Genetic abnormalities seen on CVS in early pregnancy failure

Comprehensive chromosome FISH assessment of sperm aneuploidy in normozoospermic males

PURPOSE

Sperm chromosomal abnormalities impact male fertility and pregnancy outcomes. However, the proportion of sperm with chromosomal abnormalities in normozoospermic men remains unclear. Herein, we evaluated sperm aneuploidy for 23 chromosomes to elucidate its incidence in normozoospermic men.

METHODS

Sperm from ten normozoospermic donors were obtained from a human sperm bank and analyzed using fluorescence in situ hybridization. The frequencies of nullisomy, disomy, and diploidy were analyzed along with trisomy, triploidy, tetraploidy, and other numerical abnormalities per chromosome and per donor levels.

RESULTS

A total of 248,811 sperm cells were analyzed (average: 24,881 ± 381 cells/donor), of which 246, 658 were haploid, 818 nullisomic, 393 disomic, 894 diploid, 13 triploid, 8 tetraploid, 3 trisomic, and 24 harbored multiple aneuploidies. Among the 22 autosomal and 2 sex chromosomes, the mean frequency of aneuploidy per chromosome was 0.49 ± 0.16%, including 0.33 ± 0.16% for nullisomy and 0.16 ± 0.08% for disomy. The mean frequencies of nullisomy, disomy, and aneuploidy per donor were 0.33 ± 0.13%, 0.16 ± 0.05%, and 0.49 ± 0.13%, respectively. The total frequencies of nullisomy, disomy, diploidy, and aneuploidy per donor were 7.62 ± 3.06%, 3.63 ± 1.12%, 0.36 ± 0.15%, and 11.25 ± 3.05%, respectively.

CONCLUSIONS

The dominant chromosome numerical abnormalities in normozoospermic men are nullisomy, disomy, and diploidy. Generally, the frequency of nullisomy is higher than that of disomy. The disomy or nullisomy frequencies for each chromosome being gained or lost were not unified and varied; some chromosomes (e.g., chromosomes 21 and 22 and sex chromosomes) are more prone to disomy while some others (e.g., chromosome 3) are more prone to nullisomy.

A New Stepwise Molecular Work-Up After Chorionic Villi Sampling in Women With an Early Pregnancy Loss

Objective: To explore the use of a new molecular work-up based on the stepwise use of Quantitative Fluorescence PCR (QF-PCR) extended to eight chromosomes and single nucleotide polymorphism array (SNP-array) in chorionic villi obtained by chorionic villi sampling (CVS) offered to women experiencing an early pregnancy loss.

Methods: During a 3-year period (January 2016–December 2018), CVS was offered to women experiencing an early pregnancy loss before the evacuation of the products of conception (POC) to retrieve chorionic villi, irrespective of the number of previous losses. A new molecular work-up was prospectively assayed encompassing a first QF-PCR round (with the 21, 18, 13, 7, X, and Y chromosomes), a second QF-PCR round (with the 15, 16, and 22 chromosomes), and a high resolution SNP-array in those cases with normal QF-PCR results. A control group in which POC were collected after surgical uterine evacuation was used to be compared with the intervention group.

Results: Around 459 women were enrolled in the intervention group (CVS) and 185 in the control group (POC after uterine evacuation). The QF-PCR testing success rates were significantly higher in the intervention group (98.5%: 452/459) as compared to the control group (74%: 109/147; p < 0.001), while the chromosomal anomaly rate at the two QF-PCR rounds was similar between the two groups: 52% (234/452) in the intervention and 42% (46/109) in the control group (p = 0.073). The SNP-array was performed in 202 QF-PCR normal samples of the intervention group and revealed 67 (33%) atypical chromosomal anomalies (>10 Mb), 5 (2.5%) submicroscopic pathogenic copy number variants, and 2 (1%) variant of uncertain significance (VOUS).

Conclusion: Eighty-two percent of women experiencing an early pregnancy loss opted for a CVS. The testing success rates were higher in the intervention group (CVS; 98%) as compared to the control group (POC; 74%). The overall yields were 52% by QF-PCR (including three complete hydatiform moles), and 16% by SNP-array, including 15% atypical chromosomal anomalies and 1.1% submicroscopic pathogenic copy number variants.