1
|
Ma Y, Wang J, Wen T, Xu Y, Huang L, Mai Q, Xu Y. An Incidental Detection of a Rare UPD in SNP-Array Based PGT-SR: A Case Report. Reprod Sci 2024:10.1007/s43032-024-01598-5. [PMID: 38780745 DOI: 10.1007/s43032-024-01598-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024]
Abstract
Uniparental disomies (UPD) refers to the inheritance of both homologs of a chromosome from only one parent with no representative copy from the other parent. UPD was with an estimated prevalence of 0.15‰ in population. Current understanding of UPD was limited to subjects for which UPD was associated with clinical manifestation due to imprinting disorders or recessive diseases. Segmental UPD was rare, especially for a segmental UPD with a combination of hetero- and isodisomy. This paper presents a couple with reciprocal translocation 46,XY, t(14;22)(q32.3;q12.2) for PGT-SR. Among 8 biopsied blastocysts, one euploid blastocyst (No.4) with segmental loss of heterozygosity (LOH)(22) [arr[hg19] q12.1q22.3 (28,160,407 - 35,407,682)] was detected by B allele frequency. We found the chromosome contained both UPiD(22) [arr[hg19] q12.1q22.3 (28,160,407 - 35,407,682) ×2 hmz mat] and UPhD(22) [arr[hg19] q22.3qter(35,407,682 - 51,169,045) ×2 htz mat] by haplotype analysis. UPDtool software confirmed the result. What's more, the segmental UPD and reciprocal translocation shared the same breakpoint, chr22q12.1 (28,160,407), while the breakpoint between iso- and heterodisomy was chr22q22.3 (35,407,682). We reported the first segmental UPD with a combination of hetero- and isodisomy, which may result from aneuploidy rescue. This case emphasizes the importance of the combination of comprehensive chromosome screening and haplotype analysis to reduce the risk of misdiagnosis.
Collapse
Affiliation(s)
- Yuanlin Ma
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Zhongshan 2nd Road No. 1, Yuexiu District, 510080, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, Yuexiu District, 510080, Guangzhou, Guangdong, China
- Guangdong Provincial Clinical Research Center for obstetrical and gynecological diseases, Yuexiu District, 510080, Guangzhou, Guangdong, China
| | - Jing Wang
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Zhongshan 2nd Road No. 1, Yuexiu District, 510080, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, Yuexiu District, 510080, Guangzhou, Guangdong, China
- Guangdong Provincial Clinical Research Center for obstetrical and gynecological diseases, Yuexiu District, 510080, Guangzhou, Guangdong, China
| | - Tianrui Wen
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Zhongshan 2nd Road No. 1, Yuexiu District, 510080, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, Yuexiu District, 510080, Guangzhou, Guangdong, China
- Guangdong Provincial Clinical Research Center for obstetrical and gynecological diseases, Yuexiu District, 510080, Guangzhou, Guangdong, China
| | - Yan Xu
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Zhongshan 2nd Road No. 1, Yuexiu District, 510080, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, Yuexiu District, 510080, Guangzhou, Guangdong, China
- Guangdong Provincial Clinical Research Center for obstetrical and gynecological diseases, Yuexiu District, 510080, Guangzhou, Guangdong, China
| | - Linhuan Huang
- Fetal Medicine Centre, The First Affiliated Hospital of Sun Yat-sen University, 510080, Guangzhou, Guangdong, China
| | - Qingyun Mai
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Zhongshan 2nd Road No. 1, Yuexiu District, 510080, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, Yuexiu District, 510080, Guangzhou, Guangdong, China
- Guangdong Provincial Clinical Research Center for obstetrical and gynecological diseases, Yuexiu District, 510080, Guangzhou, Guangdong, China
| | - Yanwen Xu
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Zhongshan 2nd Road No. 1, Yuexiu District, 510080, Guangzhou, Guangdong, China.
- Guangdong Provincial Key Laboratory of Reproductive Medicine, Yuexiu District, 510080, Guangzhou, Guangdong, China.
- Guangdong Provincial Clinical Research Center for obstetrical and gynecological diseases, Yuexiu District, 510080, Guangzhou, Guangdong, China.
| |
Collapse
|
2
|
Xia Q, Ding T, Chang T, Ruan J, Yang J, Ma M, Liu J, Liu Z, Jiao S, Wu J, Ren J, Lu S, Li Y, Yao Z. Nanopore sequencing with T2T-CHM13 for accurate detection and preventing the transmission of structural rearrangements in highly repetitive heterochromatin regions in human embryos. Clin Transl Med 2024; 14:e1612. [PMID: 38445430 PMCID: PMC10915734 DOI: 10.1002/ctm2.1612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 02/08/2024] [Accepted: 02/18/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Structural rearrangements in highly repetitive heterochromatin regions can result in miscarriage or foetal malformations; however, detecting and preventing the transmission of these rearrangements has been challenging. Recently, the completion of sequencing of the complete human genome (T2T-CHM13) has made it possible to accurately characterise structural rearrangements in these regions. We developed a method based on T2T-CHM13 and nanopore sequencing to detect and block structural rearrangements in highly repetitive heterochromatin sequences. METHODS T2T-CHM13-based "Mapping Allele with Resolved Carrier Status" was performed for couples who carry structural rearrangements in heterochromatin regions. Using nanopore sequencing and the T2T-CHM13 reference genome, the precise breakpoints of inversions and translocations close to the centromere were detected and haplotypes were constructed using flanking single-nucleotide polymorphisms (SNPs). Haplotype linkage analysis was then performed by comparing consistent parental SNPs with embryonic SNPs to determine whether the embryos carried hereditary inversions or balanced translocations. Based on copy number variation and haplotype linkage analysis, we transplanted normal embryos, which were further verified by an amniotic fluid test. RESULTS To validate this approach, we used nanopore sequencing of families with inversions and reciprocal translocations close to the centromere. Using the T2T-CHM13 reference genome, we accurately detected inversions and translocations in centromeres, constructed haplotypes and prevented the transmission of structural rearrangements in the offspring. CONCLUSIONS This study represents the first successful application of T2T-CHM13 in human reproduction and provides a feasible protocol for detecting and preventing the transmission of structural rearrangements of heterochromatin in embryos.
Collapse
Affiliation(s)
- Qiuping Xia
- Reproductive Medicine CenterXiangya HospitalCentral South UniversityChangshaChina
| | | | - Tianli Chang
- Reproductive Medicine CenterXiangya HospitalCentral South UniversityChangshaChina
| | | | - Ji Yang
- Yikon Genomics Company, Ltd.SuzhouChina
| | | | - Jiaqi Liu
- Yikon Genomics Company, Ltd.SuzhouChina
| | - Zhen Liu
- Yikon Genomics Company, Ltd.SuzhouChina
| | | | - Jian Wu
- Yikon Genomics Company, Ltd.SuzhouChina
| | - Jun Ren
- Yikon Genomics Company, Ltd.SuzhouChina
| | - Sijia Lu
- Yikon Genomics Company, Ltd.SuzhouChina
| | - Yanping Li
- Reproductive Medicine CenterXiangya HospitalCentral South UniversityChangshaChina
| | - Zhongyuan Yao
- Reproductive Medicine CenterXiangya HospitalCentral South UniversityChangshaChina
| |
Collapse
|
3
|
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.
Collapse
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.
| |
Collapse
|
4
|
Xia Q, Li S, Ding T, Liu Z, Liu J, Li Y, Zhu H, Yao Z. Nanopore sequencing for detecting reciprocal translocation carrier status in preimplantation genetic testing. BMC Genomics 2023; 24:1. [PMID: 36593441 PMCID: PMC9809107 DOI: 10.1186/s12864-022-09103-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 12/29/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Balanced reciprocal translocation (BRT) is one of the most common chromosomal abnormalities that causes infertility, recurrent miscarriage, and birth defects. Preimplantation genetic testing (PGT) is widely used to select euploid embryos for BRT carriers to increase the chance of a healthy live birth. Several strategies can be used to distinguish reciprocal translocation carrier embryos from those with a normal karyotype; however, these techniques are time-consuming and difficult to implement in clinical laboratories. In this study, nanopore sequencing was performed in two reciprocal translocation carriers, and the results were validated using the next-generation sequencing-based method named, "Mapping Allele with Resolved Carrier Status" (MaReCs). RESULTS The translocation breakpoints in both reciprocal translocation carriers were accurately identified by nanopore sequencing and were in accordance with the results obtained using MaReCs. More than one euploid non-balanced translocation carrier embryo was identified in both patients. Amniocentesis results revealed normal karyotypes, consistent with the findings by MaReCs and nanopore sequencing. CONCLUSION Our results suggest that nanopore sequencing is a powerful strategy for accurately distinguishing non-translocation embryos from translocation carrier embryos and precisely localizing translocation breakpoints, which is essential for PGT and aids in reducing the propagation of reciprocal translocation in the population.
Collapse
Affiliation(s)
- Qiuping Xia
- grid.216417.70000 0001 0379 7164Reproductive Medicine Center, Xiangya Hospital, Central South University, 410008 Changsha, Hunan China
| | - Shenglan Li
- grid.216417.70000 0001 0379 7164Department of Gastroenterology, Xiangya Hospital, Central South University, 410008 Changsha, Hunan China
| | - Taoli Ding
- Yikon Genomics Co., Ltd, 215000 Suzhou, Jiangsu China
| | - Zhen Liu
- Yikon Genomics Co., Ltd, 215000 Suzhou, Jiangsu China
| | - Jiaqi Liu
- Yikon Genomics Co., Ltd, 215000 Suzhou, Jiangsu China
| | - Yanping Li
- grid.216417.70000 0001 0379 7164Reproductive Medicine Center, Xiangya Hospital, Central South University, 410008 Changsha, Hunan China
| | - Huimin Zhu
- grid.216417.70000 0001 0379 7164Center for Medical Genetics and Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, 410008 Changsha, Hunan China
| | - Zhongyuan Yao
- grid.216417.70000 0001 0379 7164Reproductive Medicine Center, Xiangya Hospital, Central South University, 410008 Changsha, Hunan China
| |
Collapse
|
5
|
Wang Y, Zhao Z, Fu X, Li S, Zhang Q, Kong X. Detection of a Cryptic 25 bp Deletion and a 269 Kb Microduplication by Nanopore Sequencing in a Seemingly Balanced Translocation Involving the LMLN and LOC105378102 Genes. Front Genet 2022; 13:883398. [PMID: 36110201 PMCID: PMC9469083 DOI: 10.3389/fgene.2022.883398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 06/07/2022] [Indexed: 12/03/2022] Open
Abstract
Preimplantation genetic testing plays a critical role in enabling a balanced translocation carrier to obtain the normal embryo. Identifying the precise breakpoints for the carriers with phenotypic abnormity, allows us to reveal disrupted genes. In this study, a seemingly balanced translocation 46, XX, t (3; 6) (q29; q26) was first detected using conventional karyotype analysis. To locate the precise breakpoints, whole genomes of DNA were sequenced based on the nanopore GridION platform, and bioinformatic analyses were further confirmed by polymerase-chain-reaction (PCR) and copy number variation (CNV). Nanopore sequencing results were consistent with the karyotype analysis. Meanwhile, two breakpoints were successfully validated using polymerase-chain-reaction and Sanger Sequencing. LOC105378102 and LMLN genes were disrupted at the breakpoint junctions. Notably, observations found that seemingly balanced translocation was unbalanced due to a cryptic 269 kilobases (Kb) microduplication and a 25 bp deletion at the breakpoints of chromosome (chr) 6 and chr 3, respectively. Furthermore, 269 Kb microduplication was also confirmed by copy number variation analyses. In summary, nanopore sequencing was a rapid and direct method for identifying the precise breakpoints of a balanced translocation despite low coverage (3.8×). In addition, cryptic deletion and duplication were able to be detected at the single-nucleotide level.
Collapse
|
6
|
Liu Q, Chen X, Qiao J. Advances in studying human gametogenesis and embryonic development in China. Biol Reprod 2022; 107:12-26. [PMID: 35788258 DOI: 10.1093/biolre/ioac134] [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: 01/21/2022] [Revised: 05/21/2022] [Accepted: 06/20/2022] [Indexed: 11/12/2022] Open
Abstract
Reproductive medicine in China has developed rapidly since 1988 due to the support from the government and scientific exploration. However, the success rate of assisted reproduction technology (ART) is around 30-40% and many unknown "black boxes" in gametogenesis and embryo development are still present. With the development of single-cell and low-input sequencing technologies, the network of transcriptome and epigenetic regulation (DNA methylation, chromatin accessibility, and histone modifications) during the development of human primordial germ cells (PGCs), gametes and embryos has been investigated in depth. Furthermore, pre-implantation genetic testing (PGT) has also rapidly developed. In this review, we summarize and analyze China's outstanding progress in these fields.
Collapse
Affiliation(s)
- Qiang Liu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China.,Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Xi Chen
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China.,Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Jie Qiao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China.,Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China.,Beijing Advanced Innovation Center for Genomics, Beijing, China.,Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China.,Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest, Chinese Academy of Medical Sciences, Beijing, China
| |
Collapse
|
7
|
Zhang Z, Zhang L, Wang Y, Bi X, Liang L, Yuan Y, Su D, Wu X. Logistic regression analyses of factors affecting the euploidy of blastocysts undergoing in vitro fertilization and preimplantation genetic testing. Medicine (Baltimore) 2022; 101:e29774. [PMID: 35777007 PMCID: PMC9239646 DOI: 10.1097/md.0000000000029774] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Embryo chromosomal abnormalities are considered as the main cause of low pregnancy rate for in vitro fertilization (IVF). Recently, a new metric of success in assisted reproductive technology, that is, the ability to achieve at least 1 euploid blastocyst for transfer, has been brought into focus among clinicians. Our study aimed to investigate the effects of different factors on the euploidy of blastocysts undergoing IVF and preimplantation genetic testing (PGT). This retrospective observational study included 493 cycles underwent IVF/intracytroplasmatic sperm injection intended to obtain trophectoderm biopsy for PGT from June 2016 to December 2019 at a single academic fertility center. Logistic regression was adopted to analyze the clinical characteristics and embryonic data related to the ability to achieve at least 1 euploid blastocyst for transfer. The study took 1471 blastocysts from 493 cycles as samples for PGT. Among them, 149 cycles (30.22%) had no euploid blastocyst and 344 cycles (69.78%) had at least 1 euploid blastocyst. A multivariate logistic analysis suggested that maternal age >36, abnormal parental karyotype, nonfirst cycles and blastocysts number per cycle <3 were the risk factors for no euploid blastocyst. The parental karyotype, maternal age, number of cycles, and number of blastocysts per cycle were the dominant factors affecting the ability to achieve at least 1 euploid blastocyst for transfer and therefore could be regarded as potential predictors for genetic counseling.
Collapse
Affiliation(s)
- Zhiping Zhang
- Center of Reproductive Medicine, Affiliated Children’s Hospital of Shanxi & Women Health Center of Shanxi Medicine University, Taiyuan, Shanxi, China
| | - Lei Zhang
- Center of Reproductive Medicine, Affiliated Children’s Hospital of Shanxi & Women Health Center of Shanxi Medicine University, Taiyuan, Shanxi, China
| | - Yaoqin Wang
- Center of Reproductive Medicine, Affiliated Children’s Hospital of Shanxi & Women Health Center of Shanxi Medicine University, Taiyuan, Shanxi, China
| | - Xingyu Bi
- Center of Reproductive Medicine, Affiliated Children’s Hospital of Shanxi & Women Health Center of Shanxi Medicine University, Taiyuan, Shanxi, China
| | - Lixia Liang
- Center of Reproductive Medicine, Affiliated Children’s Hospital of Shanxi & Women Health Center of Shanxi Medicine University, Taiyuan, Shanxi, China
| | - Yuan Yuan
- Center of Reproductive Medicine, Affiliated Children’s Hospital of Shanxi & Women Health Center of Shanxi Medicine University, Taiyuan, Shanxi, China
| | - Dan Su
- Center of Reproductive Medicine, Affiliated Children’s Hospital of Shanxi & Women Health Center of Shanxi Medicine University, Taiyuan, Shanxi, China
| | - Xueqing Wu
- Center of Reproductive Medicine, Affiliated Children’s Hospital of Shanxi & Women Health Center of Shanxi Medicine University, Taiyuan, Shanxi, China
| |
Collapse
|
8
|
Xie P, Hu L, Peng Y, Tan YQ, Luo K, Gong F, Lu G, Lin G. Risk Factors Affecting Alternate Segregation in Blastocysts From Preimplantation Genetic Testing Cycles of Autosomal Reciprocal Translocations. Front Genet 2022; 13:880208. [PMID: 35719400 PMCID: PMC9201810 DOI: 10.3389/fgene.2022.880208] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/11/2022] [Indexed: 11/23/2022] Open
Abstract
Reciprocal translocations are the most common structural chromosome rearrangements and may be associated with reproductive problems. Therefore, the objective of this study was to analyze factors that can influence meiotic segregation patterns in blastocysts for reciprocal translocation carriers. Segregation patterns of quadrivalents in 10,846 blastocysts from 2,871 preimplantation genetic testing cycles of reciprocal translocation carriers were analyzed. The percentage of normal/balanced blastocysts was 34.3%, and 2:2 segregation was observed in 90.0% of the blastocysts. Increased TAR1 (ratio of translocated segment 1 over the chromosome arm) emerged as an independent protective factor associated with an increase in alternate segregation (p = 0.004). Female sex and involvement of an acrocentric chromosome (Acr-ch) were independent risk factors that reduced alternate segregation proportions (p < 0.001). Notably, a higher TAR1 reduced the proportion of adjacent-1 segregation (p < 0.001); a longer translocated segment and female sex increased the risk of adjacent-2 segregation (p = 0.009 and p < 0.001, respectively). Female sex and involvement of an Acr-ch enhanced the ratio of 3:1 segregation (p < 0.001 and p = 0.012, respectively). In conclusion, autosomal reciprocal translocation carriers have reduced proportions of alternate segregation in blastocysts upon the involvement of an Acr-ch, female sex, and lower TAR1. These results may facilitate more appropriate genetic counseling for couples with autosomal reciprocal translocation regarding their chances of producing normal/balanced blastocysts.
Collapse
Affiliation(s)
- Pingyuan Xie
- Hunan Normal University School of Medicine, Changsha, China
- National Engineering and Research Center of Human Stem Cells, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Development and Carcinogenesis, Changsha, China
| | - Liang Hu
- National Engineering and Research Center of Human Stem Cells, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Development and Carcinogenesis, Changsha, China
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
| | - Yangqin Peng
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
| | - Yue-qiu Tan
- National Engineering and Research Center of Human Stem Cells, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Development and Carcinogenesis, Changsha, China
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
| | - Keli Luo
- National Engineering and Research Center of Human Stem Cells, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Development and Carcinogenesis, Changsha, China
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
| | - Fei Gong
- National Engineering and Research Center of Human Stem Cells, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Development and Carcinogenesis, Changsha, China
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
| | - Guangxiu Lu
- National Engineering and Research Center of Human Stem Cells, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Development and Carcinogenesis, Changsha, China
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
| | - Ge Lin
- National Engineering and Research Center of Human Stem Cells, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Development and Carcinogenesis, Changsha, China
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
- *Correspondence: Ge Lin,
| |
Collapse
|
9
|
Zhai F, Wang Y, Li H, Wang Y, Zhu X, Kuo Y, Guan S, Li J, Song S, He Q, An J, Zhi X, Lian Y, Huang J, Li R, Qiao J, Yan L, Yan Z. Low-coverage NGS-based PGT-SR accurately discriminate normal/carrier embryos for patients with translocations in IVF. Reprod Biomed Online 2022; 45:473-480. [DOI: 10.1016/j.rbmo.2022.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/09/2022] [Accepted: 05/17/2022] [Indexed: 11/28/2022]
|
10
|
Whole Genome Amplification in Preimplantation Genetic Testing in the Era of Massively Parallel Sequencing. Int J Mol Sci 2022; 23:ijms23094819. [PMID: 35563216 PMCID: PMC9102663 DOI: 10.3390/ijms23094819] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 12/16/2022] Open
Abstract
Successful whole genome amplification (WGA) is a cornerstone of contemporary preimplantation genetic testing (PGT). Choosing the most suitable WGA technique for PGT can be particularly challenging because each WGA technique performs differently in combination with different downstream processing and detection methods. The aim of this review is to provide insight into the performance and drawbacks of DOP-PCR, MDA and MALBAC, as well as the hybrid WGA techniques most widely used in PGT. As the field of PGT is moving towards a wide adaptation of comprehensive massively parallel sequencing (MPS)-based approaches, we especially focus our review on MPS parameters and detection opportunities of WGA-amplified material, i.e., mappability of reads, uniformity of coverage and its influence on copy number variation analysis, and genomic coverage and its influence on single nucleotide variation calling. The ability of MDA-based WGA solutions to better cover the targeted genome and the ability of PCR-based solutions to provide better uniformity of coverage are highlighted. While numerous comprehensive PGT solutions exploiting different WGA types and adjusted bioinformatic pipelines to detect copy number and single nucleotide changes are available, the ones exploiting MDA appear more advantageous. The opportunity to fully analyse the targeted genome is influenced by the MPS parameters themselves rather than the solely chosen WGA.
Collapse
|
11
|
Pei Z, Deng K, Lei C, Du D, Yu G, Sun X, Xu C, Zhang S. Identifying Balanced Chromosomal Translocations in Human Embryos by Oxford Nanopore Sequencing and Breakpoints Region Analysis. Front Genet 2022; 12:810900. [PMID: 35116057 PMCID: PMC8804325 DOI: 10.3389/fgene.2021.810900] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 12/13/2021] [Indexed: 01/02/2023] Open
Abstract
Background: Balanced chromosomal aberrations, especially balanced translocations, can cause infertility, recurrent miscarriage or having chromosomally defective offspring. Preimplantation genetic testing for structural rearrangement (PGT-SR) has been widely implemented to improve the clinical outcomes by selecting euploid embryos for transfer, whereas embryos with balanced translocation karyotype were difficult to be distinguished by routine genetic techniques from those with a normal karyotype. Method: In this present study, we developed a clinically applicable method for reciprocal translocation carriers to reduce the risk of pregnancy loss. In the preclinical phase, we identified reciprocal translocation breakpoints in blood of translocation carriers by long-read Oxford Nanopore sequencing, followed by junction-spanning polymerase chain reaction (PCR) and Sanger sequencing. In the clinical phase of embryo diagnosis, aneuploidies and unbalanced translocations were screened by comprehensive chromosomal screening (CCS) with single nucleotide polymorphism (SNP) microarray, carrier embryos were diagnosed by junction-spanning PCR and family haplotype linkage analysis of the breakpoints region. Amniocentesis and cytogenetic analysis of fetuses in the second trimester were performed after embryo transfer to conform the results diagnosed by the presented method. Results: All the accurate reciprocal translocation breakpoints were effectively identified by Nanopore sequencing and confirmed by Sanger sequencing. Twelve embryos were biopsied and detected, the results of junction-spanning PCR and haplotype linkage analysis were consistent. In total, 12 biopsied blastocysts diagnosed to be euploid, in which 6 were aneuploid or unbalanced, three blastocysts were identified to be balanced translocation carriers and three to be normal karyotypes. Two euploid embryos were subsequently transferred back to patients and late prenatal karyotype analysis of amniotic fluid cells was performed. The outcomes diagnosed by the current approach were totally consistent with the fetal karyotypes. Conclusions: In summary, these investigations in our study illustrated that chromosomal reciprocal translocations in embryos can be accurately diagnosed. Long-read Nanopore sequencing and breakpoint analysis contributes to precisely evaluate the genetic risk of disrupted genes, and provides a way of selecting embryos with normal karyotype, especially for couples those without a reference.
Collapse
Affiliation(s)
- Zhenle Pei
- Shanghai Ji Ai Genetics and IVF Institute, Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Ke Deng
- Shanghai Ji Ai Genetics and IVF Institute, Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Caixai Lei
- Shanghai Ji Ai Genetics and IVF Institute, Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Danfeng Du
- Shanghai Ji Ai Genetics and IVF Institute, Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Guoliang Yu
- Chigene (Beijing) Translational Medical Research Center Co. Ltd., Beijing, China
| | - Xiaoxi Sun
- Shanghai Ji Ai Genetics and IVF Institute, Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Congjian Xu
- Shanghai Ji Ai Genetics and IVF Institute, Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- *Correspondence: Congjian Xu, ; Shuo Zhang,
| | - Shuo Zhang
- Shanghai Ji Ai Genetics and IVF Institute, Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- *Correspondence: Congjian Xu, ; Shuo Zhang,
| |
Collapse
|
12
|
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.
Collapse
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.
| |
Collapse
|
13
|
Zhang S, Lei C, Wu J, Xiao M, Zhou J, Zhu S, Fu J, Lu D, Sun X, Xu C. A comprehensive and universal approach for embryo testing in patients with different genetic disorders. Clin Transl Med 2021; 11:e490. [PMID: 34323405 PMCID: PMC8265165 DOI: 10.1002/ctm2.490] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 06/01/2021] [Accepted: 06/20/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND In vitro fertilization (IVF) with preimplantation genetic testing (PGT) has markedly improved clinical pregnancy outcomes for carriers of gene mutations or chromosomal structural rearrangements by the selection of embryos free of disease-causing genes and chromosome abnormalities. However, for detecting whole or segmental chromosome aneuploidies, gene variants or balanced chromosome rearrangements in the same embryo require separate procedures, and none of the existing detection platforms is universal for all patients with different genetic disorders. METHODS Here, we report a cost-effective, family-based haplotype phasing approach that can simultaneously evaluate multiple genetic variants, including monogenic disorders, aneuploidy, and balanced chromosome rearrangements in the same embryo with a single test. A total of 12 monogenic diseases carrier couples and either of them carried chromosomal rearrangements were enrolled simultaneously in this present study. Genome-wide genotyping was performed with single-nucleotide polymorphism (SNP)-array, and aneuploidies were analyzed through SNP allele frequency and Log R ratio. Parental haplotypes were phased by an available genotype from a close relative, and the embryonic genome-wide haplotypes were determined through family haplotype linkage analysis (FHLA). Disease-causing genes and chromosomal rearrangements were detected by haplotypes located within the 2 Mb region covering the targeted genes or breakpoint regions. RESULTS Twelve blastocysts were thawed, and then transferred into the uterus of female patients. Nine pregnancies had reached the second trimester and five healthy babies have been born. Fetus validation results, performed with the amniotic fluid or umbilical cord blood samples, were consistent with those at the blastocyst stage diagnosed by PGT. CONCLUSIONS We demonstrate that SNP-based FHLA enables the accurate genetic detection of a wide spectrum of monogenic diseases and chromosome abnormalities in embryos, preventing the transfer of parental genetic abnormalities to the fetus. This method can be implemented as a universal platform for embryo testing in patients with different genetic disorders.
Collapse
Affiliation(s)
- Shuo Zhang
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology HospitalFudan UniversityShanghaiChina
| | - Caixia Lei
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology HospitalFudan UniversityShanghaiChina
| | - Junping Wu
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology HospitalFudan UniversityShanghaiChina
| | - Min Xiao
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology HospitalFudan UniversityShanghaiChina
| | - Jing Zhou
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology HospitalFudan UniversityShanghaiChina
| | - Saijuan Zhu
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology HospitalFudan UniversityShanghaiChina
| | - Jing Fu
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology HospitalFudan UniversityShanghaiChina
| | - Daru Lu
- State Key Laboratory of Genetic Engineering, School of Life ScienceFudan UniversityShanghaiChina
- NHC Key Laboratory of Birth Defects and Reproductive Health, Chongqing Key Laboratory of Birth Defects and Reproductive Health, Chongqing Population and Family PlanningScience and Technology Research InstituteChongqingChina
| | - Xiaoxi Sun
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology HospitalFudan UniversityShanghaiChina
- Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology HospitalFudan UniversityShanghaiChina
| | - Congjian Xu
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology HospitalFudan UniversityShanghaiChina
- Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology HospitalFudan UniversityShanghaiChina
| |
Collapse
|
14
|
Qiao J, Wang Y, Li X, Jiang F, Zhang Y, Ma J, Song Y, Ma J, Fu W, Pang R, Zhu Z, Zhang J, Qian X, Wang L, Wu J, Chang HM, Leung PCK, Mao M, Ma D, Guo Y, Qiu J, Liu L, Wang H, Norman RJ, Lawn J, Black RE, Ronsmans C, Patton G, Zhu J, Song L, Hesketh T. A Lancet Commission on 70 years of women's reproductive, maternal, newborn, child, and adolescent health in China. Lancet 2021; 397:2497-2536. [PMID: 34043953 DOI: 10.1016/s0140-6736(20)32708-2] [Citation(s) in RCA: 176] [Impact Index Per Article: 58.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Jie Qiao
- National Clinical Research Center for Obstetrical and Gynecological Diseases, Ministry of Education Key Laboratory of Assisted Reproduction, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
| | - Yuanyuan Wang
- National Clinical Research Center for Obstetrical and Gynecological Diseases, Ministry of Education Key Laboratory of Assisted Reproduction, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Xiaohong Li
- National Office for Maternal and Child Health Surveillance of China, National Center for Birth Defect Surveillance of China, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Fan Jiang
- Child Health Advocacy Institute, National Children's Medical Center, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yunting Zhang
- Child Health Advocacy Institute, National Children's Medical Center, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jun Ma
- Institute of Child and Adolescent Health, Key Laboratory of Reproductive Health, School of Public Health, Peking University, Beijing, China
| | - Yi Song
- Institute of Child and Adolescent Health, Key Laboratory of Reproductive Health, School of Public Health, Peking University, Beijing, China
| | - Jing Ma
- China Program for Health Innovation & Transformation, Department of Population Medicine, Harvard University, Boston, MA, USA
| | - Wei Fu
- China National Health and Development Research Centre, Beijing, China
| | - Ruyan Pang
- China Maternal and Child Health Association, Beijing, China
| | - Zhaofang Zhu
- China National Health and Development Research Centre, Beijing, China
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xu Qian
- School of Public Health & Global Health Institute, Fudan University, Shanghai, China
| | - Linhong Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiuling Wu
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hsun-Ming Chang
- National Clinical Research Center for Obstetrical and Gynecological Diseases, Ministry of Education Key Laboratory of Assisted Reproduction, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Peter C K Leung
- National Clinical Research Center for Obstetrical and Gynecological Diseases, Ministry of Education Key Laboratory of Assisted Reproduction, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Meng Mao
- National Office for Maternal and Child Health Surveillance of China, National Center for Birth Defect Surveillance of China, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Duan Ma
- Key Laboratory of Metabolism and Molecular Medicine, Ministry of Education, Department of Biochemistry and Molecular Biology, Fudan University, Shanghai, China
| | - Yan Guo
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Jie Qiu
- Gansu Provincial Maternity and Child-care Hospital, Lanzhou, China
| | - Li Liu
- Department of Population Family and Reproductive Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Haidong Wang
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Robert J Norman
- Robinson Research Institute, Fertility SA, University of Adelaide, Adelaide, SA, Australia
| | - Joy Lawn
- Centre for Maternal, Adolescent, Reproductive and Child Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Robert E Black
- Department of Population Family and Reproductive Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Carine Ronsmans
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - George Patton
- Centre for Adolescent Health, Murdoch Children's Research Institute, University of Melbourne, Melbourne, VIC, Australia
| | - Jun Zhu
- National Office for Maternal and Child Health Surveillance of China, National Center for Birth Defect Surveillance of China, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China.
| | - Li Song
- Department of Women and Children Health, National Health Commission of the People's Republic of China, Bejing, China.
| | - Therese Hesketh
- Center for Global Health, School of Medicine, Zhejiang University, Hangzhou, China; and Institute for Global Health, University College London, London, UK
| |
Collapse
|
15
|
Chen S, Yin X, Zhang S, Xia J, Liu P, Xie P, Yan H, Liang X, Zhang J, Chen Y, Fei H, Zhang L, Hu Y, Jiang H, Lin G, Chen F, Xu C. Comprehensive preimplantation genetic testing by massively parallel sequencing. Hum Reprod 2021; 36:236-247. [PMID: 33306794 DOI: 10.1093/humrep/deaa269] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 09/15/2020] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Can whole genome sequencing (WGS) offer a relatively cost-effective approach for embryonic genome-wide haplotyping and preimplantation genetic testing (PGT) for monogenic disorders (PGT-M), aneuploidy (PGT-A) and structural rearrangements (PGT-SR)? SUMMARY ANSWER Reliable genome-wide haplotyping, PGT-M, PGT-A and PGT-SR could be performed by WGS with 10× depth of parental and 4× depth of embryonic sequencing data. WHAT IS KNOWN ALREADY Reduced representation genome sequencing with a genome-wide next-generation sequencing haplarithmisis-based solution has been verified as a generic approach for automated haplotyping and comprehensive PGT. Several low-depth massively parallel sequencing (MPS)-based methods for haplotyping and comprehensive PGT have been developed. However, an additional family member, such as a sibling, or a proband, is required for PGT-M haplotyping using low-depth MPS methods. STUDY DESIGN, SIZE, DURATION In this study, 10 families that had undergone traditional IVF-PGT and 53 embryos, including 13 embryos from two PGT-SR families and 40 embryos from eight PGT-M families, were included to evaluate a WGS-based method. There were 24 blastomeres and 29 blastocysts in total. All embryos were used for PGT-A. Karyomapping validated the WGS results. Clinical outcomes of the 10 families were evaluated. PARTICIPANTS/MATERIALS, SETTING, METHODS A blastomere or a few trophectoderm cells from the blastocyst were biopsied, and multiple displacement amplification (MDA) was performed. MDA DNA and bulk DNA of family members were used for library construction. Libraries were sequenced, and data analysis, including haplotype inheritance deduction for PGT-M and PGT-SR and read-count analysis for PGT-A, was performed using an in-house pipeline. Haplotyping with a proband and parent-only haplotyping without additional family members were performed to assess the WGS methodology. Concordance analysis between the WGS results and traditional PGT methods was performed. MAIN RESULTS AND THE ROLE OF CHANCE For the 40 PGT-M and 53 PGT-A embryos, 100% concordance between the WGS and single-nucleotide polymorphism (SNP)-array results was observed, regardless of whether additional family members or a proband was included for PGT-M haplotyping. For the 13 embryos from the two PGT-SR families, the embryonic balanced translocation was detected and 100% concordance between WGS and MicroSeq with PCR-seq was demonstrated. LIMITATIONS, REASONS FOR CAUTION The number of samples in this study was limited. In some cases, the reference embryo for PGT-M or PGT-SR parent-only haplotyping was not available owing to failed direct genotyping. WIDER IMPLICATIONS OF THE FINDINGS WGS-based PGT-A, PGT-M and PGT-SR offered a comprehensive PGT approach for haplotyping without the requirement for additional family members. It provided an improved complementary method to PGT methodologies, such as low-depth MPS- and SNP array-based methods. STUDY FUNDING/COMPETING INTEREST(S) This research was supported by the research grant from the National Key R&D Program of China (2018YFC0910201 and 2018YFC1004900), the Guangdong province science and technology project of China (2019B020226001), the Shenzhen Birth Defect Screening Project Lab (JZF No. [2016] 750) and the Shenzhen Municipal Government of China (JCYJ20170412152854656). This work was also supported by the National Natural Science Foundation of China (81771638, 81901495 and 81971344), the National Key R&D Program of China (2018YFC1004901 and 2016YFC0905103), the Shanghai Sailing Program (18YF1424800), the Shanghai Municipal Commission of Science and Technology Program (15411964000) and the Shanghai 'Rising Stars of Medical Talent' Youth Development Program Clinical Laboratory Practitioners Program (201972). The authors declare no competing interests. TRIAL REGISTRATION NUMBER N/A.
Collapse
Affiliation(s)
- Songchang Chen
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Xuyang Yin
- MGI, BGI-Shenzhen, Shenzhen, China.,BGI-Shenzhen, Beishan Industrial Zone, Shenzhen, China.,China National GeneBank, BGI-Shenzhen, Shenzhen, China
| | | | - Jun Xia
- MGI, BGI-Shenzhen, Shenzhen, China.,BGI-Shenzhen, Beishan Industrial Zone, Shenzhen, China.,China National GeneBank, BGI-Shenzhen, Shenzhen, China
| | - Ping Liu
- MGI, BGI-Shenzhen, Shenzhen, China.,BGI-Shenzhen, Beishan Industrial Zone, Shenzhen, China.,China National GeneBank, BGI-Shenzhen, Shenzhen, China
| | - Pingyuan Xie
- CITIC-Xiangya Reproductive & Genetic Hospital, Changsha, China
| | | | | | - Junyu Zhang
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Yiyao Chen
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Hongjun Fei
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Lanlan Zhang
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Yuting Hu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hui Jiang
- MGI, BGI-Shenzhen, Shenzhen, China.,BGI-Shenzhen, Beishan Industrial Zone, Shenzhen, China.,China National GeneBank, BGI-Shenzhen, Shenzhen, China
| | - Ge Lin
- CITIC-Xiangya Reproductive & Genetic Hospital, Changsha, China
| | - Fang Chen
- MGI, BGI-Shenzhen, Shenzhen, China.,BGI-Shenzhen, Beishan Industrial Zone, Shenzhen, China.,China National GeneBank, BGI-Shenzhen, Shenzhen, China
| | - Chenming Xu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| |
Collapse
|
16
|
M M YC, Yu Q, Ma M, Wang H, Tian S, Zhang W, M M JZ, Liu Y, Yang Q, Pan X, Liang H, Wang L, Leigh D, Cram DS, Yao Y. Variant haplophasing by long-read sequencing: a new approach to preimplantation genetic testing workups. Fertil Steril 2021; 116:774-783. [PMID: 34020778 DOI: 10.1016/j.fertnstert.2021.04.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/23/2021] [Accepted: 04/15/2021] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To apply long-read, third-generation sequencing as a part of a general workup strategy for performing structural rearrangement (PGT-SR) and monogenic disease (PGT-M) embryo testing. DESIGN Prospective study. SETTING In vitro fertilization unit. PATIENT(S) Couples presenting for PGT-SR (n = 15) and PGT-M (n = 2). INTERVENTION(S) Blastocyst biopsy with molecular testing for translocation breakpoints or mutations (targets). MAIN OUTCOME MEASURE(S) Detailed, parental-phased, single-nucleotide polymorphism (SNP) profiles around targets for selection of informative polymorphic markers to simplify and facilitate clinical preimplantation genetic testing (PGT) designs that enable discrimination between carrier and noncarrier embryos. RESULT(S) High definition of chromosome breakpoints together with closely phased polymorphic markers was achieved for all 15 couples presenting for PGT-SR. Similarly, for the two couples presenting for PGT-M, tightly linked informative markers around the mutations were also simply identified. Three couples with translocations t(1;17)(q21;p13), t(3;13)(p25;q21.2), and t(12;13)(q23;q22) proceeded with PGT-SR, requesting preferential identification of noncarrier embryos for transfer. Following selection of a set of informative SNPs linked to breakpoints, we successfully performed PGT-SR tests, resulting in ongoing pregnancies with a noncarrier fetus for all couples. Similarly, with the use of tests based on informative SNPs linked to the parental mutations, one couple proceeded with PGT-M for maple syrup urine disease, resulting in an ongoing pregnancy with a disease-free fetus. CONCLUSION(S) For couples contemplating clinical PGT, variant haplophasing around the target reduces the workup process by enabling rapid selection of closely linked informative markers for patient-specific test design.
Collapse
Affiliation(s)
- Yanfei Cheng M M
- Department of Obstetrics and Gynecology, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Qian Yu
- Berry Genomics Corporation, Beijing, People's Republic of China
| | - Minyue Ma
- Department of Obstetrics and Gynecology, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Hui Wang
- Department of Obstetrics and Gynecology, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Shuang Tian
- Department of Obstetrics and Gynecology, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Wenling Zhang
- Department of Clinical Laboratory, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Jinning Zhang M M
- Department of Obstetrics and Gynecology, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Yifan Liu
- Prenatal Diagnostic Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Qi Yang
- Berry Genomics Corporation, Beijing, People's Republic of China
| | - Xiao Pan
- Berry Genomics Corporation, Beijing, People's Republic of China
| | - Hongbin Liang
- Genetics and Precision Medicine Center, First Hospital of Kunming, Calmette Hospital, Kunming, People's Republic of China
| | - Li Wang
- Genetics and Precision Medicine Center, First Hospital of Kunming, Calmette Hospital, Kunming, People's Republic of China
| | - Don Leigh
- Genetics and Precision Medicine Center, First Hospital of Kunming, Calmette Hospital, Kunming, People's Republic of China
| | - David S Cram
- Berry Genomics Corporation, Beijing, People's Republic of China; Genetics and Precision Medicine Center, First Hospital of Kunming, Calmette Hospital, Kunming, People's Republic of China
| | - Yuanqing Yao
- Department of Obstetrics and Gynecology, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China.
| |
Collapse
|
17
|
Liu D, Chen C, Zhang X, Dong M, He T, Dong Y, Lu J, Yu L, Yang C, Liu F. Successful birth after preimplantation genetic testing for a couple with two different reciprocal translocations and review of the literature. Reprod Biol Endocrinol 2021; 19:58. [PMID: 33879178 PMCID: PMC8056626 DOI: 10.1186/s12958-021-00731-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Preimplantation genetic testing for chromosomal structural rearrangements (PGT-SR) is widely applied in couples with single reciprocal translocation to increase the chance for a healthy live birth. However, limited knowledge is known on the data of PGT-SR when both parents have a reciprocal translocation. Here, we for the first time present a rare instance of PGT-SR for a non-consanguineous couple in which both parents carried an independent balanced reciprocal translocation and show how relevant genetic counseling data can be generated. METHODS The precise translocation breakpoints were identified by whole genome low-coverage sequencing (WGLCS) and Sanger sequencing. Next-generation sequencing (NGS) combining with breakpoint-specific polymerase chain reaction (PCR) was used to define 24-chromosome and the carrier status of the euploid embryos. RESULTS Surprisingly, 2 out of 3 day-5 blastocysts were found to be balanced for maternal reciprocal translocation while being normal for paternal translocation and thus transferable. The transferable embryo rate was significantly higher than that which would be expected theoretically. Transfer of one balanced embryo resulted in the birth of a healthy boy. CONCLUSION(S) Our data of PGT-SR together with a systematic review of the literature should help in providing couples carrying two different reciprocal translocations undergoing PGT-SR with more appropriate genetic counseling.
Collapse
Affiliation(s)
- Dun Liu
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Chuangqi Chen
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Xiqian Zhang
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Mei Dong
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Tianwen He
- Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Yunqiao Dong
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Jian Lu
- Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Lihua Yu
- Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Chuanchun Yang
- CheerLand Precision Biomed Co., Ltd., Shenzhen, Guangdong, China
| | - Fenghua Liu
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.
| |
Collapse
|
18
|
Xie P, Li Y, Cheng D, Hu L, Tan Y, Luo K, Gong F, Lu G, Lin G. Preimplantation genetic testing results of blastocysts from 12 non-Robertsonian translocation carriers with chromosome fusion and comparison with Robertsonian translocation carriers. Fertil Steril 2021; 116:174-180. [PMID: 33676754 DOI: 10.1016/j.fertnstert.2020.11.033] [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: 07/08/2020] [Revised: 11/05/2020] [Accepted: 11/20/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To investigate the effects of non-Robertsonian translocation with chromosome fusion (N-RBCF) on preimplantation embryos. DESIGN Case series. SETTING University-affiliated center. PATIENT(S) Twelve couples with N-RBCF. INTERVENTION(S) Assisted reproduction with preimplantation genetic testing in chromosomal structural rearrangement (PGT-SR). MAIN OUTCOME MEASURE(S) Normal embryo rate, unbalanced translocation rate. RESULT(S) PGT was performed in 12 N-RBCF carriers, of whom 4 carried Y-autosome fusions and 8 autosomal fusions. A total of 12 (63.2%) of 19 blastocysts exhibited normal/balanced embryos, and only one (5.3%) embryo exhibited unbalanced translocations among Y-autosome fusion cases. In contrast to these findings, the percentage of normal/balanced blastocysts in 8 autosomal N-RBCF cases was 28.2% (11/39), whereas the unbalanced translocation rate was 53.8%. Furthermore, the percentage of normal/balanced embryos in the Robertsonian translocation group was significantly higher than that of the 8 autosomal N-RBCF (48.7% vs. 28.2%) cases. The rates of abnormality from chromosomal fusion in the 8 autosomal N-RBCF cases were significantly higher than those noted in the Robertsonian translocation (53.8% vs. 31.4%) subjects. The results of the stratified analysis according to the carrier's sex demonstrated that the rates of unbalanced translocation were significantly higher in the male autosomal N-RBCF subjects than those from the corresponding Robertsonian translocation (55% vs. 19.7%) cases. CONCLUSION(S) A low number of unbalanced translocations was identified in blastocysts from N-RBCF subjects who carried the Y fusion. The risk of unbalanced translocation in autosomal N-RBCF was higher than that of the Robertsonian translocation, notably in male carriers.
Collapse
Affiliation(s)
- Pingyuan Xie
- Hunan Normal University School of Medicine, Changsha, People's Republic of China; National Engineering and Research Center of Human Stem Cell, Changsha, People's Republic of China
| | - Yiqing Li
- Hunan Normal University, Changsha, People's Republic of China
| | - Dehua Cheng
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, People's Republic of China; Laboratory of Reproductive and Stem Cell Engineering, Key Lab National Health and Family Planning Commission, Central South University, Changsha, People's Republic of China
| | - Liang Hu
- National Engineering and Research Center of Human Stem Cell, Changsha, People's Republic of China; Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, People's Republic of China; Laboratory of Reproductive and Stem Cell Engineering, Key Lab National Health and Family Planning Commission, Central South University, Changsha, People's Republic of China
| | - Yueqiu Tan
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, People's Republic of China; Laboratory of Reproductive and Stem Cell Engineering, Key Lab National Health and Family Planning Commission, Central South University, Changsha, People's Republic of China
| | - Keli Luo
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, People's Republic of China; Laboratory of Reproductive and Stem Cell Engineering, Key Lab National Health and Family Planning Commission, Central South University, Changsha, People's Republic of China
| | - Fei Gong
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, People's Republic of China; Laboratory of Reproductive and Stem Cell Engineering, Key Lab National Health and Family Planning Commission, Central South University, Changsha, People's Republic of China
| | - Guangxiu Lu
- National Engineering and Research Center of Human Stem Cell, Changsha, People's Republic of China; Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, People's Republic of China; Laboratory of Reproductive and Stem Cell Engineering, Key Lab National Health and Family Planning Commission, Central South University, Changsha, People's Republic of China
| | - Ge Lin
- National Engineering and Research Center of Human Stem Cell, Changsha, People's Republic of China; Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, People's Republic of China; Laboratory of Reproductive and Stem Cell Engineering, Key Lab National Health and Family Planning Commission, Central South University, Changsha, People's Republic of China.
| |
Collapse
|
19
|
Li R, Wang J, Gu A, Xu Y, Guo J, Pan J, Zeng Y, Ma Y, Zhou C, Xu Y. Feasibility study of using unbalanced embryos as a reference to distinguish euploid carrier from noncarrier embryos by single nucleotide polymorphism array for reciprocal translocations. Prenat Diagn 2021; 41:681-689. [PMID: 33411373 DOI: 10.1002/pd.5897] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 12/24/2020] [Accepted: 12/30/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To study the feasibility of using unbalanced embryos as a reference in distinguishing euploid carrier and noncarrier embryos by single nucleotide polymorphism (SNP) array-based preimplantation genetic testing (PGT) for reciprocal translocations. METHODS After comprehensive chromosome screening (CCS), euploid embryos were identified as normal or carriers using a family member as a reference. Next, unbalanced embryos were used as a reference, and the results were compared with the previous ones. Karyotypes of transferred embryos were validated by prenatal diagnosis. RESULTS Of 995 embryos from 110 couples, 288 were found to be euploid. Using a family member as a reference, 142 and 144 embryos were tested to be euploid noncarrier and carrier respectively, and the remaining 2 embryos were undetermined. When unbalanced embryos were selected as references, all the results were consistent with the previous ones. A total of 107 embryos were transferred, resulting in 66 clinical pregnancies. Karyotypes of prenatal diagnosis were all in accordance with the results of tested embryos. CONCLUSIONS SNP array-based haplotyping is a rapid and effective way to distinguish between euploid carrier and noncarrier embryos. In case no family member is available as a reference, unbalanced embryos can be used for identification of euploid carrier and noncarrier embryos.
Collapse
Affiliation(s)
- Rong Li
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, Guangdong, China
| | - Jing Wang
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, Guangdong, China
| | - Ailing Gu
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yan Xu
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, Guangdong, China
| | - Jing Guo
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, Guangdong, China
| | - Jiafu Pan
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, Guangdong, China
| | - Yanhong Zeng
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, Guangdong, China
| | - Yuanlin Ma
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, Guangdong, China
| | - Canquan Zhou
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, Guangdong, China
| | - Yanwen Xu
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, Guangdong, China
| |
Collapse
|
20
|
Clinical outcomes following preimplantation genetic testing and microdissecting junction region in couples with balanced chromosome rearrangement. J Assist Reprod Genet 2021; 38:735-742. [PMID: 33432423 PMCID: PMC7910386 DOI: 10.1007/s10815-020-02052-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 12/28/2020] [Indexed: 10/27/2022] Open
Abstract
PURPOSE The purpose of this study is to summarize the clinical outcomes of apparently balanced chromosome rearrangement (ABCR) carriers in preimplantation genetic testing (PGT) cycles by next-generation sequencing following microdissecting junction region (MicroSeq) to distinguish non-carrier embryos from balanced carriers. METHODS A retrospective study of 762 ABCR carrier couples who requested PGT for structural rearrangements combined with MicroSeq at the Reproductive and Genetic Hospital of CITIC-Xiangya was conducted between October 2014 and October 2019. RESULTS Trophectoderm biopsy was performed in 4122 blastocysts derived from 917 PGT-SR cycles and 3781 blastocysts were detected. Among the 3781 blastocysts diagnosed, 1433 (37.9%, 1433/3781) were balanced, of which 739 blastocysts were carriers (51.57%, 739/1433) and 694 blastocysts were normal (48.43%, 694/1433). Approximately 26.39% of cycles had both carrier and normal embryo transfer, and the average number of biopsied blastocysts was 6.7. In the cumulative 223 biopsied cycles with normal embryo transfer, all couples chose to transfer the normal embryos. In the 225 cycles with only carrier embryos, the couples chose to transfer the carrier embryos in 169/225 (75.11%) cycles. A total of 732 frozen embryo transfer cycles were performed, resulting in 502 clinical pregnancies. Cumulatively, 326 babies were born; all of these babies were healthy and free of any developmental issues. CONCLUSION Our study provides the first evaluation of the clinical outcomes of a large sample with ABCR carrier couples undergoing the MicroSeq-PGT technique and reveals its powerful ability to distinguish between carrier and non-carrier balanced embryos.
Collapse
|
21
|
Huang S, Niu Y, Li J, Gao M, Zhang Y, Yan J, Ma S, Gao X, Gao Y. Complex preimplantation genetic tests for Robertsonian translocation, HLA, and X-linked hyper IgM syndrome caused by a novel mutation of CD40LG gene. J Assist Reprod Genet 2020; 37:2025-2031. [PMID: 32500460 DOI: 10.1007/s10815-020-01846-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 05/28/2020] [Indexed: 12/22/2022] Open
Abstract
PURPOSE To perform complex preimplantation genetic tests (PGT) for aneuploidy screening, Robertsonian translocation, HLA-matching, and X-linked hyper IgM syndrome (XHIGM) caused by a novel mutation c.156 G>T of CD40LG gene. METHODS Reverse transcription PCR (RT-PCR) and Sanger sequencing were carried out to confirm the causative variant of CD40LG gene in the proband and parents. Day 5 and D6 blastocysts, obtained by in vitro fertilization (IVF) with intracytoplasmic sperm injection, underwent trophectoderm (TE) biopsy and whole genomic amplification (WGA) and next generation sequencing (NGS)-based PGT to detect the presence of a maternal CD40LG mutation, aneuploidy, Robertsonian translocation carrier, and human leukocyte antigen (HLA) haplotype. RESULTS Sanger sequencing data of the genomic DNA showed that the proband has a hemizygous variant of c. 156 G>T in the CD40LG gene, while his mother has a heterozygous variant at the same position. Complementary DNA (cDNA) of CD40LG amplification and sequencing displayed that no cDNA of CD40LG was found in proband, while only wild-type cDNA of CD40LG was amplified in the mother. PGT results showed that only one of the six tested embryos is free of the variant c.156 G>T and aneuploidy and having the consistent HLA type as the proband. Meanwhile, the embryo is a Robertsonian translocation carrier. The embryo was transplanted into the mother's uterus. Amniotic fluid testing results are consistent with that of PGT. A healthy baby girl was delivered, and the peripheral blood testing data was also consistent with the testing results of transplanted embryo. CONCLUSIONS The novel mutation of c. 156 G>T in CD40LG gene probably leads to XHIGM by nonsense-meditated mRNA decay (NMD), and complex PGT of preimplantation genetic testing for monogenic disease (PGT-M), aneuploidy (PGT-A), structural rearrangement (PGT-SR), and HLA-matching (PGT-HLA) can be performed in pedigree with both X-linked hyper IgM syndrome and Robertsonian translocation.
Collapse
Affiliation(s)
- Sexin Huang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China
| | - Yuping Niu
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China
| | - Jie Li
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China
| | - Ming Gao
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China
| | - Yan Zhang
- Shandong Provincial Hospital, Jinan, 250001, Shandong, China
| | - Junhao Yan
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China
| | - Shuiying Ma
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China
| | - Xuan Gao
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China
| | - Yuan Gao
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China.
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China.
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China.
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China.
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China.
| |
Collapse
|
22
|
Preimplantation Genetic Testing for Chromosomal Abnormalities: Aneuploidy, Mosaicism, and Structural Rearrangements. Genes (Basel) 2020; 11:genes11060602. [PMID: 32485954 PMCID: PMC7349251 DOI: 10.3390/genes11060602] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/25/2020] [Accepted: 05/27/2020] [Indexed: 12/18/2022] Open
Abstract
There is a high incidence of chromosomal abnormalities in early human embryos, whether they are generated by natural conception or by assisted reproductive technologies (ART). Cells with chromosomal copy number deviations or chromosome structural rearrangements can compromise the viability of embryos; much of the naturally low human fecundity as well as low success rates of ART can be ascribed to these cytogenetic defects. Chromosomal anomalies are also responsible for a large proportion of miscarriages and congenital disorders. There is therefore tremendous value in methods that identify embryos containing chromosomal abnormalities before intrauterine transfer to a patient being treated for infertility—the goal being the exclusion of affected embryos in order to improve clinical outcomes. This is the rationale behind preimplantation genetic testing for aneuploidy (PGT-A) and structural rearrangements (-SR). Contemporary methods are capable of much more than detecting whole chromosome abnormalities (e.g., monosomy/trisomy). Technical enhancements and increased resolution and sensitivity permit the identification of chromosomal mosaicism (embryos containing a mix of normal and abnormal cells), as well as the detection of sub-chromosomal abnormalities such as segmental deletions and duplications. Earlier approaches to screening for chromosomal abnormalities yielded a binary result of normal versus abnormal, but the new refinements in the system call for new categories, each with specific clinical outcomes and nuances for clinical management. This review intends to give an overview of PGT-A and -SR, emphasizing recent advances and areas of active development.
Collapse
|
23
|
Gao M, Wang L, Xu P, Xie H, Liu X, Huang S, Zou Y, Li J, Wang Y, Li P, Gao Y, Chen Z. Noncarrier embryo selection and transfer in preimplantation genetic testing cycles for reciprocal translocation by Oxford Nanopore Technologies. J Genet Genomics 2020; 47:718-721. [PMID: 33775291 DOI: 10.1016/j.jgg.2020.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Ming Gao
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, China; Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, China
| | - Lijuan Wang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, China; Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, China
| | - Peiwen Xu
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, China; Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, China
| | - Hongqiang Xie
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, China; Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, China
| | - Xiaowei Liu
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, China; Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, China
| | - Sexin Huang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, China; Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, China
| | - Yang Zou
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, China; Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, China
| | - Jie Li
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, China; Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, China
| | - Yang Wang
- GrandOmics Biosciences Co., Ltd, Beijing, 102206, China
| | - Pidong Li
- GrandOmics Biosciences Co., Ltd, Beijing, 102206, China
| | - Yuan Gao
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, China; Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, China.
| | - Zijiang Chen
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, China; Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, China
| |
Collapse
|
24
|
Novel PGD strategy based on single sperm linkage analysis for carriers of single gene pathogenic variant and chromosome reciprocal translocation. J Assist Reprod Genet 2020; 37:1239-1250. [PMID: 32350783 DOI: 10.1007/s10815-020-01753-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 03/17/2020] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Preimplantation genetic diagnosis (PGD) analysis can be challenging for couples who carry more than one genetic condition. In this study, we describe a new PGD strategy to select which embryo(s) to transfer for two clinically challenging cases. Both cases lack essential family members for linkage analysis including de novo mutation combined with reciprocal translocation. METHODS Diverging from conventional method, we performed direct point mutation detection, quantitative analysis of gene copy number, combined with linkage analysis assisted by SNP information from single sperm (or polar bodies), thus establishing an all-in-one protocol for single embryonic cell preimplantation diagnosis for two co-existing genetic conditions (monogenic disease and chromosomal abnormality) on the NGS-based platform. RESULTS Using this newly developed method, 15 embryos from two cases were screened, and two embryos were determined as free of the monogenic disease and specific chromosomal abnormalities created by the prospective father's reciprocal translocations. CONCLUSION This novel PGD strategy could effectively select unaffected embryo(s) for couples affected with or carrying a monogenetic disease and a reciprocal chromosome translocation concurrently.
Collapse
|
25
|
Toft CLF, Ingerslev HJ, Kesmodel US, Diemer T, Degn B, Ernst A, Okkels H, Kjartansdóttir KR, Pedersen IS. A systematic review on concurrent aneuploidy screening and preimplantation genetic testing for hereditary disorders: What is the prevalence of aneuploidy and is there a clinical effect from aneuploidy screening? Acta Obstet Gynecol Scand 2020; 99:696-706. [PMID: 32039470 DOI: 10.1111/aogs.13823] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/23/2020] [Accepted: 02/05/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION In assisted reproductive technology, aneuploidy is considered a primary cause of failed embryo implantation. This has led to the implementation of preimplantation genetic testing for aneuploidy in some clinics. The prevalence of aneuploidy and the use of aneuploidy screening during preimplantation genetic testing for inherited disorders has not previously been reviewed. Here, we systematically review the literature to investigate the prevalence of aneuploidy in blastocysts derived from patients carrying or affected by an inherited disorder, and whether screening for aneuploidy improves clinical outcomes. MATERIAL AND METHODS PubMed and Embase were searched for articles describing preimplantation genetic testing for monogenic disorders and/or structural rearrangements in combination with preimplantation genetic testing for aneuploidy. Original articles reporting aneuploidy rates at the blastocyst stage and/or clinical outcomes (positive human chorionic gonadotropin, gestational sacs/implantation rate, fetal heartbeat/clinical pregnancy, ongoing pregnancy, miscarriage, or live birth/delivery rate on a per transfer basis) were included. Case studies were excluded. RESULTS Of the 26 identified studies, none were randomized controlled trials, three were historical cohort studies with a reference group not receiving aneuploidy screening, and the remaining were case series. In weighted analysis, 34.1% of 7749 blastocysts were aneuploid. Screening for aneuploidy reduced the proportion of embryos suitable for transfer, thereby increasing the risk of experiencing a cycle without transferable embryos. In pooled analysis the percentage of embryos suitable for transfer was reduced from 57.5% to 37.2% following screening for aneuploidy. Among historical cohort studies, one reported significantly improved pregnancy and birth rates but did not control for confounding, one did not report any statistically significant difference between groups, and one properly designed study concluded that preimplantation genetic testing for aneuploidy enhanced the chance of achieving a pregnancy while simultaneously reducing the chance of miscarriage following single embryo transfer. CONCLUSIONS On average, aneuploidy is detected in 34% of embryos when performing a single blastocyst biopsy derived from patients carrying or affected by an inherited disorder. Accordingly, when screening for aneuploidy, the risk of experiencing a cycle with no transferable embryos increases. Current available data on the clinical effect of preimplantation genetic testing for aneuploidy performed concurrently with preimplantation genetic testing for inherited disorders are sparse, rendering the clinical effect from preimplantation genetic testing for aneuploidy difficult to access.
Collapse
Affiliation(s)
- Christian Liebst Frisk Toft
- Department of Molecular Diagnostics, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | | | - Ulrik Schiøler Kesmodel
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Fertility Unit, Aalborg University Hospital, Aalborg, Denmark
| | - Tue Diemer
- Department of Clinical Genetics, Aalborg University Hospital, Aalborg, Denmark
| | - Birte Degn
- Department of Molecular Diagnostics, Aalborg University Hospital, Aalborg, Denmark
| | - Anja Ernst
- Department of Molecular Diagnostics, Aalborg University Hospital, Aalborg, Denmark
| | - Henrik Okkels
- Department of Molecular Diagnostics, Aalborg University Hospital, Aalborg, Denmark
| | | | - Inge Søkilde Pedersen
- Department of Molecular Diagnostics, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| |
Collapse
|
26
|
Chow JF, Cheng HH, Lau EY, Yeung WS, Ng EH. Distinguishing between carrier and noncarrier embryos with the use of long-read sequencing in preimplantation genetic testing for reciprocal translocations. Genomics 2020; 112:494-500. [DOI: 10.1016/j.ygeno.2019.04.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 02/16/2019] [Accepted: 04/01/2019] [Indexed: 01/21/2023]
|
27
|
Zhang S, Liang F, Lei C, Wu J, Fu J, Yang Q, Luo X, Yu G, Wang D, Zhang Y, Lu D, Sun X, Liang Y, Xu C. Long-read sequencing and haplotype linkage analysis enabled preimplantation genetic testing for patients carrying pathogenic inversions. J Med Genet 2019; 56:741-749. [PMID: 31439719 PMCID: PMC6860410 DOI: 10.1136/jmedgenet-2018-105976] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 05/31/2019] [Accepted: 06/13/2019] [Indexed: 01/04/2023]
Abstract
Background Preimplantation genetic testing (PGT) has already been applied in patients known to carry chromosomal structural variants to improve the clinical outcome of assisted reproduction. However, conventional molecular techniques are not capable of reliably distinguishing embryos that carry balanced inversion from those with a normal karyotype. We aim to evaluate the use of long-read sequencing in combination with haplotype linkage analysis to address this challenge. Methods Long-read sequencing on Oxford Nanopore platform was employed to identify the precise positions of inversion break points in four patients. Comprehensive chromosomal screening and genome-wide haplotype linkage analysis were performed based on SNP microarray. The haplotypes, including the break point regions, the whole chromosomes involved in the inversion and the corresponding homologous chromosomes, were established using informative SNPs. Results All the inversion break points were successfully identified by long-read sequencing and validated by Sanger sequencing, and on average only 13 bp differences were observed between break points inferred by long-read sequencing and Sanger sequencing. Eighteen blastocysts were biopsied and tested, in which 10 were aneuploid or unbalanced and eight were diploid with normal or balanced inversion karyotypes. Diploid embryos were transferred back to patients, the predictive results of the current methodology were consistent with fetal karyotypes of amniotic fluid or cord blood. Conclusions Nanopore long-read sequencing is a powerful method to assay chromosomal inversions and identify exact break points. Identification of inversion break points combined with haplotype linkage analysis is an efficient strategy to distinguish embryos with normal or balanced inversion karyotypes, facilitating PGT applications.
Collapse
Affiliation(s)
- Shuo Zhang
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.,Collaborative Innovation Center for Genetics and Development, State Key Laboratory of Genetic Engineering, School of Life Science, Fudan University, Shanghai, China
| | - Fan Liang
- GrandOmics Biosciences, Beijing, China
| | - Caixia Lei
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Junping Wu
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Jing Fu
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Qi Yang
- GrandOmics Biosciences, Beijing, China
| | - Xiao Luo
- GrandOmics Biosciences, Beijing, China
| | | | | | - Yueping Zhang
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Daru Lu
- Collaborative Innovation Center for Genetics and Development, State Key Laboratory of Genetic Engineering, School of Life Science, Fudan University, Shanghai, China
| | - Xiaoxi Sun
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China .,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Yu Liang
- GrandOmics Biosciences, Beijing, China
| | - Congjian Xu
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China .,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| |
Collapse
|
28
|
Xie P, Hu L, Tan Y, Gong F, Zhang S, Xiong B, Peng Y, Lu GX, Lin G. Retrospective analysis of meiotic segregation pattern and interchromosomal effects in blastocysts from inversion preimplantation genetic testing cycles. Fertil Steril 2019; 112:336-342.e3. [PMID: 31103288 DOI: 10.1016/j.fertnstert.2019.03.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 02/26/2019] [Accepted: 03/28/2019] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To determine factors affecting unbalanced chromosomal rearrangement originating from parental inversion and interchromosomal effect occurrence in blastocysts from inversion carriers. DESIGN Retrospective study. SETTING University-affiliated center. PATIENT(S) Couples with one partner carrying inversion underwent preimplantation genetic testing for chromosomal structural rearrangement cycles. INTERVENTION(S) Not applicable. MAIN OUTCOME MEASURE(S) Unbalanced rearrangement embryo rate, normal embryo rate, interchromosomal effect. RESULT(S) Preimplantation genetic testing was performed for 576 blastocysts from 57 paracentric (PAI) and 94 pericentric (PEI) inversion carriers. The percentage of normal/balanced blastocysts was significantly higher in PAI than PEI carriers (70.4% vs. 57.5%). Logistic regression indicated the inverted segment size ratio was a statistically significant risk factor for abnormality from parental inversion in both PEI and PAI. The optimal cutoff values to predict unbalanced rearrangement risk were 35.7% and 57%. In PAI, rates of abnormality from parental inversion were 0% and 12.1% in the <35.7% and ≥35.7% groups, respectively, with no gender difference. For PEI, the rates of abnormality from parental inversion were 7.9% and 33.1% in the <57% and ≥57% groups, respectively. In the ≥57% group, the rate of unbalanced rearrangement was significantly higher from paternal than maternal inversion (43.3% vs. 23.6%). In inversion carriers, 21,208 chromosomes were examined, and 187 (0.88%) malsegregations were identified from structurally normal chromosomes. In controls, 56,488 chromosomes were assessed, and 497 (0.88%) aneuploidies were identified, indicating no significant difference. CONCLUSION(S) The risk of unbalanced rearrangement is affected by the ratio of inverted segment size in both PAI and PEI carriers and is associated with gender.
Collapse
Affiliation(s)
- PingYuan Xie
- Hunan Normal University School of Medicine, Changsha, Hunan, China; National Engineering and Research Center of Human Stem Cells, Changsha, China
| | - Liang Hu
- Reproductive and 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, School of Basic Medical Science, Central South University, Changsha, People's Republic of China
| | - Yueqiu Tan
- Reproductive and 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, School of Basic Medical Science, Central South University, Changsha, People's Republic of China
| | - Fei Gong
- Reproductive and 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, School of Basic Medical Science, Central South University, Changsha, People's Republic of China
| | - ShuoPing Zhang
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
| | - Bo Xiong
- National Engineering and Research Center of Human Stem Cells, Changsha, China
| | - Yangqin Peng
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
| | - Guang Xiu Lu
- National Engineering and Research Center of Human Stem Cells, Changsha, China; Reproductive and 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, School of Basic Medical Science, Central South University, Changsha, People's Republic of China
| | - Ge Lin
- National Engineering and Research Center of Human Stem Cells, Changsha, China; Reproductive and 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, School of Basic Medical Science, Central South University, Changsha, People's Republic of China.
| |
Collapse
|
29
|
Xu J, Zhang Z, Niu W, Yang Q, Yao G, Shi S, Jin H, Song W, Chen L, Zhang X, Guo Y, Su Y, Hu L, Zhai J, Zhanga Y, Dong F, Gao Y, Li W, Bo S, Hu M, Ren J, Huang L, Xie XS, Sun Y, Lu S. Mapping allele with resolved carrier status of Robertsonian and reciprocal translocation in human preimplantation embryos. Reprod Biomed Online 2019. [DOI: 10.1016/j.rbmo.2019.03.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
30
|
Zhang S, Zhao D, Zhang J, Mao Y, Kong L, Zhang Y, Liang B, Sun X, Xu C. BasePhasing: a highly efficient approach for preimplantation genetic haplotyping in clinical application of balanced translocation carriers. BMC Med Genomics 2019; 12:52. [PMID: 30885195 PMCID: PMC6423798 DOI: 10.1186/s12920-019-0495-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 02/28/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Preimplantation genetic testing (PGT) has already been applied in chromosomally balanced translocation carriers to improve the clinical outcome of assisted reproduction. However, traditional methods could not further distinguish embryos carrying a translocation from those with a normal karyotype prior to implantation. METHODS To solve this problem, we developed a method named "Chromosomal Phasing on Base level" (BasePhasing), which based on Infinium Asian Screening Array-24 v1.0 (ASA) and a specially phasing pipeline. Firstly, by comparing the number of single nucleotide polymorphism (SNP) loci in different minor allele frequencies (MAFs) and in 2Mbp continuous windows of ASA chip and karyomap-12 chip, we verified whether ASA could be adopted for genome-wide haplotype linkage analysis. Besides, the whole gene amplification (WGA) of 3-10 cells of GM16457 cell line was used to verify whether ASA chip could be used for testing of WGA products. Finally, two balanced translocation families were utilized to carry out BasePhasing and to validate the feasibility of its clinical application. RESULTS The average number of SNP loci in each window of ASA (473.2) was twice of that of Karyomap-12 (201.2). The coincidence rate of SNP loci in genomic DNA and WGA products was about 97%. The 5.3Mbp deletion was detected positively in cell line GM16457 of both genomic DNA and WGA products, and haplotype linkage analysis was performed in genome wide successfully. In the two balanced translocation families, 18 blastocysts were analyzed, in which 8 were unbalanced and the other 10 were balanced or normal chromosomes. Two embryos were transferred back to the patients successfully, and prenatal cytogenetic analysis of amniotic fluid was performed in the second trimester. The results predicted by BasePhasing and prenatal diagnosis were totally consistent. CONCLUSIONS Infinium ASA bead chip based BasePhasing pipeline shows good performance in balanced translocation carrier testing. With the characteristics of simple operation procedure and accurate results, we demonstrate that BasePhasing is one of the most suitable methods to distinguish between balanced and structurally normal chromosome embryos from translocation carriers in PGT at present.
Collapse
Affiliation(s)
- Shuo Zhang
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China.,State Key Laboratory of Genetic Engineering, Collaborative Innovation Center for Genetics and Development, School of Life Science, Fudan University, 588 Fangxie Rd, Shanghai, 200438, China
| | - Dingding Zhao
- Basecare Medical Device Co., Ltd, 218 Xinghu Road, SIP, Suzhou, Jiangsu, 215001, China
| | - Jun Zhang
- Basecare Medical Device Co., Ltd, 218 Xinghu Road, SIP, Suzhou, Jiangsu, 215001, China
| | - Yan Mao
- Basecare Medical Device Co., Ltd, 218 Xinghu Road, SIP, Suzhou, Jiangsu, 215001, China
| | - Lingyin Kong
- Basecare Medical Device Co., Ltd, 218 Xinghu Road, SIP, Suzhou, Jiangsu, 215001, China
| | - Yueping Zhang
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China
| | - Bo Liang
- Basecare Medical Device Co., Ltd, 218 Xinghu Road, SIP, Suzhou, Jiangsu, 215001, China. .,State Key Laboratory of Microbial Metabolism, Joint International Research Laboratory of Metabolic and Developmental Sciences, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University , 800 Dongchuan Road, Shanghai, 200240, China.
| | - Xiaoxi Sun
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China. .,Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China.
| | - Congjian Xu
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China. .,Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China.
| |
Collapse
|
31
|
Cai Y, Ding M, Lin F, Diao Z, Zhang N, Sun H, Zhou J. Evaluation of preimplantation genetic testing based on next-generation sequencing for balanced reciprocal translocation carriers. Reprod Biomed Online 2019; 38:669-675. [PMID: 30885668 DOI: 10.1016/j.rbmo.2018.12.043] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 11/26/2018] [Accepted: 12/12/2018] [Indexed: 12/15/2022]
Abstract
RESEARCH QUESTION Can next-generation sequencing (NGS) based on copy number variation sequencing (CNV-Seq) identify normal/balanced embryos in balanced reciprocal translocation carriers and what are their reproductive outcomes? DESIGN One hundred couples with balanced reciprocal translocation who underwent a total of 134 preimplantation genetic testing (PGT) cycles between January 2015 and October 2017 were evaluated. Trophectoderm cells of blastocysts were biopsied for CNV-Seq-based NGS. All the balanced/normal blastocysts were vitrified and cryopreserved. Single balanced/normal blastocysts were warmed and transferred in the subsequent frozen embryo transfer (FET) cycle. RESULTS During the study period, 400 blastocysts were analysed by NGS-PGT, of which 109 (27.25%) were balanced and euploid. A total of 52 blastocysts were transferred in the FET cycle. Clinical pregnancy was confirmed in 34 women (65.38%), with a miscarriage rate of 2.94%; 26 healthy term babies were born, including 24 singletons and one set of twins, while eight couples had ongoing pregnancies. Amniocentesis revealed a fetal chromosome status that was consistent with the NGS-PGT results. Female carriers had a significantly higher blastocyst rate than did the male carriers (37.01% versus 31.27%, P = 0.04). The transferable blastocyst rate was higher in couples treated with gonadotrophin-releasing hormone (GnRH) antagonist than in those treated with GnRH agonist (38.20% versus 24.37%, P = 0.01). However, neither carrier sex nor ovarian stimulation protocol influenced the clinical pregnancy rate. CONCLUSIONS CNV-Seq-based NGS is an efficient and reliable PGT method for balanced reciprocal translocation.
Collapse
Affiliation(s)
- Yunni Cai
- Reproductive Medicine Centre, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing Jiangsu 210008, China
| | - Min Ding
- Reproductive Medicine Centre, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing Jiangsu 210008, China
| | - Fei Lin
- Reproductive Medicine Centre, Nanjing Drum Tower Hospital, The Affiliated Hospital to Nanjing University Medical School, Nanjing Jiangsu 210008, China
| | - Zhenyu Diao
- Reproductive Medicine Centre, Nanjing Drum Tower Hospital, The Affiliated Hospital to Nanjing University Medical School, Nanjing Jiangsu 210008, China
| | - Ningyuan Zhang
- Reproductive Medicine Centre, Nanjing Drum Tower Hospital, The Affiliated Hospital to Nanjing University Medical School, Nanjing Jiangsu 210008, China
| | - Haixiang Sun
- Reproductive Medicine Centre, Nanjing Drum Tower Hospital, The Affiliated Hospital to Nanjing University Medical School, Nanjing Jiangsu 210008, China
| | - Jianjun Zhou
- Reproductive Medicine Centre, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing Jiangsu 210008, China; Reproductive Medicine Centre, Nanjing Drum Tower Hospital, The Affiliated Hospital to Nanjing University Medical School, Nanjing Jiangsu 210008, China.
| |
Collapse
|
32
|
Identifying normal embryos from reciprocal translocation carriers by whole chromosome haplotyping. J Genet Genomics 2018; 45:505-508. [PMID: 30287172 DOI: 10.1016/j.jgg.2018.05.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 03/28/2018] [Accepted: 05/13/2018] [Indexed: 11/24/2022]
|
33
|
Wang J, Zeng Y, Ding C, Cai B, Lu B, Li R, Xu Y, Xu Y, Zhou C. Preimplantation genetic testing of Robertsonian translocation by SNP array-based preimplantation genetic haplotyping. Prenat Diagn 2018; 38:547-554. [PMID: 29799617 DOI: 10.1002/pd.5258] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 03/23/2018] [Accepted: 03/26/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVES The present study attempted to confirm a method that distinguishes a balanced Robertsonian translocation carrier embryo from a truly normal embryo in parallel with comprehensive chromosome screening (CCS). METHODS Comprehensive chromosome screening was performed in 107 embryos from 11 couples carrying Robertsonian translocations. Among them, embryos from 2 families had been transferred before the diagnosis of translocation, which resulted in successful pregnancies; embryos from the remaining families were transferred after the identification of translocations. The single nucleotide polymorphism (SNP) genotypes were acquired on a genome-wide basis, and breakpoint regions and flanking were assessed by establishing haplotypes. The predicted karyotypes from the transferred embryos were confirmed by prenatal diagnosis. RESULTS Among the 9 families finally undergoing translocation diagnosis, the amniotic cell karyotypes of 3 families were concordant with the results predicted by preimplantation genetic haplotyping, revealing a good consistency rate. After CCS, the euploid embryos from 2 other families could not be further detected because of the absence of abnormal embryos as probands. CONCLUSIONS Molecular karyotypes and haplotypes could be established with SNP microarray simultaneously in each embryo. SNP array-based PGT can simultaneously complete the CCS and identify Robertsonian translocation carriers, thus making it possible to prevent Robertsonian translocations from being passed to subsequent generations.
Collapse
Affiliation(s)
- Jing Wang
- Center for Reproductive Medicine and Department of Gynecology & Obstetrics, First Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China
| | - Yanhong Zeng
- Center for Reproductive Medicine and Department of Gynecology & Obstetrics, First Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China
| | - Chenhui Ding
- Center for Reproductive Medicine and Department of Gynecology & Obstetrics, First Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China
| | - Bin Cai
- Center for Reproductive Medicine and Department of Gynecology & Obstetrics, First Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China
| | - Baomin Lu
- Center for Reproductive Medicine and Department of Gynecology & Obstetrics, First Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China
| | - Rong Li
- Center for Reproductive Medicine and Department of Gynecology & Obstetrics, First Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China
| | - Yan Xu
- Center for Reproductive Medicine and Department of Gynecology & Obstetrics, First Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China
| | - Yanwen Xu
- Center for Reproductive Medicine and Department of Gynecology & Obstetrics, First Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China
| | - Canquan Zhou
- Center for Reproductive Medicine and Department of Gynecology & Obstetrics, First Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China
| |
Collapse
|