Obtaining metaphase spreads from single blastomeres for PGD of chromosomal rearrangements

Preimplantation genetic diagnosis to improve pregnancy outcomes in subfertility

Pre-implantation genetic diagnosis provides prenatal genetic diagnosis before implantation, thus allowing detection of chromosomal abnormalities and their exclusion from embryo transfer in assisted reproductive technologies. Polar body, blastomere or trophectoderm can each be used to obtain requisite genetic or embryonic DNA. Pre-implantation genetic diagnosis for excluding unbalanced translocations is well accepted, and pre-implantation genetic diagnosis aneuploidy testing to avoid repeated pregnancy losses in couples having recurrent aneuploidy is efficacious in reducing miscarriages. Controversy remains about whether pre-implantation genetic diagnosis aneuploidy testing improves take home pregnancy rates, for which reason adherence to specific indications is recommended while the issue is being adjudicated. Current recommendations are for obligatory 24 chromosome testing, most readily using array comparative genome hybridisation.

Preimplantation genetic diagnosis at 20 years

First reported in 1990, PGD has evolved into a complementary form of prenatal diagnosis offering novel indications. DNA for PGD can be recovered with equal safety and facility from polar bodies I and II, blastomere (8 cell embryo) and trophectoderm (5-6 day blastocyst). Diagnostic accuracy is very high (>99%) for both chromosomal abnormalities and single gene disorders. Traditional application of FISH with chromosome specific probes for detecting aneuploidy and translocations may be replaced or complemented by array comparative genome hybridization (array CGH); biopsied embryos can now be cryopreserved (vitrification) while analysis proceeds in orderly fashion. PGD has been accomplished for over 200 different single gene disorders. Novel indications for PGD not readily applicable by traditional prenatal genetic diagnosis include avoiding clinical pregnancy termination, performing preconceptional diagnosis (polar body I), obtaining prenatal diagnosis without disclosure of prenatal genotype (nondisclosure), diagnosing adult-onset disorders particularly cancer, and identifying HLA compatible embryos suitable for recovering umbilical cord blood stem cells.

Conversion and non-conversion approach to preimplantation diagnosis for chromosomal rearrangements in 475 cycles

Due to the limitations of preimplantation genetic diagnosis (PGD) for chromosomal rearrangements by interphase fluorescent in-situ hybridization (FISH) analysis, a method for obtaining chromosomes from single blastomeres was introduced by their fusion with enucleated or intact mouse zygotes, followed by FISH analysis of the resulting heterokaryons. Although this allowed a significant improvement in the accuracy of testing of both maternally and paternally derived translocations, it is still labour intensive and requires the availability of fertilized mouse oocytes, also creating ethical issues related to the formation of interspecies heterokaryons. This method was modified with a chemical conversion procedure that has now been clinically applied for the first time on 877 embryos from PGD cycles for chromosomal rearrangements and has become the method of choice for performing PGD for structural rearrangements. This is presented within the context of overall experience of 475 PGD cycles for translocations with pre-selection and transfer of balanced or normal embryos in 342 (72%) of these cycles, which resulted in 131 clinical pregnancies (38%), with healthy deliveries of 113 unaffected children. The spontaneous abortion rate in these cycles was as low as 17%, which confirms an almost five-fold reduction of spontaneous abortion rate following PGD for chromosomal rearrangements.

Role of Preimplantation Genetic Diagnosis (PGD) in Current Infertility Practice

Chromosome imbalances are the leading cause of pregnancy loss in humans and play major roles in male and female infertility. Within the past two decades, the development and application of preimplantation genetic diagnosis (PGD) has played an important role in infertility practices worldwide. The purpose of this review is to discuss, how PGD may be applied in combating numerical chromosomal abnormalities and in Robertsonian and reciprocal chromosome translocations. We shall consider prevalence and risk of each aberration, interchromosomal effects and rationale behind use of PGD in each case. Numerical chromosome abnormalities (aneuploidy and polyploidy) in particular affect a very high proportion of preimplantation embryos (~ 50%). Given that a majority of preimplantation embryos are aneuploid, PGD can be used to screen embryos and transfer euploid embryos to improve pregnancy rates and reduce spontaneous abortions. The rationale of utilize PGD to transfer only euploid embryos would seem sound, but controversies exist surrounding application of PGD for aneuploidy detection. To this end, we will discuss the dichotomy between favorable descriptive reports and less favorable randomized clinical trial data. This review will discuss the trend towards differing sources of embryonic DNA (e.g. polar body vs blastomere vs blastocyst) as well as development of novel technologies for 24 chromosomes analysis.

Can preimplantation genetic diagnosis overcome recurrent pregnancy failure?

PURPOSE OF REVIEW

Preimplantation genetic diagnosis is widely used for the detection of embryo aneuploidy before implantation, with the aim of avoiding miscarriage or pregnancy termination of an aneuploid fetus. The majority of first trimester miscarriages occur due to chromosomal imbalances. The aim of this review is to assess whether preimplantation genetic diagnosis can help women who suffer from recurrent pregnancy loss.

RECENT FINDINGS

Several in-vitro fertilization clinics have employed preimplantation genetic diagnosis in women with recurrent pregnancy loss. Patients were classified into groups according to their age. Preimplantation genetic diagnosis was very successful in treating couples where one of the parents was a carrier of a balanced chromosomal abnormality such as a translocation. Similarly, recurrent pregnancy loss rate was reduced in women more than 35 years in age with a normal karyotype. On the other hand, in younger patients the beneficial effect of this procedure is debatable. In general, women with recurrent pregnancy loss produced more abnormal embryos than control groups.

SUMMARY

Preimplantation genetic diagnosis can be beneficial for three major subgroups of patients with recurrent pregnancy loss: couples carrying chromosomal translocations; women more than 35 years of age; women of any age whose previous miscarriages were due to fetal aneuploidy. It is likely that the rate of miscarriage will be further reduced with the new advances in methods of performing preimplantation genetic diagnosis for more chromosomes.

Previous maternal chemotherapy by cyclophosphamide (Cp) causes numerical chromosome abnormalities in preimplantation mouse embryos

This study investigated the consequences of maternal cyclophosphamide treatment on fertilization rate, development and chromosomal integrity of embryos. It also evaluated efficiency of two methods of classic and metaphase induction for chromosomes assessment. Two different groups of NMRI mice 2-3 weeks and 6-7 weeks were injected intraperitonealy with 75 mg cyclophosphamide/kg. Six weeks later, oocytes were recovered, fertilized and incubated for 3 days in 5% CO(2) in air. Eight to 10 cell stage embryos were subjected to chromosomal study. Cyclophosphamide in both experimental groups reduced the oocyte fertilization rate and in the 6-7 weeks group it was significantly lower compared with control group (P<0.01). Also there was a reduction in 8-cell stage embryos formation from 48 to 72 h post-fertilization in both treated groups (P<0.05). Aneuploidy increased in the treatment groups compared with controls, which in the older group was significant (P<0.001). The success rate of the classic method to analyze metaphase plates was 30.1% and the success rate of heterokaryons formation with analyzable chromosomes was 67.8% in the metaphase induction method. In regards to the adverse effects of cyclophosphamide on fertilization rate, embryo development and chromosomal integrity of the mouse embryos, using Preimplantation Genetic Diagnosis in addition to Assisted Reproductive Technique is suggested.

Calyculin-A improves chromosome condensation for cytogenetic analysis of blastomeres from bovine and murine eight-cell stage embryos

This study evaluated the serine/threonine phosphatase inhibitor calyculin-A for rapid, efficient induction of premature chromosome condensation (PCC) in blastomeres obtained from Day 3 bovine and Day 2 murine eight-cell stage embryos, and its potential for use in cytogenetic analysis. Experiment 1 tested calyculin-A duration (0, 60, 120, and 180min) to induce PCC in bovine blastomeres. More blastomeres that underwent PCC had chromosomes suitable for cytogenetic analysis if treated for 120 or 180min (P<0.005). Experiment 2 compared doses of calyculin-A (0, 10, 50, and 100nM) on bovine blastomeres; calyculin-A (50nM, 120min) induced PCC suitable for cytogenetic analysis in the greatest number of blastomeres when compared to other doses (52.5%; P<0.005). Effects of calyculin-A (50nM) on murine blastomeres at durations of 0, 60, 90, and 120min to induce PCC were tested in Experiment 3, with 90min inducing the highest frequency of condensed chromosomes suitable for cytogenetic analysis (34%; P<0.05). Finally, Experiment 4 evaluated calyculin-A treated bovine embryos under optimal conditions (50nM, 120min) for use in gender and cytogenetic analysis. Whole chromosome paint probes were successfully hybridized to chromosomes along with 4',6-diamidino-2-phenylindole dihydrochloride hydrate (DAPI) counterstaining, allowing detection of embryo gender (54% F:46% M) and ploidy of individual blastomeres within embryos (64% diploid:36% mixoploid embryos). In conclusion, we inferred that calyculin-A was useful for rapid induction of PCC, producing chromosome spreads suitable for cytogenetic analysis of blastomeres in G1 or G2/M phase of the cell cycle.

Memory encoded throughout our bodies: molecular and cellular basis of tissue regeneration

When a sheep loses its tail, it cannot regenerate it in the manner of lizards. On the other hand, it is possible to clone mammals from somatic cells, showing that a complete developmental program is intact in a wounded sheep's tail the same way it is in a lizard. Thus, there is a requirement for more than only the presence of the entire genetic code in somatic cells for regenerative abilities. Thoughts like this have motivated us to assemble more than just a factographic synopsis on tissue regeneration. As a model, we review skin wound healing in chronological order, and when possible, we use that overview as a framework to point out possible mechanisms of how damaged tissues can restore their original structure. This article postulates the existence of tissue structural memory as a complex distributed homeostatic mechanism. We support such an idea by referring to an extremely fragmented literature base, trying to synthesize a broad picture of important principles of how tissues and organs may store information about their own structure for the purposes of regeneration. Selected developmental, surgical, and tissue engineering aspects are presented and discussed in the light of recent findings in the field. When a sheep loses its tail, it cannot regenerate it in the manner of lizards. On the other hand, it is possible to clone mammals from somatic cells, showing that a complete developmental program is intact in a wounded sheep's tail the same way it is in a lizard. Thus, there is a requirement for more than only the presence of the entire genetic code in somatic cells for regenerative abilities. Thoughts like this have motivated us to assemble more than just a factographic synopsis on tissue regeneration. As a model, we review skin wound healing in chronological order, and when possible, we use that overview as a framework to point out possible mechanisms of how damaged tissues can restore their original structure. This article postulates the existence of tissue structural memory as a complex distributed homeostatic mechanism. We support such an idea by referring to an extremely fragmented literature base, trying to synthesize a broad picture of important principles of how tissues and organs may store information about their own structure for the purposes of regeneration. Selected developmental, surgical, and tissue engineering aspects are presented and discussed in the light of recent findings in the field.