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Factors influencing mosaicism: A retrospective analysis. Reprod Biomed Online 2022; 45:491-500. [DOI: 10.1016/j.rbmo.2022.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 04/14/2022] [Accepted: 04/27/2022] [Indexed: 11/22/2022]
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2
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Sánchez-Herrero Á, Carmona-Talavera D, García-Verdevio ME, Hernando-Espinilla A, Estañ-Capell N. Mosaic Trisomy 5: Prenatal Genetic Diagnosis and Outcomes of a New Case. J Pediatr Genet 2020; 12:64-68. [PMID: 36684541 PMCID: PMC9848760 DOI: 10.1055/s-0040-1721076] [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: 08/01/2020] [Accepted: 10/11/2020] [Indexed: 01/25/2023]
Abstract
Chromosomal mosaicism is defined as the presence of two or more different cell lines in an organism that originate from the same embryo. Trisomy of chromosome 5 is one of the most severe forms of autosomal trisomy and only seven cases of mosaic trisomy 5 have been reported to date. Mosaicism at prenatal level constitutes a challenge in genetic counseling, particularly in the case of mosaic trisomy 5, due to its low incidence. We report the case of a girl with a prenatal diagnosis of mosaic trisomy 5. The pre- and postnatal genetic tests (noninvasive prenatal testing, array comparative genomic hybridization, karyotype in amniotic fluid cells, karyotype in peripheral blood, and uniparental disomy analysis) revealed the fetal chromosomal status and indicated etiology giving rise to the mosaicism, suggesting a prezygotic meiotic error corrected through late trisomic rescue in the zygote.
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Affiliation(s)
- Ángeles Sánchez-Herrero
- Cytogenetics and Molecular Biology Unit, Department of Clinical Analysis, Hospital Universitario Doctor Peset, Valencia, Spain,Address for correspondence Angeles Sánchez Herrero Cytogenetics and Molecular Biology Unit, Department of Clinical Analysis, Hospital Universitario Doctor PesetValenciaSpain
| | - Diego Carmona-Talavera
- Cytogenetics and Molecular Biology Unit, Department of Clinical Analysis, Hospital Universitario Doctor Peset, Valencia, Spain
| | - M Elia García-Verdevio
- Department of Gynecology and Obstetrics, Hospital Universitario Doctor Peset, Valencia, Spain
| | - Amaya Hernando-Espinilla
- Cytogenetics and Molecular Biology Unit, Department of Clinical Analysis, Hospital Universitario Doctor Peset, Valencia, Spain
| | - Nuria Estañ-Capell
- Cytogenetics and Molecular Biology Unit, Department of Clinical Analysis, Hospital Universitario Doctor Peset, Valencia, Spain
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3
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Coll L, Parriego M, Mateo S, García-Monclús S, Rodríguez I, Boada M, Coroleu B, Polyzos NP, Vidal F, Veiga A. Prevalence, types and possible factors influencing mosaicism in IVF blastocysts: results from a single setting. Reprod Biomed Online 2020; 42:55-65. [PMID: 33153932 DOI: 10.1016/j.rbmo.2020.09.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/08/2020] [Accepted: 09/29/2020] [Indexed: 12/11/2022]
Abstract
RESEARCH QUESTION Are intrinsic or extrinsic factors associated with embryo mosaicism prevalence in IVF cycles? DESIGN Retrospective cohort study of preimplantation genetic testing for aneuploidy (PGT-A) cycles carried out at a university-affiliated IVF clinic between October 2017 and October 2019. Trophectoderm biopsies were analysed by next generation sequencing. Mosaicism prevalence, type of anomaly and the chromosomes involved were analysed. Intrinsic and extrinsic factors potentially inducing mosaicism were studied: maternal and paternal age, antral follicle count, cumulus-oocyte complexes retrieved, female body mass index, PGT-A indication, sperm concentration, total dosage of gonadotrophins, embryo quality and day of blastocyst formation, single-step commercial media used and biopsy operator. RESULTS Overall prevalence of mosaicism in our PGT-A setting was 13.9%. In segmental mosaicism, larger chromosomes tended to be more affected, which was not observed in whole-chromosome mosaicism. Additionally, segmental mosaicism was mostly observed in monosomy (69.6%; P < 0.01) compared with whole-chromosome mosaicism (49.7% monosomies versus 50.3% trisomies; P = 0.83). Although a high inter-patient variability was observed, only paternal age showed a positive association with mosaicism (adjusted OR 1.26, 95% CI 1.02 to 1.54) among the analysed variables. CONCLUSIONS Our results suggest remarkable differences in the mechanisms generating segmental and whole-chromosome mosaicism, indicating that they may deserve different consideration when studying them and when prioritizing them for transfer. Male factor seems to be associated with mosaicism and may be worthy of specific assessment in future studies.
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Affiliation(s)
- Lluc Coll
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproduction, Dexeus Mujer, Hospital Universitari Dexeus, Gran Via Carles III, 71-75, Barcelona 08028, Spain.
| | - Mònica Parriego
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproduction, Dexeus Mujer, Hospital Universitari Dexeus, Gran Via Carles III, 71-75, Barcelona 08028, Spain
| | - Sílvia Mateo
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproduction, Dexeus Mujer, Hospital Universitari Dexeus, Gran Via Carles III, 71-75, Barcelona 08028, Spain
| | - Sílvia García-Monclús
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproduction, Dexeus Mujer, Hospital Universitari Dexeus, Gran Via Carles III, 71-75, Barcelona 08028, Spain
| | - Ignacio Rodríguez
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproduction, Dexeus Mujer, Hospital Universitari Dexeus, Gran Via Carles III, 71-75, Barcelona 08028, Spain
| | - Montserrat Boada
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproduction, Dexeus Mujer, Hospital Universitari Dexeus, Gran Via Carles III, 71-75, Barcelona 08028, Spain
| | - Buenaventura Coroleu
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproduction, Dexeus Mujer, Hospital Universitari Dexeus, Gran Via Carles III, 71-75, Barcelona 08028, Spain
| | - Nikolaos P Polyzos
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproduction, Dexeus Mujer, Hospital Universitari Dexeus, Gran Via Carles III, 71-75, Barcelona 08028, Spain
| | - Francesca Vidal
- Unitat de Biologia Cellular, Facultat de Biociències, Universitat Autònoma de Barcelona, Bellaterra 08193, Spain
| | - Anna Veiga
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproduction, Dexeus Mujer, Hospital Universitari Dexeus, Gran Via Carles III, 71-75, Barcelona 08028, Spain; Barcelona Stem Cell Bank, IDIBELL Programme for Regenerative Medicine, 08908 L'Hospitalet de Llobregat, Spain
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4
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Arian SE, Erfani H, Westerfield LE, Buffie A, Nassef S, Gibbons WE, Van den Veyver IB. Prenatal testing in pregnancies conceived by in vitro fertilization with pre-implantation genetic testing. Prenat Diagn 2020; 40:846-851. [PMID: 32297346 DOI: 10.1002/pd.5711] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 02/26/2020] [Accepted: 03/28/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Women with pregnancies resulting from in vitro fertilization (IVF) with normal pre-implantation genetic testing for aneuploidy (PGT-A) are advised to undergo prenatal screening and testing during pregnancy. It is not well known how many follow these recommendations. Our objective was to study prenatal testing decisions made by women with pregnancies conceived through IVF with PGT-A. METHODS We performed a retrospective review of women who received genetic counseling during pregnancies conceived through IVF with normal PGT-A. We excluded those who received genetic counseling preconceptionally prior to IVF. Statistical analysis included descriptive statistics and after testing for normality by the Kolmogorov-Smirnov test, independent t test, Mann-Whitney U test, or Chi-square/Fisher's exact test. RESULTS Data from 83 women were included. Of these, 53 (63.9%) had at least one of the following prenatal tests: first trimester combined screening (16.9%), non-invasive prenatal screening (NIPS) (45.8%), second trimester serum screening (6%), and invasive diagnostic testing (6%). 10.8% had more than one of the above tests and 36.1% declined all tests. CONCLUSION Almost two-thirds of women who were pregnant after IVF with normal PGT-A had prenatal aneuploidy screening or testing. Future prospective studies with larger cohorts are needed to further ascertain decision making in this population.
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Affiliation(s)
- Sara E Arian
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Baylor College of Medicine, Houston, TX, USA
| | - Hadi Erfani
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
| | - Lauren E Westerfield
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Alexandra Buffie
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA.,Present address: Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Salma Nassef
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - William E Gibbons
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Baylor College of Medicine, Houston, TX, USA
| | - Ignatia B Van den Veyver
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA.,Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, Baylor College of Medicine, Houston, TX, USA
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5
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Alteri A, Corti L, Sanchez AM, Rabellotti E, Papaleo E, Viganò P. Assessment of pre-implantation genetic testing for embryo aneuploidies: A SWOT analysis. Clin Genet 2019; 95:479-487. [DOI: 10.1111/cge.13510] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/29/2018] [Accepted: 01/04/2019] [Indexed: 12/25/2022]
Affiliation(s)
- Alessandra Alteri
- Obstetrics and Gynaecology Department; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - Laura Corti
- Obstetrics and Gynaecology Department; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - Ana M. Sanchez
- Reproductive Sciences Laboratory; Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute; Milan Italy
| | - Elisa Rabellotti
- Obstetrics and Gynaecology Department; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - Enrico Papaleo
- Obstetrics and Gynaecology Department; IRCCS San Raffaele Scientific Institute; Milan Italy
- Reproductive Sciences Laboratory; Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute; Milan Italy
| | - Paola Viganò
- Reproductive Sciences Laboratory; Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute; Milan Italy
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6
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Henry MP, Hawkins JR, Boyle J, Bridger JM. The Genomic Health of Human Pluripotent Stem Cells: Genomic Instability and the Consequences on Nuclear Organization. Front Genet 2019; 9:623. [PMID: 30719030 PMCID: PMC6348275 DOI: 10.3389/fgene.2018.00623] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 11/23/2018] [Indexed: 12/11/2022] Open
Abstract
Human pluripotent stem cells (hPSCs) are increasingly used for cell-based regenerative therapies worldwide, with embryonic and induced pluripotent stem cells as potential treatments for debilitating and chronic conditions, such as age-related macular degeneration, Parkinson's disease, spinal cord injuries, and type 1 diabetes. However, with the level of genomic anomalies stem cells generate in culture, their safety may be in question. Specifically, hPSCs frequently acquire chromosomal abnormalities, often with gains or losses of whole chromosomes. This review discusses how important it is to efficiently and sensitively detect hPSC aneuploidies, to understand how these aneuploidies arise, consider the consequences for the cell, and indeed the individual to whom aneuploid cells may be administered.
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Affiliation(s)
- Marianne P Henry
- Advanced Therapies Division, National Institute for Biological Standards and Control, Potters Bar, United Kingdom.,Laboratory of Nuclear and Genomic Health, Division of Biosciences, Department of Life Sciences, College of Health and Life Sciences, Brunel University London, London, United Kingdom
| | - J Ross Hawkins
- Advanced Therapies Division, National Institute for Biological Standards and Control, Potters Bar, United Kingdom
| | - Jennifer Boyle
- Advanced Therapies Division, National Institute for Biological Standards and Control, Potters Bar, United Kingdom
| | - Joanna M Bridger
- Laboratory of Nuclear and Genomic Health, Division of Biosciences, Department of Life Sciences, College of Health and Life Sciences, Brunel University London, London, United Kingdom
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7
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Rosenwaks Z, Handyside AH, Fiorentino F, Gleicher N, Paulson RJ, Schattman GL, Scott RT, Summers MC, Treff NR, Xu K. The pros and cons of preimplantation genetic testing for aneuploidy: clinical and laboratory perspectives. Fertil Steril 2018; 110:353-361. [DOI: 10.1016/j.fertnstert.2018.06.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 06/01/2018] [Indexed: 12/01/2022]
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8
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Armstrong ME, Weaver DD, Lah MD, Vance GH, Landis BJ, Ware SM, Helm BM. Novel phenotype of 5p13.3-q11.2 duplication resulting from supernumerary marker chromosome 5: implications for management and genetic counseling. Mol Cytogenet 2018; 11:23. [PMID: 29599822 PMCID: PMC5870180 DOI: 10.1186/s13039-018-0372-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 03/22/2018] [Indexed: 01/04/2023] Open
Abstract
Background Supernumerary marker chromosomes derived from chromosome 5 (SMC5) and 5p13 duplication syndrome are rare disorders, and phenotypic descriptions of patients are necessary to better define genotype-phenotype correlations for accurate, comprehensive genetic counseling. The purpose of this study is to highlight the unique findings of a patient with a 5p13.3-q11.2 duplication arising from a SMC5 and compare and contrast the phenotype with cases in the literature. Case presentation We report on an adult male with a 22 Mb duplication of chromosome 5p13.3-q11.2 resulting from a small SMC5. The patient has a history of prenatal polyhydramnios, dysmorphic features, respiratory issues, talipes equinovarus, hypotonia, developmental delay, and autistic features. The patient also has novel features of aortic dilation, pectus excavatum, kyphoscoliosis, and skin striae, suggestive of a connective tissue disorder. Despite these features he did not meet clinical diagnostic criteria for a well-characterized connective tissue disorder. Additional molecular genetic testing for syndromic and non-syndromic aortic aneurysms was negative. Conclusions Many of the patient’s features are consistent with individuals reported with 5p13 duplication syndrome and similar cases of SMC5, including polyhydramnios, macrocephaly, dolichocephaly, pre-auricular pits, arachnodactyly, respiratory problems, and developmental delays. It is unclear if the patient’s unique features of aortic dilation, pectus excavatum, kyphoscoliosis, and skin striae could be novel features of the SMC5 given its rarity and the few well-phenotyped adults in the literature. This report reviews the literature and provides additional phenotypic information to define the genotype-phenotype correlation of SMC5 and 5p13 duplication syndrome.
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Affiliation(s)
- Margaret E Armstrong
- 1Department of Medical and Molecular Genetics and Department of Pediatrics, Indiana University School of Medicine, 550 N. University Blvd, AOC 5001, Indianapolis, Indiana 46202 USA.,3Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa USA
| | - David D Weaver
- 1Department of Medical and Molecular Genetics and Department of Pediatrics, Indiana University School of Medicine, 550 N. University Blvd, AOC 5001, Indianapolis, Indiana 46202 USA
| | - Melissa D Lah
- 1Department of Medical and Molecular Genetics and Department of Pediatrics, Indiana University School of Medicine, 550 N. University Blvd, AOC 5001, Indianapolis, Indiana 46202 USA
| | - Gail H Vance
- 1Department of Medical and Molecular Genetics and Department of Pediatrics, Indiana University School of Medicine, 550 N. University Blvd, AOC 5001, Indianapolis, Indiana 46202 USA.,2Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana USA
| | - Benjamin J Landis
- 1Department of Medical and Molecular Genetics and Department of Pediatrics, Indiana University School of Medicine, 550 N. University Blvd, AOC 5001, Indianapolis, Indiana 46202 USA.,2Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana USA
| | - Stephanie M Ware
- 1Department of Medical and Molecular Genetics and Department of Pediatrics, Indiana University School of Medicine, 550 N. University Blvd, AOC 5001, Indianapolis, Indiana 46202 USA.,2Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana USA
| | - Benjamin M Helm
- 1Department of Medical and Molecular Genetics and Department of Pediatrics, Indiana University School of Medicine, 550 N. University Blvd, AOC 5001, Indianapolis, Indiana 46202 USA
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9
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Sermon KD, Spits C, Mertzanidou A, Vermeesch JR, Fiorentino F. Detecting mosaicism in trophectoderm biopsies. Hum Reprod 2018; 32:712-713. [PMID: 28043945 DOI: 10.1093/humrep/dew346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2016] [Indexed: 11/13/2022] Open
Affiliation(s)
- Karen D Sermon
- Research Group Reproduction and Genetics, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Claudia Spits
- Research Group Reproduction and Genetics, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | | | - Joris R Vermeesch
- Laboratory of Cytogenetics and Genome Research, UZ Leuven, K.U. Leuven, campus Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium
| | - Francesco Fiorentino
- GENOMA-Molecular Genetics Laboratories, Via di Castel Giubileo, 1100138Rome, Italy
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Bunnell M, Wilkins-Haug L, Reiss R. Should embryos with autosomal monosomy by preimplantation genetic testing for aneuploidy be transferred?: Implications for embryo selection from a systematic literature review of autosomal monosomy survivors. Prenat Diagn 2017; 37:1273-1280. [DOI: 10.1002/pd.5185] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 11/05/2017] [Accepted: 11/08/2017] [Indexed: 01/24/2023]
Affiliation(s)
- M.E. Bunnell
- Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Biology; Brigham and Women's Hospital; Boston MA 02115 USA
- Geisel School of Medicine; Dartmouth College; Hanover NH 03755 USA
| | - L. Wilkins-Haug
- Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Biology; Brigham and Women's Hospital; Boston MA 02115 USA
| | - R. Reiss
- Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Biology; Brigham and Women's Hospital; Boston MA 02115 USA
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11
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Wang MZ, Lin FQ, Li M, He D, Yu QH, Yang XX, Wu YS. Semiconductor Sequencing Analysis of Chromosomal Copy Number Variations in Spontaneous Miscarriage. Med Sci Monit 2017; 23:5550-5557. [PMID: 29162795 PMCID: PMC5707912 DOI: 10.12659/msm.905094] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Array CGH is the criterion standard for identifying copy number variations (CNV), but the restrictive requirement of DNA quality and relatively high cost prevent the use of this method as a general assay in hospitals in developing countries. Our principal objective was to determine whether the semiconductor sequencing platform (SSP) could be an alternative method in CNV detection for spontaneous miscarriage. MATERIAL AND METHODS A total of 443 spontaneous miscarriage samples were collected and subjected to low-coverage (0.1X) whole-genome analysis by SSP. These samples were verified by array CGH and 8 low-quality DNA samples were analyzed by SSP and validated by MLPA. RESULTS SSP detected 195 chromosomal numerical abnormalities, 74 CNVs, and 9 mosaicisms among the 435 samples. Among 74 CNV abnormalities, SSP detected an equal number (56) of CNVs 56 >1 Mb with array CGH. However, SSP missed more 6 cases CNVs <1 Mb than array CGH (12 vs. 18). SSP detected more mosaicisms than array CGH (9 vs. 7, p=0.5). Interestingly, SSP detected the mosaicism which had only 8% X monosomy, which was much lower than the minimal percentage of monosomy that was detected by array CGH. CONCLUSIONS SSP is of equivalent efficacy as array CGH in detecting CNVs >1 Mb, and performs better in identifying mosaicism. With the merits of low cost and less demand of input DNA, SSP is a good alternative for use in genetic diagnosis.
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Affiliation(s)
- Ming-Zhu Wang
- Institute of Antibody Engineering, School of Laboratory Medical and Biotechnology, Southern Medical University, Guangzhou, Guangdong, China (mainland)
| | - Fang-Qin Lin
- Guangzhou Darui Biotechnology Co. Ltd., Guangzhou, Guangdong, China (mainland)
| | - Min Li
- Institute of Antibody Engineering, School of Laboratory Medical and Biotechnology, Southern Medical University, Guangzhou, Guangdong, China (mainland)
| | - Dan He
- Guangzhou Darui Biotechnology Co. Ltd., Guangzhou, Guangdong, China (mainland)
| | - Qi-Hong Yu
- Guangzhou DAAN Center for Clinical Laboratory Co., Ltd., Guangzhou, Guangdong, China (mainland)
| | - Xue-Xi Yang
- Institute of Antibody Engineering, School of Laboratory Medical and Biotechnology, Southern Medical University, Guangzhou, Guangdong, China (mainland)
| | - Ying-Song Wu
- Institute of Antibody Engineering, School of Laboratory Medical and Biotechnology, Southern Medical University, Guangzhou, Guangdong, China (mainland)
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12
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Reittinger AM, Helm BM, Boles DJ, Gadi IK, Schrier Vergano SA. A prenatal diagnosis of mosaic trisomy 5 reveals a postnatal complete uniparental disomy of chromosome 5 with multiple congenital anomalies. Am J Med Genet A 2017; 173:2528-2533. [PMID: 28653809 DOI: 10.1002/ajmg.a.38344] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 05/25/2017] [Accepted: 06/06/2017] [Indexed: 11/11/2022]
Abstract
Mosaic trisomy 5 is a very rare condition in liveborns, with few cases reported in the last four decades. There are some reports of prenatally diagnosed mosaic trisomy 5 resulting in phenotypically normal offspring, suggesting a low level of mosaicism, but there are also reports associated with multiple congenital anomalies, cardiovascular malformations, and intrauterine growth restriction. We report an infant male diagnosed with mosaic trisomy 5 (5/15 cells) via amniocentesis. The patient was subsequently found to have uniparental disomy 5 (UPD5) by postnatal chromosome microarray, but high-resolution chromosome analysis on peripheral blood did not identify trisomy 5. Dysmorphic features included a tall forehead with low anterior hairline, hypertelorism, low-set ears, and a prominent nose and midface. Other anomalies included bilateral bifid thumbs, hypospadias, a perineal fistula, unilateral multicystic kidney, and decreased subcutaneous fat with loose skin. He had complex congenital heart disease consisting of ventricular and atrial septal defects and polyvalvular defects. The patient died at age one after a prolonged admission. We add this case to the literature with the added benefit of data from a postnatal microarray, which was not available in other cases, to broaden the phenotype of mosaic trisomy 5 and UPD5.With the current available technology, we stress the importance of postnatal genetic testing to confirm prenatal cytogenetic findings in order to further define such phenotypes. This will provide the most accurate information and counseling to affected families.
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Affiliation(s)
- Andrew M Reittinger
- Department of Pediatrics, Eastern Virginia Medical School, Norfolk, Virginia
| | - Benjamin M Helm
- Department of Medical & Molecular Genetics, Indiana University School of Medicine and Riley Hospital for Children at IU Health, Indianapolis, Indiana
| | - Debra J Boles
- Quest Diagnostics, Nichols Institute, Chantilly, Virginia
| | - Inder K Gadi
- Laboratory Corporation of America, Research Triangle Park, North Carolina
| | - Samantha A Schrier Vergano
- Department of Pediatrics, Eastern Virginia Medical School, Norfolk, Virginia.,Division of Medical Genetics and Metabolism, Children's Hospital of The King's Daughters, Norfolk, Virginia
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13
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Current experience concerning mosaic embryos diagnosed during preimplantation genetic screening. Fertil Steril 2017; 107:1113-1119. [DOI: 10.1016/j.fertnstert.2017.03.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 03/15/2017] [Accepted: 03/15/2017] [Indexed: 11/19/2022]
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14
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Fragouli E, Alfarawati S, Spath K, Babariya D, Tarozzi N, Borini A, Wells D. Analysis of implantation and ongoing pregnancy rates following the transfer of mosaic diploid–aneuploid blastocysts. Hum Genet 2017; 136:805-819. [DOI: 10.1007/s00439-017-1797-4] [Citation(s) in RCA: 148] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 03/09/2017] [Indexed: 11/24/2022]
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15
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Capalbo A, Ubaldi F, Rienzi L, Scott R, Treff N. Reply: Detecting mosaicism in trophectoderm biopsies. Hum Reprod 2017; 32:714-715. [PMID: 28043946 DOI: 10.1093/humrep/dew347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2016] [Indexed: 11/14/2022] Open
Affiliation(s)
- Antonio Capalbo
- GENETYX, Molecular Genetics Laboratory, Via Fermi, Marostica, 36063 Vicenza, Italy.,GENERA, Centers for Reproductive Medicine, Via G. De Notaris 2/B, Rome 00197, Italy
| | - Filippo Ubaldi
- GENETYX, Molecular Genetics Laboratory, Via Fermi, Marostica, 36063 Vicenza, Italy.,GENERA, Centers for Reproductive Medicine, Via G. De Notaris 2/B, Rome 00197, Italy
| | - Laura Rienzi
- GENETYX, Molecular Genetics Laboratory, Via Fermi, Marostica, 36063 Vicenza, Italy.,GENERA, Centers for Reproductive Medicine, Via G. De Notaris 2/B, Rome 00197, Italy
| | - Richard Scott
- Reproductive Medicine Associates of New Jersey, 140 Allen Road, Basking Ridge, NJ 07920, USA
| | - Nathan Treff
- Reproductive Medicine Associates of New Jersey, 140 Allen Road, Basking Ridge, NJ 07920, USA
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16
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Esfandiari N, Bunnell ME, Casper RF. Human embryo mosaicism: did we drop the ball on chromosomal testing? J Assist Reprod Genet 2016; 33:1439-1444. [PMID: 27577322 DOI: 10.1007/s10815-016-0797-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 08/16/2016] [Indexed: 12/27/2022] Open
Abstract
There are newly recognized challenges presented by the occurrence of mosaicism in the context of trophectoderm (TE) biopsy for pre-implantation genetic screening (PGS) in in vitro fertilization (IVF) embryos. Chromosomal mosaicism, known to be significantly higher in IVF embryos than in later prenatal samples, may contribute to errors in diagnosis. In particular, PGS may result in discarding embryos diagnosed as aneuploid but in which the inner cell mass may be completely or mainly euploid, thus representing a false positive diagnosis. Although less likely, some embryos diagnosed as euploid could be mosaic and contain some aneuploid cells, possibly impacting their implantation potential. The ability of current diagnostic techniques to detect mosaicism is limited by the number and location of TE cells in the biopsy and by the methodology used for chromosomal assessment. The clinical consequences of mosaicism are dependent on the chromosome(s) involved, the developmental stage at which the mosaicism evolved, and whether TE biopsy accurately reflects the status of the inner cell mass that forms the fetus. Consequently, in patients with no euploid embryos identified on PGS, it may be appropriate to consider the transfer of diagnosed aneuploid embryos if the TE biopsy result is a non-viable chromosomal monosomy or triploidy that could not result in a birth. It should be acknowledged in consent forms that mosaicism has the potential to impact test results and that its detection may be below the resolution of the genetic tests being used. This concept represents a major shift in current IVF practice and ought to be considered given the data, or lack thereof, of the impact of mosaicism on IVF/PGS outcomes.
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Affiliation(s)
- Navid Esfandiari
- Division of Reproductive Endocrinology and Infertility, Department of OB-GYN, Dartmouth Hitchcock Medical Center, Geisel School of Medicine, Lebanon, NH, USA.
| | - Megan E Bunnell
- Division of Reproductive Endocrinology and Infertility, Department of OB-GYN, Dartmouth Hitchcock Medical Center, Geisel School of Medicine, Lebanon, NH, USA
| | - Robert F Casper
- Division of Reproductive Endocrinology and Infertility., Department of OB-GYN, School of Medicine, University of Toronto, Toronto, Canada
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17
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Patel DV, Shah PB, Kotdawala AP, Herrero J, Rubio I, Banker MR. Morphokinetic behavior of euploid and aneuploid embryos analyzed by time-lapse in embryoscope. J Hum Reprod Sci 2016; 9:112-8. [PMID: 27382237 PMCID: PMC4915281 DOI: 10.4103/0974-1208.183511] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND: Embryonic aneuploidy may result in miscarriage, implantation failure, or birth defects. Thus, it is clinically necessary to avoid the selection of aneuploid embryos during in vitro fertilization treatment. AIM: The aim of this study was to identify the morphokinetic differences by analyzing the development of euploid and aneuploid embryos using a time-lapse technology. We also checked the accuracy of a previously described model for selection of euploid embryos based on morphokinetics in our study population. MATERIALS AND METHODS: It is a retrospective study of 29 cycles undergoing preimplantation genetic screening from October 2013 to April 2015 at our center. Of 253 embryos, 167 suitable for biopsy embryos were analyzed for their chromosomal status using array-comparative genome hybridization (CGH). The morphokinetic behavior of these embryos was further analyzed in embryoscope using time-lapse technology. RESULTS: Among the analyzed embryos, 41 had normal and 126 had abnormal chromosome content. No significant difference in morphokinetics was found between euploid and aneuploid embryos. The percentage of embryos with blastulation was similar in the euploid (65.85%, 27/41) and aneuploid (60.31%, 76/126) embryos (P = 0.76). Although hard to define, majority of the chromosomal defects might be due to meiotic errors. On applying embryo selection model from Basile et al., embryos falling within optimal ranges for time to division to 5 cells (t5), time period of the third cell cycle (CC3), and time from 2 cell division to 5 cell division (t5-t2) exhibited greater proportion of normal embryos than those falling outside the optimal ranges (28.6%, 25.9%, and 26.7% vs. 17.5%, 20.8%, and 14.3%). CONCLUSION: Keeping a track of time interval between two stages can help us recognize aneuploid embryos at an earlier stage and prevent their selection of transfer. However, it cannot be used as a substitute for array CGH to select euploid embryos for transfer.
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Affiliation(s)
- Deven V Patel
- Nova IVI Fertility Centre, Ahmedabad, Gujarat, India
| | - Preeti B Shah
- Nova IVI Fertility Centre, Ahmedabad, Gujarat, India
| | | | | | - Irene Rubio
- Nova IVI Fertility Centre, Bengaluru, Karnataka, India
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18
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Brezina PR, Anchan R, Kearns WG. Preimplantation genetic testing for aneuploidy: what technology should you use and what are the differences? J Assist Reprod Genet 2016; 33:823-32. [PMID: 27299602 DOI: 10.1007/s10815-016-0740-2] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 05/02/2016] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The purpose of the review was to define the various diagnostic platforms currently available to perform preimplantation genetic testing for aneuploidy and describe in a clear and balanced manner the various strengths and weaknesses of these technologies. METHODS A systematic literature review was conducted. We used the terms "preimplantation genetic testing," "preimplantation genetic diagnosis," "preimplantation genetic screening," "preimplantation genetic diagnosis for aneuploidy," "PGD," "PGS," and "PGD-A" to search through PubMed, ScienceDirect, and Google Scholar from the year 2000 to April 2016. Bibliographies of articles were also searched for relevant studies. When possible, larger randomized controlled trials were used. However, for some emerging data, only data from meeting abstracts were available. RESULTS PGS is emerging as one of the most valuable tools to enhance pregnancy success with assisted reproductive technologies. While all of the current diagnostic platforms currently available have various advantages and disadvantages, some platforms, such as next-generation sequencing (NGS), are capable of evaluating far more data points than has been previously possible. The emerging complexity of different technologies, especially with the utilization of more sophisticated tools such as NGS, requires an understanding by clinicians in order to request the best test for their patients.. CONCLUSION Ultimately, the choice of which diagnostic platform is utilized should be individualized to the needs of both the clinic and the patient. Such a decision must incorporate the risk tolerance of both the patient and provider, fiscal considerations, and other factors such as the ability to counsel patients on their testing results and how these may or may not impact clinical outcomes.
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Affiliation(s)
- Paul R Brezina
- Department of OB/GYN, Vanderbilt University School of Medicine, Nashville, TN, USA.,AdvaGenix, Rockville, MD, USA.,Fertility Associates of Memphis, Memphis, TN, USA
| | - Raymond Anchan
- Department of OB/GYN, Division of Reproductive Endocrinology and Infertility, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - William G Kearns
- AdvaGenix, Rockville, MD, USA. .,Department of OB/GYN, GENETICS, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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19
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Lu L, Lv B, Huang K, Xue Z, Zhu X, Fan G. Recent advances in preimplantation genetic diagnosis and screening. J Assist Reprod Genet 2016; 33:1129-34. [PMID: 27272212 DOI: 10.1007/s10815-016-0750-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Accepted: 05/25/2016] [Indexed: 12/18/2022] Open
Abstract
Preimplantation genetic diagnosis/screening (PGD/PGS) aims to help couples lower the risks of transmitting genetic defects to their offspring, implantation failure, and/or miscarriage during in vitro fertilization (IVF) cycles. However, it is still being debated with regard to the practicality and diagnostic accuracy of PGD/PGS due to the concern of invasive biopsy and the potential mosaicism of embryos. Recently, several non-invasive and high-throughput assays have been developed to help overcome the challenges encountered in the conventional invasive biopsy and low-throughput analysis in PGD/PGS. In this mini-review, we will summarize the recent progresses of these new methods for PGD/PGS and discuss their potential applications in IVF clinics.
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Affiliation(s)
- Lina Lu
- Translational Center for Stem Cell Research, Tongji Hospital, Department of Regenerative Medicine, Tongji University School of Medicine, Shanghai, 200065, China.,School of Life Sciences and Technology, Advanced Institute of Translational Medicine, Tongji University, 1239 Siping Road, Shanghai, 200092, China
| | - Bo Lv
- Translational Center for Stem Cell Research, Tongji Hospital, Department of Regenerative Medicine, Tongji University School of Medicine, Shanghai, 200065, China
| | - Kevin Huang
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, CA, 90095, USA
| | - Zhigang Xue
- Translational Center for Stem Cell Research, Tongji Hospital, Department of Regenerative Medicine, Tongji University School of Medicine, Shanghai, 200065, China
| | - Xianmin Zhu
- School of Life Sciences and Technology, Advanced Institute of Translational Medicine, Tongji University, 1239 Siping Road, Shanghai, 200092, China
| | - Guoping Fan
- School of Life Sciences and Technology, Advanced Institute of Translational Medicine, Tongji University, 1239 Siping Road, Shanghai, 200092, China. .,Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, CA, 90095, USA.
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20
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Abstract
Preimplantation genetic testing (PGT) of oocytes and embryos is the earliest form of prenatal testing. PGT requires in vitro fertilization for embryo creation. In the past 25 years, the use of PGT has increased dramatically. The indications of PGT include identification of embryos harboring single-gene disorders, chromosomal structural abnormalities, chromosomal numeric abnormalities, and mitochondrial disorders; gender selection; and identifying unaffected, HLA-matched embryos to permit the creation of a savior sibling. PGT is not without risks, limitations, or ethical controversies. This review discusses the techniques and clinical applications of different forms of PGT and the debate surrounding its associated uncertainty and expanded use.
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Affiliation(s)
- Anthony N Imudia
- Division of Reproductive Endocrinology and Infertility, University of South Florida Morsani College of Medicine, 2 Tampa General Circle, Suite 6022, Tampa, FL 33606, USA.
| | - Shayne Plosker
- Division of Reproductive Endocrinology and Infertility, University of South Florida Morsani College of Medicine, 2 Tampa General Circle, Suite 6022, Tampa, FL 33606, USA
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21
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Scott RT, Galliano D. The challenge of embryonic mosaicism in preimplantation genetic screening. Fertil Steril 2016; 105:1150-1152. [PMID: 26845661 DOI: 10.1016/j.fertnstert.2016.01.007] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 01/03/2016] [Accepted: 01/05/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Richard T Scott
- Reproductive Medicine Associates of New Jersey, Basking Ridge, New Jersey
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22
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Magli MC, Pomante A, Cafueri G, Valerio M, Crippa A, Ferraretti AP, Gianaroli L. Preimplantation genetic testing: polar bodies, blastomeres, trophectoderm cells, or blastocoelic fluid? Fertil Steril 2015; 105:676-683.e5. [PMID: 26658131 DOI: 10.1016/j.fertnstert.2015.11.018] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 10/28/2015] [Accepted: 11/09/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the blastocoelic fluid (BF) for the presence of DNA that could be amplified and analyzed; the extent to which its chromosomal status corresponds to that found in trophectoderm (TE) cells, polar bodies (PBs), or blastomeres; and the identification of segmental abnormalities. DESIGN Longitudinal cohort study. SETTING In vitro fertilization unit. PATIENT(S) Fifty-one couples undergoing preimplantation genetic screening or preimplantation genetic diagnosis for translocations by array-comparative genomic hybridization on PBs (n = 21) or blastomeres (n = 30). INTERVENTION(S) BFs and TE cells were retrieved from 116 blastocysts, whose chromosome status had already been established by PB or blastomere assessment. Separate chromosome analysis was performed in 70 BFs. MAIN OUTCOME MEASURE(S) Presence of DNA in BFs, evaluation of the chromosome condition, and comparison with the diagnosis made in TE cells and at earlier stage biopsies. RESULT(S) DNA detection was 82%, with a net improvement after refinement of the procedure. In 97.1% of BFs, the ploidy condition corresponded to that found in TE cells, with one false positive and one false negative. The rate of concordance per single chromosome was 98.4%. Ploidy and chromosome concordance with PBs were 94% and 97.9%, respectively; with blastomeres, the concordances were 95% and 97.7%, respectively. Segmental abnormalities, which were detected in PBs or blastomeres of 16 blastocysts, were also identified in the corresponding BFs. CONCLUSION(S) BF represents to a good extent the blastocyst ploidy condition and chromosome status when compared with TE cells. If the proportion of clinically useful BFs is improved, blastocentesis could become the preferred source of DNA for chromosomal testing.
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Affiliation(s)
| | | | | | | | - Andor Crippa
- SISMER, Reproductive Medicine Unit, Bologna, Italy
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23
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Confirmation rates of array-CGH in day-3 embryo and blastocyst biopsies for preimplantation genetic screening. J Assist Reprod Genet 2015; 33:59-66. [PMID: 26547204 DOI: 10.1007/s10815-015-0605-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 10/26/2015] [Indexed: 10/22/2022] Open
Abstract
PURPOSE The purpose of this study was to compare the confirmation rate of day-3 embryo biopsy (blastomere) and trophectoderm biopsy using array-comparative genomic hybridization (array-CGH) technology. METHODS A blinded study was conducted to re-analyse 109 embryos previously diagnosed as chromosomally abnormal by array-CGH. Preimplantation genetic screening (PGS) was performed using array-CGH on day 3 (n = 50) or day 5 (n = 59). Partial chromosome gains or losses were excluded (n=6), and only whole chromosome aneuploidies were considered. Re-analysis of whole blastocysts was carried out following the same array-CGH protocol used for PGS. RESULTS The PGS result was confirmed in the whole blastocyst in (a) 49/50 (98 %) abnormal embryos after day-3 biopsy and (b) 57/59 (96.6 %) abnormal embryos after trophectoderm biopsy. One embryo (1/50; 2 %) was diagnosed as abnormal, with monosomy 18, on day 3, and software analysis of the whole blastocyst gave a euploid result; however, a mosaic pattern was observed for monosomy 18 in the whole blastocyst. Two trophectoderm biopsy cases (3.4 %) did not have the abnormalities (trisomy 7, and trisomy 1 and 4, respectively) verified in the whole embryo. Concordance rates for both biopsy strategies and for individual chromosomes were evaluated by Fisher's exact test and showed no significant differences. CONCLUSIONS Both types of biopsies showed similar high concordance rates with whole blastocyst results. Therefore, regarding the confirmation rates shown in this work, day-3 embryo biopsies can be representative of the whole embryo and both types of biopsy can be used for clinical analysis in PGS following the described array-CGH protocol.
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24
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Carbone L, Chavez SL. Mammalian pre-implantation chromosomal instability: species comparison, evolutionary considerations, and pathological correlations. Syst Biol Reprod Med 2015; 61:321-35. [PMID: 26366555 DOI: 10.3109/19396368.2015.1073406] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Pre-implantation embryo development in mammals begins at fertilization with the migration and fusion of the maternal and paternal pro-nuclei, followed by the degradation of inherited factors involved in germ cell specification and the activation of embryonic genes required for subsequent cell divisions, compaction, and blastulation. The majority of studies on early embryogenesis have been conducted in the mouse or non-mammalian species, often requiring extrapolation of the findings to human development. Given both conserved similarities and species-specific differences, however, even comparison between closely related mammalian species may be challenging as certain aspects, including susceptibility to chromosomal aberrations, varies considerably across mammals. Moreover, most human embryo studies are limited to patient samples obtained from in vitro fertilization (IVF) clinics and donated for research, which are generally of poorer quality and produced with germ cells that may be sub-optimal. Recent technical advances in genetic, epigenetic, chromosomal, and time-lapse imaging analyses of high quality whole human embryos have greatly improved our understanding of early human embryogenesis, particularly at the single embryo and cell level. This review summarizes the major characteristics of mammalian pre-implantation development from a chromosomal perspective, in addition to discussing the technological achievements that have recently been developed to obtain this data. We also discuss potential translation to clinical applications in reproductive medicine and conclude by examining the broader implications of these findings for the evolution of mammalian species and cancer pathology in somatic cells.
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Affiliation(s)
- Lucia Carbone
- a Division of Neuroscience , Oregon National Primate Research Center .,b Department of Behavioral Neuroscience .,c Department of Molecular & Medical Genetics .,d Bioinformatics & Computational Biology, Oregon Health & Science University
| | - Shawn L Chavez
- e Division of Reproductive & Developmental Sciences , Oregon National Primate Research Center .,f Department of Obstetrics & Gynecology , and.,g Department of Physiology & Pharmacology , Oregon Health & Science University , Portland , Oregon , USA
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25
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Kurahashi H, Kato T, Miyazaki J, Nishizawa H, Nishio E, Furukawa H, Miyamura H, Ito M, Endo T, Ouchi Y, Inagaki H, Fujii T. Preimplantation genetic diagnosis/screening by comprehensive molecular testing. Reprod Med Biol 2015; 15:13-19. [PMID: 29259418 DOI: 10.1007/s12522-015-0216-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 07/01/2015] [Indexed: 11/28/2022] Open
Abstract
Although embryo screening by preimplantation genetic diagnosis (PGD) has become the standard technique for the treatment of recurrent pregnancy loss in couples with a balanced gross chromosomal rearrangement, the implantation and pregnancy rates of PGD using conventional fluorescence in situ hybridization (FISH) remain suboptimal. Comprehensive molecular testing, such as array comparative genomic hybridization and next-generation sequencing, can improve these rates, but amplification bias in the whole genome amplification method remains an obstacle to accurate diagnosis. Recent advances in amplification procedures combined with improvements in the microarray platform and analytical method have overcome the amplification bias, and the data accuracy of the comprehensive PGD method has reached the level of clinical laboratory testing. Currently, comprehensive PGD is also applied to recurrent pregnancy loss due to recurrent fetal aneuploidy or infertility with recurrent implantation failure, known as preimplantation genetic screening. However, there are still numerous problems to be solved, including misdiagnosis due to somatic mosaicism, cell cycle-related background noise, and difficulty in diagnosis of polyploidy. The technology for comprehensive PGD also requires further improvement.
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Affiliation(s)
- Hiroki Kurahashi
- Division of Molecular Genetics, Institute for Comprehensive Medical Science Fujita Health University 1-98 Dengakugakubo, Kutsukake-cho 470-1192 Toyoake Aichi Japan.,Genome and Transcriptome Analysis Center Fujita Health University 470-1192 Toyoake Aichi Japan
| | - Takema Kato
- Division of Molecular Genetics, Institute for Comprehensive Medical Science Fujita Health University 1-98 Dengakugakubo, Kutsukake-cho 470-1192 Toyoake Aichi Japan
| | - Jun Miyazaki
- Division of Molecular Genetics, Institute for Comprehensive Medical Science Fujita Health University 1-98 Dengakugakubo, Kutsukake-cho 470-1192 Toyoake Aichi Japan.,Department of Obstetrics and Gynecology Fujita Health University School of Medicine 470-1192 Toyoake Aichi Japan
| | - Haruki Nishizawa
- Department of Obstetrics and Gynecology Fujita Health University School of Medicine 470-1192 Toyoake Aichi Japan
| | - Eiji Nishio
- Department of Obstetrics and Gynecology Fujita Health University School of Medicine 470-1192 Toyoake Aichi Japan
| | - Hiroshi Furukawa
- Department of Laboratory Medicine Fujita Health University Hospital 470-1192 Toyoake Aichi Japan
| | - Hironori Miyamura
- Department of Obstetrics and Gynecology Fujita Health University School of Medicine 470-1192 Toyoake Aichi Japan
| | - Mayuko Ito
- Department of Obstetrics and Gynecology Fujita Health University School of Medicine 470-1192 Toyoake Aichi Japan
| | - Toshiaki Endo
- Department of Obstetrics and Gynecology Sapporo Medical University 060-8543 Sapporo Hokkaido Japan
| | - Yuya Ouchi
- Genome and Transcriptome Analysis Center Fujita Health University 470-1192 Toyoake Aichi Japan
| | - Hidehito Inagaki
- Division of Molecular Genetics, Institute for Comprehensive Medical Science Fujita Health University 1-98 Dengakugakubo, Kutsukake-cho 470-1192 Toyoake Aichi Japan.,Genome and Transcriptome Analysis Center Fujita Health University 470-1192 Toyoake Aichi Japan
| | - Takuma Fujii
- Department of Obstetrics and Gynecology Fujita Health University School of Medicine 470-1192 Toyoake Aichi Japan
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26
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Increasing live birth rate by preimplantation genetic screening of pooled polar bodies using array comparative genomic hybridization. PLoS One 2015; 10:e0128317. [PMID: 26024488 PMCID: PMC4449032 DOI: 10.1371/journal.pone.0128317] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 04/26/2015] [Indexed: 11/30/2022] Open
Abstract
Meiotic errors during oocyte maturation are considered the major contributors to embryonic aneuploidy and failures in human IVF treatment. Various technologies have been developed to screen polar bodies, blastomeres and trophectoderm cells for chromosomal aberrations. Array-CGH analysis using bacterial artificial chromosome (BAC) arrays is widely applied for preimplantation genetic diagnosis (PGD) using single cells. Recently, an increase in the pregnancy rate has been demonstrated using array-CGH to evaluate trophectoderm cells. However, in some countries, the analysis of embryonic cells is restricted by law. Therefore, we used BAC array-CGH to assess the impact of polar body analysis on the live birth rate. A disadvantage of polar body aneuploidy screening is the necessity of the analysis of both the first and second polar bodies, resulting in increases in costs for the patient and complex data interpretation. Aneuploidy screening results may sometimes be ambiguous if the first and second polar bodies show reciprocal chromosomal aberrations. To overcome this disadvantage, we tested a strategy involving the pooling of DNA from both polar bodies before DNA amplification. We retrospectively studied 351 patients, of whom 111 underwent polar body array-CGH before embryo transfer. In the group receiving pooled polar body array-CGH (aCGH) analysis, 110 embryos were transferred, and 29 babies were born, corresponding to live birth rates of 26.4% per embryo and 35.7% per patient. In contrast, in the control group, the IVF treatment was performed without preimplantation genetic screening (PGS). For this group, 403 embryos were transferred, and 60 babies were born, resulting in live birth rates of 14.9% per embryo and 22.7% per patient. In conclusion, our data show that in the aCGH group, the use of aneuploidy screening resulted in a significantly higher live birth rate compared with the control group, supporting the benefit of PGS for IVF couples in addition to the suitability and effectiveness of our polar body pooling strategy.
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