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Weizel I, Shavit T, Shuli Y, Adler Lazarovich C, Halevi R, Ben Ari T, Yaacobi-Artzi S, Bentov Y, Feldman B, Hershko Klement A. Outcomes of BRCA pre-implantation genetic testing according to the parental mutation origin: a cohort study. Reprod Biol Endocrinol 2024; 22:8. [PMID: 38172815 PMCID: PMC10762833 DOI: 10.1186/s12958-023-01180-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 12/26/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The process of gamete formation and early embryonic development involves rapid DNA replication, chromosome segregation and cell division. These processes may be affected by mutations in the BRCA1/2 genes. The aim of this study was to evaluate BRCA mutation inheritance and its effect on early embryonic development according to the parental origin of the mutation. The study question was approached by analyzing in vitro fertilization cycles (IVF) that included pre-implantation testing (PGT-M) for a BRCA gene mutation. METHODS This retrospective cohort study compared cycles of pre-implantation genetic testing for mutations (PGT-M) between male and female patients diagnosed with BRCA 1/2 mutations (cases), to a control group of two other mutations with dominant inheritance (myotonic dystrophy (MD) and polycystic kidney disease (PKD)). Results were compared according to mutation type and through a generalized linear model analysis. RESULTS The cohort included 88 PGT-M cycles (47 BRCA and 41 non-BRCA) among 50 patients. Maternal and paternal ages at oocyte retrieval were comparable between groups. When tested per cycle, FSH dose, maximum estradiol level, oocytes retrieved, number of zygotes, and number of embryos available for biopsy and affected embryos, were not significantly different among mutation types. All together 444 embryos were biopsied: the rate of affected embryos was comparable between groups. Among BRCA patients, the proportion of affected embryos was similar between maternal and paternal mutation origin (p = 0.24). In a generalized linear model analysis, the relative oocyte yield in maternal BRCA patients was significantly lower (0.7, as related to the non BRCA group)(p < 0.001). Zygote formation and blastulation were not affected by the BRCA gene among paternal cases (P = 0.176 and P = 0.293 respectively), nor by paternal versus maternal BRCA carriage (P = 0.904 and P = 0.149, respectively). CONCLUSIONS BRCA PGT-M cycles performed similarly compared to non-BRCA cycles. Inheritance rate and cycle parameters were not affected by the parental origin of the mutation.
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Affiliation(s)
- Ilana Weizel
- The IVF Unit, Department of Obstetrics and Gynecology, Hadassah Mount Scopus- Hebrew University Medical Center, Mt Scopus, Jerusalem, 9112001, Israel
| | - Tal Shavit
- The IVF unit, Assuta Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Yulia Shuli
- The Unit for Medical Genetics, Assuta Medical Center, Tel Aviv, Israel
| | - Chana Adler Lazarovich
- The IVF Unit, Department of Obstetrics and Gynecology, Hadassah Mount Scopus- Hebrew University Medical Center, Mt Scopus, Jerusalem, 9112001, Israel
| | - Rivka Halevi
- The Unit for Medical Genetics, Assuta Medical Center, Tel Aviv, Israel
| | - Tal Ben Ari
- The IVF unit, Assuta Medical Center, Tel Aviv, Israel
| | | | - Yaakov Bentov
- The IVF Unit, Department of Obstetrics and Gynecology, Hadassah Mount Scopus- Hebrew University Medical Center, Mt Scopus, Jerusalem, 9112001, Israel
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Baruch Feldman
- The Unit for Medical Genetics, Assuta Medical Center, Tel Aviv, Israel
| | - Anat Hershko Klement
- The IVF Unit, Department of Obstetrics and Gynecology, Hadassah Mount Scopus- Hebrew University Medical Center, Mt Scopus, Jerusalem, 9112001, Israel.
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
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