
| | - John Engelen
- Department of Clinical Genetics, Academic Hospital Maastricht, P. Debyelaan 25, HX Maastricht 6229, The Netherlands.
| | - Jolande Land
- Department of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, GZ Groningen 9713, The Netherlands.
| | - Edith Coonen
- Department of Obstetrics & Gynaecology, Academic Hospital Maastricht, P. Debyelaan 25, HX Maastricht 6229, The Netherlands.
| | - Conny van Ravenswaaij-Arts
- Department of Genetics, University of Groningen, University Medical Center Groningen, Hanzeplein 1, GZ Groningen 9713, The Netherlands.
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Munné S. Improving pregnancy outcome for IVF patients with preimplantation genetic screening. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/17474108.3.5.635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Renwick P, Ogilvie CM. Preimplantation genetic diagnosis for monogenic diseases: overview and emerging issues. Expert Rev Mol Diagn 2014; 7:33-43. [PMID: 17187482 DOI: 10.1586/14737159.7.1.33] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Preimplantation genetic diagnosis (PGD) is an established reproductive option for couples at risk of conceiving a pregnancy affected with a known genetic disease, who wish to avoid an (additional) affected child, termination of pregnancy or recurrent miscarriages. Early technologies concentrated on different approaches to direct mutation testing for monogenic diseases using single cell PCR protocols, or sex selection by fluorescent in situ hybridization for X-linked monogenic disease. Development of multiplex fluorescent PCR allowed simultaneously testing of linked markers alongside the mutation test, increasing the accuracy by controlling for contamination and identifying allele drop-out. The advent of highly effective whole genome amplification methods has opened the way for new technologies such as preimplantation genetic haplotyping and microarrays, thus increasing the number of genetic defects that can be detected in preimplantation embryos; the number of cases carried out and the new indications tested increases each year. Different countries have taken very different approaches to legislating and regulating PGD, giving rise to the phenomenon of reproductive tourism. PGD is now being performed for scenarios previously not undertaken using prenatal diagnosis, some of which raise significant ethical concerns. While PGD has benefited many couples aiming to have healthy children, ethical concerns remain over inappropriate use of this technology.
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Affiliation(s)
- Pamela Renwick
- Guy's & St Thomas' Hospital Foundation Trust, Genetics Center, London SE1 9RT, UK.
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Li G, Jin H, Xin Z, Su Y, Brezina PR, Benner AT, Kearns WG, Sun Y. Increased IVF pregnancy rates after microarray preimplantation genetic diagnosis due to parental translocations. Syst Biol Reprod Med 2013; 60:119-24. [DOI: 10.3109/19396368.2013.875241] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Gang Li
- Reproductive Medical Center, The First Affiliated Hospital of Zhengzhou University
ZhengzhouChina
| | - Haixia Jin
- Reproductive Medical Center, The First Affiliated Hospital of Zhengzhou University
ZhengzhouChina
| | - Zhimin Xin
- Reproductive Medical Center, The First Affiliated Hospital of Zhengzhou University
ZhengzhouChina
| | - Yingchun Su
- Reproductive Medical Center, The First Affiliated Hospital of Zhengzhou University
ZhengzhouChina
| | - Paul R. Brezina
- Johns Hopkins Medical Institutions, Department of Gynecology and Obstetrics, Division of Reproductive Endocrinology and Infertility
Baltimore, MDUSA
| | - Andrew T. Benner
- Center for Preimplantation Genetics, LabCorp Rockville
Rockville, MDUSA
| | - William G. Kearns
- Johns Hopkins Medical Institutions, Department of Gynecology and Obstetrics, Division of Reproductive Endocrinology and Infertility
Baltimore, MDUSA
| | - Yingpu Sun
- Reproductive Medical Center, The First Affiliated Hospital of Zhengzhou University
ZhengzhouChina
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