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Sarkar P, New EP, Sprague RG, Stillman R, Widra E, Jahandideh S, Devine K, Imudia AN. Live birth per embryo transfer with next generation sequencing preimplantation genetic testing: an analysis of 26,107 cycles. Syst Biol Reprod Med 2023; 69:379-386. [PMID: 37267227 DOI: 10.1080/19396368.2023.2208253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 04/17/2023] [Accepted: 04/24/2023] [Indexed: 06/04/2023]
Abstract
The technique and platform used for preimplantation genetic testing for aneuploidy (PGT-A) have undergone significant changes over time. The contemporary technique utilizes trophectoderm biopsy followed by next-generation sequencing (NGS). The goal of this study was to explore the role of PGT-A using NGS technique exclusively in contemporary in vitro fertilization (IVF) practice. For this, we performed a retrospective analysis of a large dataset collected from the Shady Grove Fertility (SGF) multicentre practice. All autologous IVF cycles which were followed by at least one single embryo transfer (ET) (fresh and/or frozen) between January 2017 to July 2020, were included. Our study group included patients who had PGT-A and the control group included patients who did not proceed with PGT-A. The primary outcome was the live birth rate (LBR) per transfer. All age-adjusted LBR was higher in the PGT-A group than the non-PGT-A group (48.9% vs. 42.7%, p < 0.001), except in women <35 years old among single embryo frozen ETs. Similarly, LBR in the PGT-A group was higher in all ages except in women <35 years old (48.7% vs. 41.7%, p < 0.001) when all single embryos fresh and frozen ETs were included. In patients of decreased ovarian reserve, transfer of euploid embryo was associated with higher LBR (46.7% vs. 26.7%, p < 0.001) whereas miscarriages were lower in patients with unexplained infertility (9.3% vs. 11.3%, p = 0.007 and endometriosis (8.9% vs. 11.6%, p < 0.001) following euploid embryo transfer. To conclude, the transfer of euploid embryos tested via NGS PGT-A was associated with improved LBR per transfer in women ≥35 years old.
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Affiliation(s)
- Papri Sarkar
- Division of Reproductive Endocrinology and Infertility, University of South FL, Sarasota, FL, USA
| | - Erika P New
- Division of Reproductive Endocrinology and Infertility, University of South FL, Sarasota, FL, USA
| | - Rachel G Sprague
- Division of Reproductive Endocrinology and Infertility, University of South FL, Sarasota, FL, USA
- Shady Grove Fertility of Tampa, Tampa, FL, USA
| | | | - Eric Widra
- Shady Grove Fertility, Rockville, MD, USA
| | | | | | - Anthony N Imudia
- Division of Reproductive Endocrinology and Infertility, University of South FL, Sarasota, FL, USA
- Shady Grove Fertility of Tampa, Tampa, FL, USA
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2
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Chen CH, Lee CI, Huang CC, Chen HH, Chang CY, Cheng EH, Lin PY, Chen CI, Lee TH, Lee MS. Increased incidence of live births in implanted day 5 versus day 6 blastocysts following single embryo transfers with PGT-A. Sci Rep 2023; 13:12725. [PMID: 37543691 PMCID: PMC10404267 DOI: 10.1038/s41598-023-40052-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 08/03/2023] [Indexed: 08/07/2023] Open
Abstract
Elective single-embryo transfers of euploid or low-level mosaic blastocysts were analyzed in this retrospective study to determine the correlations of live birth (LB) probability with embryonic developmental features of implanted day 5 (D5, n = 245) or day 6 (D6, n = 73) blastocysts using time-lapse (TL) monitoring. According to the logistic regression analyses (adjusted odds ratio [OR] = 0.341, 95% confidence interval [CI] = 0.169-0.685, P < 0.05), the LB probability was negatively associated with the D6 group. The LB rate of the D5 group was higher than the D6 group (88.2% vs. 75.3%; P < 0.05). Compared with the D5 blastocysts, the D6 blastocysts exhibited comparable dysmorphisms except for the multinucleation at the 4-cell stage (10.9% vs. 2.9%, P < 0.05). Moreover, D6 blastocysts had considerably slower developmental kinetics and poorer blastocyst morphologies. Further analysis confirmed that the LB rate was not associated with developmental kinetics or dysmorphisms but rather with blastocyst morphology (inner cell mass [ICM] grade ≤ C vs. ICM grade A, adjusted OR = 0.155, 95% CI = 0.04-0.596, P < 0.05; trophectoderm [TE] grade ≤ C vs. TE grade A, adjusted OR = 0.157, 95% CI = 0.032-0.760, P < 0.05). In conclusion, D6 implanted blastocysts have a considerably lower LB rate than D5 implanted blastocysts. As determined by TL monitoring, the diminished blastocyst morphology can be one of the primary reasons underlying the decreased likelihood of LB.
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Affiliation(s)
- Chien-Hong Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Chun-I Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chun-Chia Huang
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Hsiu-Hui Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Chih-Ying Chang
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - En-Hui Cheng
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Pin-Yao Lin
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Chung-I Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Tsung-Hsien Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan.
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan.
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
| | - Maw-Sheng Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan.
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan.
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan.
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
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Shetty S, Nair J, Johnson J, Shetty N, J AK, Thondehalmath N, Ganesh D, Bhat VR, M S, R A, Nayak R, Gunasheela D, Kadandale JS, Shetty S. Preimplantation Genetic Testing for Couples with Balanced Chromosomal Rearrangements. J Reprod Infertil 2022; 23:213-223. [PMID: 36415497 PMCID: PMC9666592 DOI: 10.18502/jri.v23i3.10013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 10/08/2021] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Chromosomal rearrangements play an important role in infertility. Carriers of chromosomal rearrangements have a lower chance of producing normal or balanced gametes due to abnormal segregation of chromosomes at meiosis, which leads to recurrent spontaneous abortions and infertility. Preimplantation genetic testing for structural chromosome rearrangements (PGT-SR) is offered to couples who have balanced chromosomal rearrangements in order to select embryos with a balanced karyotype prior to implantation, thereby increasing the chances of pregnancy. The purpose of the current study was to assess the outcomes of PGT-SR in patients carrying various balanced chromosomal rearrangements and to assess their clinical pregnancy outcome after in vitro fertilization (IVF). METHODS In this study, infertile couples with balanced chromosomal abnormalities undergoing PGT-SR were retrospectively analyzed at a single fertility center from January 2016 to December 2019. RESULTS PGT-SR was performed on 87 embryos from 22 couples in whom one partner carried a balanced translocation or an inversion. Fifty-seven (65.5%) of these embryos had unbalanced or sporadic aneuploidies, 30 (34.5%) embryos were normal or chromosomally balanced, which were then transferred in 18 couples. A higher rate of unbalanced translocations in comparison to sporadic aneuploidies was observed in couples with reciprocal translocation. The live birth rate per embryo transfer was found to be 66.6% (12/18). CONCLUSION PGT-SR is a useful tool in selecting normal or balanced embryos for transfer in IVF, which could lead to a pregnancy by reducing the chance of miscarriages due to chromosome aneuploidy in couples with balanced chromosomal rearrangements.
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Affiliation(s)
| | - Jiny Nair
- Tattvagene Pvt. Ltd., Bangalore, India
| | | | | | | | | | | | | | - Sajana M
- Gunasheela Surgical and Maternity Hospital, Bangalore, India
| | - Anjana R
- Gunasheela Surgical and Maternity Hospital, Bangalore, India
| | - Rajsekhar Nayak
- Tattvagene Pvt. Ltd., Bangalore, India
- Gunasheela Surgical and Maternity Hospital, Bangalore, India
| | - Devika Gunasheela
- Tattvagene Pvt. Ltd., Bangalore, India
- Gunasheela Surgical and Maternity Hospital, Bangalore, India
| | - Jayarama S Kadandale
- Tattvagene Pvt. Ltd., Bangalore, India
- Centre for Human Genetics Biotech Park, Bengaluru, India
| | - Swathi Shetty
- Tattvagene Pvt. Ltd., Bangalore, India
- Centre for Human Genetics Biotech Park, Bengaluru, India
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Preimplantation Genetic Testing for Aneuploidy: Has the Controversy Settled? A Review. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2022. [DOI: 10.1007/s13669-021-00322-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Pregnancy and Neonatal Outcomes after Transfer of Mosaic Embryos: A Review. J Clin Med 2021; 10:jcm10071369. [PMID: 33801687 PMCID: PMC8037456 DOI: 10.3390/jcm10071369] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/17/2021] [Accepted: 03/25/2021] [Indexed: 12/18/2022] Open
Abstract
Preimplantation genetic testing for aneuploidy (PGT-A) seeks to identify embryos with a normal chromosome complement during in vitro fertilization (IVF). Transfer of one euploid embryo at a time maximizes the chance of implantation while minimizing the risk of multiple pregnancy. The emergence of new technologies including next generation sequencing (NGS) has led to increased diagnosis of embryonic mosaicism, suggesting the presence of karyotypically distinct cells within a single trophectoderm (TE). Clinical implications of embryonic mosaicism are important in both naturally conceived and IVF pregnancies. Although information regarding outcomes after mosaic embryo transfer (MET) is limited, more than 100 live births have now been documented with rather reassuring outcomes with no abnormal phenotype. Here, we aim to provide a summary of recent data regarding clinical and neonatal outcomes after transfer of mosaic embryos in IVF/PGT-A cycles.
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Xiao M, Lei CX, Xi YP, Lu YL, Wu JP, Li XY, Zhang S, Zhu SJ, Zhou J, Li X, Zhang YP, Sun XX. Next-Generation Sequencing Is More Efficient at Detecting Mosaic Embryos and Improving Pregnancy Outcomes than Single-Nucleotide Polymorphism Array Analysis. J Mol Diagn 2021; 23:710-718. [PMID: 33781963 DOI: 10.1016/j.jmoldx.2021.02.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 01/27/2021] [Accepted: 02/25/2021] [Indexed: 11/26/2022] Open
Abstract
We compared chromosomal mosaicism, detected by next-generation sequencing (NGS), during preimplantation genetic testing (PGT) with that detected by single-nucleotide polymorphism (SNP) array-based PGT to assess the pregnancy outcomes associated with both platforms in a retrospective cohort study of patients undergoing in vitro fertilization in a single university-based assisted reproduction center. In total, 6427 blastocysts biopsied from 1513 patients who underwent 2833 oocyte retrievals from January 2017 to February 2019 were identified. The incidence of mosaicism was significantly higher in the NGS-based PGT group than in the SNP array-based PGT group. Furthermore, some aneuploid specimens were affected by mosaicism. The total mosaicism detection rate with NGS-based PGT (23.3%) was significantly higher than that with SNP array-based PGT (7.7%). Mosaicism rates were similar when stratified by maternal age or PGT type. The SNP array cohort showed a significantly higher spontaneous abortion rate than the NGS cohort (10.07% versus 6.33%; P = 0.0403). The ongoing pregnancy/live birth rate was higher in the NGS cohort (44.1%) than in the SNP array cohort (42.28%). Our results confirm that NGS-based PGT can detect mosaicism more frequently than SNP array-based PGT in trophectoderm specimens. Therefore, clinical application of NGS for PGT may improve pregnancy outcomes compared with that of SNP array-based PGT. More detailed blastocyst detection and classification is necessary to prioritize embryo transfers.
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Affiliation(s)
- Min Xiao
- Shanghai Ji Ai Genetics and In Vitro Fertilization Institute, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China; Genetics Center of Obstetrics and Gynecology of Fudan University, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Cai-Xia Lei
- Shanghai Ji Ai Genetics and In Vitro Fertilization Institute, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yan-Ping Xi
- Shanghai Ji Ai Genetics and In Vitro Fertilization Institute, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yu-Lin Lu
- Berry Genomics Corp., Beijing, China
| | - Jun-Ping Wu
- Shanghai Ji Ai Genetics and In Vitro Fertilization Institute, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | | | - Shuo Zhang
- Shanghai Ji Ai Genetics and In Vitro Fertilization Institute, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China; Genetics Center of Obstetrics and Gynecology of Fudan University, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Sai-Juan Zhu
- Shanghai Ji Ai Genetics and In Vitro Fertilization Institute, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Jing Zhou
- Shanghai Ji Ai Genetics and In Vitro Fertilization Institute, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Xiong Li
- Shanghai Ji Ai Genetics and In Vitro Fertilization Institute, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yue-Ping Zhang
- Shanghai Ji Ai Genetics and In Vitro Fertilization Institute, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Xiao-Xi Sun
- Shanghai Ji Ai Genetics and In Vitro Fertilization Institute, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China; Berry Genomics Corp., Beijing, China; Key Laboratory of Female Reproductive Endocrine-Related Diseases, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
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In vitro fertilization outcomes after preimplantation genetic testing for chromosomal structural rearrangements comparing fluorescence in-situ hybridization, microarray comparative genomic hybridization, and next-generation sequencing. F S Rep 2020; 1:249-256. [PMID: 34223252 PMCID: PMC8244371 DOI: 10.1016/j.xfre.2020.09.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/18/2020] [Accepted: 09/21/2020] [Indexed: 12/22/2022] Open
Abstract
Objective To compare in vitro fertilization (IVF) outcomes for preimplantation genetic testing for chromosomal structural rearrangements (PGT-SR) using various testing platforms. Design Retrospective cohort. Setting Large academic IVF center. Patient(s) Fifty-one balanced translocation carriers undergoing IVF with PGT-SR who completed a total of 91 cycles, including 31 fluorescence in-situ hybridization (FISH), 24 microarray comparative genomic hybridization (aCGH), and 36 next-generation sequencing (NGS) testing cycles. Intervention(s) PGT-SR. Main Outcome Measure(s) Primary outcome of live-birth rate and secondary outcomes including implantation rate, clinical loss rate, and percentages of normal or balanced, unbalanced, and aneuploid embryos detected. Result(s) There was no statistically significant difference in LBR, though there was a tendency toward a higher LBR for NGS testing (14 of 19, 73.7%) compared with FISH (8 of 18, 44.4%) and aCGH (10 of 20, 50.0%). The implantation rate was statistically significantly higher for NGS (16 of 20, 80.0%) compared with FISH (11 of 25, 44.0%) and aCGH (16 of 30, 53.3%). There was no statistically significant difference in clinical pregnancy losses. There was a lower percentage of normal or balanced embryos with FISH (12.5%) compared with aCGH (23.7%) and with NGS (20.7%). Conclusion(s) This is the first report of PGT-SR outcomes for translocation carriers directly comparing PGT-SR using FISH, aCGH, and NGS. Our findings suggest an improvement in pregnancy outcomes parallel to the advancement in technology and are reassuring for continued use of NGS for this population.
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IVF, from the past to the future: the inheritance of the Capri Workshop Group. Hum Reprod Open 2020; 2020:hoaa040. [PMID: 33005753 PMCID: PMC7508025 DOI: 10.1093/hropen/hoaa040] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 07/07/2020] [Indexed: 12/26/2022] Open
Abstract
Today IVF use is booming all over the world and has even started to play a role in demographic analyses. Prognosis-adjusted estimates suggest that up to two-thirds of couples could achieve a live birth. However, the scenario is less exciting in reality. Discontinuation during the cycles is common, and age and ovarian response continue to be crucial in modulating this rate of success. A growing interest is now given to the risk of abuses and in particular to overtreatment and to prescriptions of useless, if not harmful, expensive additional treatments (‘add-ons’). A more rational, evidence-based and wise approach is needed. From a scientific perspective, several obscure aspects remain and warrant future investigations. Of particular interest are the neglected role of sperm selection, the potential adult implications of early embryo life in vitro and the issue of sustainability.
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Aoyama N, Kato K. Trophectoderm biopsy for preimplantation genetic test and technical tips: A review. Reprod Med Biol 2020; 19:222-231. [PMID: 32684821 PMCID: PMC7360970 DOI: 10.1002/rmb2.12318] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 12/19/2019] [Accepted: 01/08/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Recently, the Japan Society of Obstetrics and Gynecology initiated a clinical study of preimplantation genetic test for aneuploidy. There will be a great need for a standardized embryo biopsy technique in Japan. However, the gold standard trophectoderm (TE) biopsy procedure has not been established, and this review outlines the clinical use of TE biopsy. METHODS Based on literature, the method and associated techniques for TE biopsy, a dissection method of TE cells from blastocysts, were investigated. MAIN FINDINGS Two TE biopsy methods are used, namely assisted hatching (herniating) and non-assisted hatching (direct suction); however, it is not clear which of these methods is superior. It is critical to understand whether the flicking or pulling method is beneficial. CONCLUSION Non-assisted hatching biopsy method may cause blastocyst collapse with a higher probability, and it may extend the biopsy time. The biopsy procedure should be performed within 3 minutes, and thus direct TE suction may have greater disadvantages. It is a fact that pulling method of TE dissection with laser pulse is simple; however, excess laser shots may induce a higher frequency of mosaicism. It is important to understand that each technique of TE biopsy has benefits and disadvantages.
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Nigmatova N, Abdilmanova B, Schigolev V. THE REPORTED SUCCESSFUL BABY DELIVERY AFTER PREIMPLANTATION GENETIC TESTING FOR ANEUPLOIDIES (PGT-A) BY MEANS OF NEXT GENERATION SEQUENCING (NGS). REPRODUCTIVE MEDICINE 2020. [DOI: 10.37800/rm2020-1-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of this case report is to demonstrate a successful delivery of a baby after transfer of a blastocyst tested for aneuplodies by means of NGS. A woman aged 35 having two miscarriages decided for ICSI program with PGT-A analysis. Six eggs were fertilized out of 9 metaphase II oocytes. Five good quality blastocysts were submitted for genetic screening using 24-chromosome next generation sequencing (NGS). Two blastocysts were diagnosed as euploid and recommended for transfer. One euploid blastocyst was thawed and transferred to the patient’s uterus lining. Successful pregnancy was confirmed at 7 weeks of gestation with heartbeat. Successful delivery was achieved by Caesarean section at 38-39 weeks of gestation. Karyotyping demonstrated healthy genetic constitution of a baby. This case demonstrates a good evidence and potential of a transport scheme collaboration between IVF and genetic laboratories.
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Alksere B, Grinfelde I, Kornejeva L, Dzalbs A, Vedmedovska N, Kovalova I, Conka U, Andersone S, Krasucka S, Blumberga A, Berzina D, Fodina V. The outcomes after transfers of embryos with chromosomal mosaicism: a single reproductive medicine center experience at iVF Riga clinic. Gynecol Endocrinol 2020; 36:53-57. [PMID: 33305664 DOI: 10.1080/09513590.2020.1816719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Aim: The aim of this study is to summarize the outcomes of transfers of mosaic embryos, which were classified according to guidelines and in strong collaboration of reproductologists, clinical geneticists and patients approved as suitable for transfer. Material and Methods: Retrospective data were collected from 70 patients from a private IVF center to whom embryos with mosaic changes in chromosomal material were transferred from 2015 to 2019. Results and Conclusion: Implantation outcomes and continuing pregnancies showed slight differences, when compared to fully normal embryos. Artifacts have to be differentiated from undeniable aberrations, and correct interpretation of results must be done with following patient counselling and prenatal testing if necessary.
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Affiliation(s)
| | - Ieva Grinfelde
- Clinic 'iVF-Riga', Riga, Latvia
- Children's Clinical University Hospital, Riga, Latvia
| | | | - Aigars Dzalbs
- Clinic 'iVF-Riga', Riga, Latvia
- Children's Clinical University Hospital, Riga, Latvia
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12
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Midha MK, Wu M, Chiu KP. Long-read sequencing in deciphering human genetics to a greater depth. Hum Genet 2019; 138:1201-1215. [PMID: 31538236 DOI: 10.1007/s00439-019-02064-y] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 09/13/2019] [Indexed: 12/12/2022]
Abstract
Through four decades' development, DNA sequencing has inched into the era of single-molecule sequencing (SMS), or the third-generation sequencing (TGS), as represented by two distinct technical approaches developed independently by Pacific Bioscience (PacBio) and Oxford Nanopore Technologies (ONT). Historically, each generation of sequencing technologies was marked by innovative technological achievements and novel applications. Long reads (LRs) are considered as the most advantageous feature of SMS shared by both PacBio and ONT to distinguish SMS from next-generation sequencing (NGS, or the second-generation sequencing) and Sanger sequencing (the first-generation sequencing). Long reads overcome the limitations of NGS and drastically improves the quality of genome assembly. Besides, ONT also contributes several unique features including ultra-long reads (ULRs) with read length above 300 kb and some close to 1 million bp, direct RNA sequencing and superior portability as made possible by pocket-sized MinION sequencer. Here, we review the history of DNA sequencing technologies and associated applications, with a special focus on the advantages as well as the limitations of ULR sequencing in genome assembly.
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Affiliation(s)
- Mohit K Midha
- Genomics Research Center, Academia Sinica, 128 Academia Road, Sec. 2, Nankang District, Taipei, 115, Taiwan.,Institute of Biochemistry and Molecular Biology, National Yang-Ming University, Taipei, Taiwan
| | - Mengchu Wu
- Health GeneTech, 22F No. 99, Xin Pu 6th St., Taoyuan, Taiwan
| | - Kuo-Ping Chiu
- Genomics Research Center, Academia Sinica, 128 Academia Road, Sec. 2, Nankang District, Taipei, 115, Taiwan. .,Institute of Biochemistry and Molecular Biology, National Yang-Ming University, Taipei, Taiwan. .,Department of Life Sciences, College of Life Sciences, National Taiwan University, Taipei, Taiwan.
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Campos Olmedo LM, López Rioja MDJ, Sánchez González CM, Zavala González PN, Recio López Y, Chávez Badiola A. Luteal phase stimulation and fertility: first outcomes. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2019. [DOI: 10.23736/s0393-3660.18.03873-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Lee CI, Chen CH, Huang CC, Cheng EH, Chen HH, Ho ST, Lin PY, Lee MS, Lee TH. Embryo morphokinetics is potentially associated with clinical outcomes of single-embryo transfers in preimplantation genetic testing for aneuploidy cycles. Reprod Biomed Online 2019; 39:569-579. [PMID: 31395516 DOI: 10.1016/j.rbmo.2019.05.020] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 04/23/2019] [Accepted: 05/29/2019] [Indexed: 12/14/2022]
Abstract
RESEARCH QUESTION Are the morphokinetics of euploid blastocysts evaluated by a generally applicable algorithm associated with the clinical outcomes of single-embryo transfer (SET)? DESIGN Time-lapse microscopy was used to compare morphokinetic variables between expanded blastocysts derived from preimplantation genetic testing for aneuploidy cycles using high-resolution next-generation sequencing (hr-NGS). The clinical efficacy of the morphokinetic algorithm KIDScore D5 was evaluated after euploid SET. RESULTS Compared with euploid blastocysts, low-level mosaic blastocysts presented comparable morphokinetic and morphological features. However, high-level mosaic blastocysts exhibited significant delays in t5 (median 51.9 h post insemination (hpi), P = 0.034) (where t is the time for the embryo to reach the specific stage in hours after ICSI or conventional IVF) and t8 (median 58.6 hpi, P = 0.032) accompanied by a prolonged time period for the third cell cycle (median 14.7 h, P = 0.012). A significantly higher incidence (P = 0.011) of multinucleation indicated a susceptibility of high-level mosaic blastocysts to mitotic errors. Only a delay in the time for the embryo to reach the full blastocyst stage (median 106.0 hpi, P = 0.039) was revealed in aneuploid blastocysts, reflecting the reduced formation of good-quality blastocysts (42.6% versus 65.7%, P < 0.001). Euploid blastocysts with specific morphokinetic characteristics were graded using the KIDScore D5 algorithm. Grade C embryos achieved significantly lower rates of clinical pregnancy, implantation and ongoing pregnancy (25%, 25% and 10%, respectively) compared with the grade A (76.2%, 79.4% and 68.3%, respectively) or grade B (62.5%, 66.7% and 62.5%, respectively) embryos (P = 0.0171 to <0.0001). CONCLUSIONS Although morphokinetic features appear dissimilar in embryos with different diploid-aneuploid mosaic levels, predicting chromosomal abnormalities using morphokinetics alone is still insufficient. When combined with hr-NGS, use of the generally applicable KIDScore D5 algorithm has the potential to discriminate euploid blastocysts with different developmental competence.
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Affiliation(s)
- Chun-I Lee
- Institute of Medicine, Chung Shan Medical University Taichung, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital Taichung, Taiwan; Division of Infertility, Lee Women's Hospital Taichung, Taiwan
| | - Chien-Hong Chen
- Division of Infertility, Lee Women's Hospital Taichung, Taiwan
| | - Chun-Chia Huang
- Division of Infertility, Lee Women's Hospital Taichung, Taiwan
| | - En-Hui Cheng
- Division of Infertility, Lee Women's Hospital Taichung, Taiwan
| | - Hsiu-Hui Chen
- Division of Infertility, Lee Women's Hospital Taichung, Taiwan
| | - Su-Ting Ho
- Division of Infertility, Lee Women's Hospital Taichung, Taiwan
| | - Pin-Yao Lin
- Institute of Medicine, Chung Shan Medical University Taichung, Taiwan; Division of Infertility, Lee Women's Hospital Taichung, Taiwan
| | - Maw-Sheng Lee
- Institute of Medicine, Chung Shan Medical University Taichung, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital Taichung, Taiwan; Division of Infertility, Lee Women's Hospital Taichung, Taiwan
| | - Tsung-Hsien Lee
- Institute of Medicine, Chung Shan Medical University Taichung, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital Taichung, Taiwan; Division of Infertility, Lee Women's Hospital Taichung, Taiwan; Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University Taipei, Taiwan.
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15
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Huang Y, Ha S, Li Z, Li J, Xiao W. CHK1-CENP B/MAD2 is associated with mild oxidative damage-induced sex chromosome aneuploidy of male mouse embryos during in vitro fertilization. Free Radic Biol Med 2019; 137:181-193. [PMID: 31042615 DOI: 10.1016/j.freeradbiomed.2019.04.037] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 04/26/2019] [Accepted: 04/26/2019] [Indexed: 02/05/2023]
Abstract
A high incidence of aneuploidy is observed in vitro fertilization (IVF)-derived embryos, but the formation and repair mechanisms are unknown. Here, we investigated the effects of slightly increased reactive oxygen species (ROS) produced by in vitro culture conditions on embryo aneuploidy and the roles of the spindle assembly checkpoint (SAC) protein, mitotic arrest-deficient 2 (MAD2), and the DNA damage response (DDR) protein, checkpoint kinase 1 (CHK1), in aneuploidy repair. By assessing chromosome abnormalities via DAPI staining, karyotype analysis and next-generation sequencing technology, we demonstrated that mild oxidative damage mainly increased the risk of sex chromosome aneuploidy in male mouse embryos (41,XXY,+X and 41,XYY,+Y) through chromosome mis-segregation during the first mitosis. Isobaric tags for relative and absolute quantitation technology revealed that mild oxidative damage inhibited the expression of male reproduction-related proteins, including a kinase anchor protein 4 (AKAP4), whose gene is located on mouse/human Chromosome X. Under mild oxidative damage, abrogation of MAD2 by MAD2 inhibitor-1 (M2I-1) or CHK1 by siRNA microinjection increased sex chromosome mosaicism rate and reduced mitosis-promoting factor (MPF) activity. CHK1 inhibition also reduced kinetochore localization of centromere protein B (CENP B) and MAD2. These findings show that DDR and SAC are responsible for repair of sex chromosome mosaicism via the pCHK1 (S345)-CENP B/MAD2-MPF pathway; further, IVF may have negative effects on male offspring's reproduction ability, which ultimately depends on their continued repair capability. Therefore, we suggest that antioxidants, especially those targeting improved CHK1-MAD2 function, may be a promising therapeutic strategy to reduce aneuploidy formation of IVF-derived embryos and to maintain genome integrity of embryo and offspring.
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Affiliation(s)
- Yue Huang
- Department of Reproductive Center, The First Affiliated Hospital of Shantou University Medical College, Shantou University, Shantou, 515000, Guangdong, China
| | - Siyao Ha
- Laboratory for Reproductive Immunology, Hospital & Institute of Obstetrics & Gynecology, Fudan University Shanghai Medical College, Shanghai, 200011, China
| | - Zhiling Li
- Department of Reproductive Center, The First Affiliated Hospital of Shantou University Medical College, Shantou University, Shantou, 515000, Guangdong, China.
| | - Jiena Li
- Department of Reproductive Center, The First Affiliated Hospital of Shantou University Medical College, Shantou University, Shantou, 515000, Guangdong, China
| | - Wanfen Xiao
- Department of Reproductive Center, The First Affiliated Hospital of Shantou University Medical College, Shantou University, Shantou, 515000, Guangdong, China
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16
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Jiang L, Chen Y, Wang Q, Wang X, Luo X, Chen J, Han H, Sun Y, Shen H. A Chinese practice guideline of the assisted reproductive technology strategies for women with advanced age. J Evid Based Med 2019; 12:167-184. [PMID: 31144467 DOI: 10.1111/jebm.12346] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 12/19/2018] [Indexed: 01/31/2023]
Abstract
More women postpone childbearing nowadays while female fertility begins to decline with advancing age. Furthermore, with the rolling out of the two-child policy, there is a huge demand for a second child for Chinese aged women. There are various assisted reproductive technology (ART) strategies applied for age-related infertility without solid evidence. On behalf of the Society of Reproductive Medicine, Chinese Medical Association, we would like to develop a Chinese guideline of ART strategies for age-related infertility. This guideline was produced following the recommendations for standard guidelines described in the 2012 WHO Handbook for guideline development. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework was also followed. A protocol was formulated and a Guideline Development Group was formed with specialists of reproductive medicine, methodologists from Chinese GRADE working group, and patient representative. Questions regarding the ART strategies for aged infertility were formulated and 8 most important ones were chosen to be structured in PICO format (Population, Intervention, Comparison, Outcomes). Comprehensive search and review of the literature were performed and the quality of the evidence was assessed and rated based on certain criteria and be categorized as high, moderate, low, or very low. Twenty-five recommendations were formulated among members of the Guidelines Development Group (Delphi method) basing on the overall quality of the evidence, in addition to the balance between benefits and harms, values and preferences, and resource implications. The final recommendations were agreed on by consensus during face-to-face meetings. This is the first Chinese practice guideline in reproductive medicine developed following the standard and scientific method.
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Affiliation(s)
- Li Jiang
- Reproductive Medicine Center, Peking University People's Hospital, Beijing, China
| | - Yaolong Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
- Chinese GRADE Center, Lanzhou, China
- WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China
| | - Qi Wang
- Health Policy PhD Program, Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada
- McMaster Health Forum, McMaster University, Hamilton, Canada
| | - Xiaoqin Wang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
- Chinese GRADE Center, Lanzhou, China
- WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China
| | - Xufei Luo
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
- Chinese GRADE Center, Lanzhou, China
- WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China
| | - Junqiao Chen
- Faculty of Science, University of Lisbon, Lisbon, Portugal
| | - Hongjing Han
- Reproductive Medicine Center, Peking University People's Hospital, Beijing, China
| | - Yingpu Sun
- Reproductive Medicine Center, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, China
| | - Huan Shen
- Reproductive Medicine Center, Peking University People's Hospital, Beijing, China
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17
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Role of aneuploidy screening in preimplantation genetic testing for monogenic diseases in young women. Fertil Steril 2019; 111:928-935. [DOI: 10.1016/j.fertnstert.2019.01.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 01/10/2019] [Accepted: 01/10/2019] [Indexed: 11/19/2022]
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18
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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.
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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.
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19
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Shao YH, Zhang XY, Buckett W, Ao A. Impact of in vitro fertilization-preimplantation genetic testing (IVF-PGT) funding policy on clinical outcome: An issue that stems beyond effectiveness of treatment. Eur J Obstet Gynecol Reprod Biol 2019; 235:1-5. [PMID: 30743159 DOI: 10.1016/j.ejogrb.2019.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 12/10/2018] [Accepted: 01/01/2019] [Indexed: 01/02/2023]
Abstract
OBJECTIVE(S) The aim of this study was to compare the patient characteristics, type of genetic disease and inheritance, volume of activity, practice patterns and pregnancy outcomes, in private versus publically funded IVF pre-implantation genetic testing (PGT) for translocation (IVF-PGT-SR) and aneuploidy (PGT-A) periods. STUDY DESIGN This study retrospectively analyzed data during both privately funded period (PRP) and publically funded period (PUP) of assisted reproductive technology (ART) for a total of 275 patients. 83 patients underwent IVF-PGT-SR and 192 patients underwent IVF-PGT-A. Given that PGT-SR is a chromosomal abnormality hereditary in nature, whereas PGT-A is sporadic in addition to the contrasting funding policies, the two cohorts were analyzed separately. To achieve the proposed objective, the two groups under analysis were grouped in accordance with their respective coverage systems for infertility. RESULTS Among translocation patients, 94 normal/balanced embryos were obtained from 47 IVF-PGT cycles in PRP whereas 145 embryos were obtained from 92 IVF-PGT cycles in PUP. The average number of embryos transferred per embryo transfer cycle was significantly lower in PUP in comparison to PRP (1.13 vs. 1.74, p < 0.0001). 13 singletons and 2 sets of twins were conceived in PRP. 14 singletons were conceived in PUP. Regardless of funding period, there were more reciprocal translocation carriers (79.4% in PRP and 76.4% in PUP) and more male carriers (82.4% in PRP and 60% in PUP), of which the majority had abnormal sperm parameters. Among aneuploidy patients, on average 2.5 embryos in PRP and 1.4 embryos in PUP were transferred per ET cycle (p = 0.05). There was a 13.3% increase in number of IVF-PGT-A attempts per patient in PRP compared to PUP. Live birth rate per IVF-PGT-A was higher in PRP (29.7% vs. 15%, P = 0.02), which consisted of 48 singletons and 18 multiparous pregnancies in PRP and 9 singletons in PUP. CONCLUSION(S) Public coverage of ART is associated with a greater utilization ART, as well as a reduced number in embryo transfer (ET) per cycle, a lower proportion of cycles resulting in successful pregnancy and a lower multiple birth rate. Our study ultimately shines light on the effect of providers' and patients' monetary conscious on pregnancy outcome.
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Affiliation(s)
- Yi-Hong Shao
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Xiao Yun Zhang
- MUHC Reproductive Centre, Department of Obstetrics and Gynecology, McGill Univeristy, Montreal, Quebec, Canada
| | - William Buckett
- MUHC Reproductive Centre, Department of Obstetrics and Gynecology, McGill Univeristy, Montreal, Quebec, Canada
| | - Asangla Ao
- MUHC Reproductive Centre, Department of Obstetrics and Gynecology, McGill Univeristy, Montreal, Quebec, Canada; Department of Human Genetics, McGill University, Montreal, Quebec, Canada.
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20
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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.
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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.
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21
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Wang LY, Rao XQ, Luo YQ, Liu B, Peng CF, Chen D, Yan K, Qian YQ, Yang YM, Huang YZ, Chen M, Sun YX, Li HG, Ye YH, Jin F, Liu HL, Dong MY. Preimplantation genetic diagnosis and screening (PGD/S) using a semiconductor sequencing platform. Hum Genomics 2019; 13:1. [PMID: 30606250 PMCID: PMC6318931 DOI: 10.1186/s40246-018-0187-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 12/10/2018] [Indexed: 02/07/2023] Open
Abstract
Background Recent advances in semiconductor sequencing platform (SSP) have provided new methods for preimplantation genetic diagnosis/screening (PGD/S). The present study aimed to evaluate the applicability and efficiency of SSP in PGD/S. Methods The artificial positive single-cell-like DNAs and normal single-cell samples were chosen to test our semiconductor sequencing platform for preimplantation genetic diagnosis/screening (SSP-PGD/S) method with two widely used whole-genome amplification (WGA) kits. A total of 557 single blastomeres were collected from in vitro fertilization (IVF) couples, and their WGA products were processed and analyzed by our SSP-PGD/S method in comparison with array comparative genomic hybridization (array-CGH). Results Our SSP-PGD/S method indicated high compatibilities with two commercial WGA kits. For 557 single blastomeres, our method with four million reads in average could detect 24-chromosome aneuploidies as well as microdeletion/microduplication of the size over 4 Mb, providing 100% consistent conclusion with array-CGH method in the classification of whether it was transplantable. Conclusions Our studies suggested that SSP-PGD/S represents a valuable alternative to array-CGH and brought PGD/S into a new era of more rapid, accurate, and economic. Electronic supplementary material The online version of this article (10.1186/s40246-018-0187-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Li-Ya Wang
- Key Laboratory of Reproductive Genetics, Ministry of Education (Zhejiang University) Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | | | - Yu-Qin Luo
- Key Laboratory of Reproductive Genetics, Ministry of Education (Zhejiang University) Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | - Bei Liu
- Key Laboratory of Reproductive Genetics, Ministry of Education (Zhejiang University) Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | | | - Dan Chen
- CapitalBio Genomics Co., Ltd., Dongguan, 532808, China
| | - Kai Yan
- Key Laboratory of Reproductive Genetics, Ministry of Education (Zhejiang University) Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | - Ye-Qing Qian
- Key Laboratory of Reproductive Genetics, Ministry of Education (Zhejiang University) Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | - Yan-Mei Yang
- Key Laboratory of Reproductive Genetics, Ministry of Education (Zhejiang University) Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | - Ying-Zhi Huang
- Key Laboratory of Reproductive Genetics, Ministry of Education (Zhejiang University) Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | - Min Chen
- Key Laboratory of Reproductive Genetics, Ministry of Education (Zhejiang University) Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | - Yi-Xi Sun
- Key Laboratory of Reproductive Genetics, Ministry of Education (Zhejiang University) Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | - Hong-Ge Li
- Key Laboratory of Reproductive Genetics, Ministry of Education (Zhejiang University) Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | - Ying-Hui Ye
- Key Laboratory of Reproductive Genetics, Ministry of Education (Zhejiang University) Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | - Fan Jin
- Key Laboratory of Reproductive Genetics, Ministry of Education (Zhejiang University) Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | - Hai-Liang Liu
- CapitalBio Genomics Co., Ltd., Dongguan, 532808, China.
| | - Min-Yue Dong
- Key Laboratory of Reproductive Genetics, Ministry of Education (Zhejiang University) Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China.
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Zhang L, Wei D, Zhu Y, Gao Y, Yan J, Chen ZJ. Rates of live birth after mosaic embryo transfer compared with euploid embryo transfer. J Assist Reprod Genet 2018; 36:165-172. [PMID: 30246223 DOI: 10.1007/s10815-018-1322-2] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 09/14/2018] [Indexed: 12/22/2022] Open
Abstract
PURPOSE Mosaicism is a prevalent characteristic of human preimplantation embryos. This retrospective cohort study aimed to investigate pregnancy outcomes after transfer of mosaic or euploid embryos. METHODS The embryos, which had been transferred as "euploidy," were processed using array-based comparative genomic hybridization (aCGH). The original aCGH charts of the transferred embryos were reanalyzed. Mosaic and control euploid embryos were defined according to log2 ratio calls. RESULTS Overall, 102 embryos were determined to be mosaic, of which 101 were estimated to harbor no more than 50% aneuploid mosaicism. Additionally, 268 euploid embryos were matched as controls. The rates of live birth (46.6% vs. 59.1%, odds ratio (OR) 0.60, 95% confidence interval (CI) 0.38-0.95), and biochemical pregnancy (65.7% vs. 76.1%, OR 0.60, 95% CI 0.37-0.99) per transfer cycle were significantly lower after mosaic embryo transfer than after euploid embryo transfer. The rates of clinical pregnancy and pregnancy loss and the risks of obstetric outcomes did not differ significantly between the two groups. CONCLUSIONS Compared with euploid embryo transfer, mosaic embryo transfer is associated with a lower rate of live birth, which is mainly attributed to a decreased rate of conception. However, as mosaic embryo transfer yielded a live birth rate of 46.6%, patients without euploid embryos could be counseled regarding this alternative option.
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Affiliation(s)
- Lei Zhang
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jingliu Road 157, Jinan, 250021, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, China.,The Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, China.,Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, China
| | - Daimin Wei
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jingliu Road 157, Jinan, 250021, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, China.,The Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, China.,Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, China
| | - Yueting Zhu
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jingliu Road 157, Jinan, 250021, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, China.,The Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, China.,Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, China
| | - Yuan Gao
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jingliu Road 157, Jinan, 250021, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, China.,The Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, China.,Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, China
| | - Junhao Yan
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jingliu Road 157, Jinan, 250021, China. .,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, China. .,The Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, China. .,Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, China.
| | - Zi-Jiang Chen
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jingliu Road 157, Jinan, 250021, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, China.,The Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, China.,Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, China.,Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
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Status of preimplantation genetic testing and embryo selection. Reprod Biomed Online 2018; 37:393-396. [PMID: 30232021 DOI: 10.1016/j.rbmo.2018.08.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 08/04/2018] [Accepted: 08/07/2018] [Indexed: 11/22/2022]
Abstract
At the recent 2018 PGDIS congress, a review of randomized controlled trials of preimplantation genetic testing for aneuploidies (PGT-A) showed improved ongoing pregnancy rates per transfer in experienced centres and in women aged 35 years and older. Young women produce 40% abnormal embryos (20-60% range), but not all centres see a selection advantage; this indicates the need for more emphasis in improving biopsy and case management. Some chromosome abnormalities are iatrogenic; PGT-A could, therefore, be used as assisted reproductive technology (ART) quality control. Great improvements in non-invasive PGT by testing spent media have been reported, ranging from 80-95% concordance with trophectoderm biopsy, probably precluding the need for biopsy soon. Mosaicism was widely discussed, with PGDIS agreeing to update their guidelines, but continuing to recommend prioritizing euploid, followed by mosaic embryos. Techniques to allow simultaneous single sample analysis of aneuploidy and inherited mutations are improving, but this does not extend to de-novo mutations. Convincing data were presented on the efficacy of using endometrial receptivity tests to improve ART outcomes adjuvant or independently of PGT-A. Imprinting, CRISPR and cloning were also discussed, with a concluding presentation on the first extensive data (aneuploidy and morphology) on in-vivo conceived embryos.
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Brunet BCFK, Shen J, Cai L, Xie J, Cui Y, Liu J, Wu W. Preimplantation genetic testing for complex chromosomal rearrangement carriers by next-generation sequencing. Reprod Biomed Online 2018; 37:375-382. [PMID: 30314889 DOI: 10.1016/j.rbmo.2018.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 07/03/2018] [Accepted: 07/03/2018] [Indexed: 02/06/2023]
Abstract
RESEARCH QUESTION Can preimplantation genetic testing (PGT) with next-generation sequencing (NGS) increase the chance of achieving a balanced euploid pregnancy in complex chromosome rearrangement (CCR) carriers? DESIGN Six couples underwent PGT at the Clinical Centre of Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University. The CCR carriers in the six couples were: Case A: 46,XY,t(1;4;11)(p31;p16;q22); Case B: 46,XY,t(3;13;5)(p14;q21;p14); Case C: 46,XX,t(6;11;21)(q21;q21;q13); Case D: 46,XX,inv(9)(p12; q13),t(13;15)(q14;q24); Case E: 46,XX,inv(9)(p12;q13),t(7;9)(q22;p22); and Case F: 46,XX,t(2;7)(q21;q36),t(2;4)(p10;q10),t(2;4)(q15;q10). After ovarian stimulation followed by oocyte retrieval and embryo culture, PGT was performed on day 5 or 6 blastocyst biopsies using NGS to identify normal/balanced euploid embryos. Vitrified-warmed single embryo transfers were performed using normal/balanced euploid embryos. RESULTS After seven cycles, 84 oocytes were retrieved. Whole genome sequencing by NGS was performed on 25 trophectoderm biosies. Six (24%) embryos were identified as normal/balanced euploid, four were transferred resulting in four live births. Case A, C, D and E each gave birth to a healthy baby after their first cycle. There was no transferable embryo after two cycles for Case B and one cycle for Case F. The implantation rate per transfer was 4/4 and the live birth rate was 4/4. CONCLUSION These results strongly support the use of NGS for CCR carriers.
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Affiliation(s)
- Beatrice Chung Fat King Brunet
- The State Key Laboratory of Reproductive MedicineClinical Centre of Reproductive MedicineFirst Affiliated Hospital of Nanjing Medical UniversityNanjing210029PR China
| | - Jiandong Shen
- The State Key Laboratory of Reproductive MedicineClinical Centre of Reproductive MedicineFirst Affiliated Hospital of Nanjing Medical UniversityNanjing210029PR China
| | - Lingbo Cai
- The State Key Laboratory of Reproductive MedicineClinical Centre of Reproductive MedicineFirst Affiliated Hospital of Nanjing Medical UniversityNanjing210029PR China
| | - Jiazhi Xie
- The State Key Laboratory of Reproductive MedicineClinical Centre of Reproductive MedicineFirst Affiliated Hospital of Nanjing Medical UniversityNanjing210029PR China
| | - Yugui Cui
- The State Key Laboratory of Reproductive MedicineClinical Centre of Reproductive MedicineFirst Affiliated Hospital of Nanjing Medical UniversityNanjing210029PR China
| | - Jiayin Liu
- The State Key Laboratory of Reproductive MedicineClinical Centre of Reproductive MedicineFirst Affiliated Hospital of Nanjing Medical UniversityNanjing210029PR China.
| | - Wei Wu
- The State Key Laboratory of Reproductive MedicineClinical Centre of Reproductive MedicineFirst Affiliated Hospital of Nanjing Medical UniversityNanjing210029PR China.
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Friedenthal J, Maxwell SM, Munné S, Kramer Y, McCulloh DH, McCaffrey C, Grifo JA. Next generation sequencing for preimplantation genetic screening improves pregnancy outcomes compared with array comparative genomic hybridization in single thawed euploid embryo transfer cycles. Fertil Steril 2018; 109:627-632. [DOI: 10.1016/j.fertnstert.2017.12.017] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 11/30/2017] [Accepted: 12/15/2017] [Indexed: 10/17/2022]
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Fragouli E. Next generation sequencing for preimplantation genetic testing for aneuploidy: friend or foe? Fertil Steril 2018; 109:606-607. [DOI: 10.1016/j.fertnstert.2018.01.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 01/22/2018] [Indexed: 01/17/2023]
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Pontré JC, Ryan JP, Tan A, Hart RJ. The interval transfer of a frozen-thawed embryo is more successful than a fresh embryo transfer for women undergoing IVF with recurrent implantation failure after cleavage stage embryo biopsy. Aust N Z J Obstet Gynaecol 2018; 59:134-139. [PMID: 29551013 DOI: 10.1111/ajo.12798] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 02/11/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Recurrent implantation failure (RIF) is repeated unsuccessful embryo transfers (ETs). AIMS To identify predictive embryonic markers of implantation in RIF, following pre-implantation genetic screening (PGS) of cleavage stage embryos, after accounting for male and female factors. MATERIALS AND METHODS Retrospective analysis of RIF patients undergoing PGS after correction of modifiable causes. RESULTS Eighty-four patients underwent 140 in vitro ferilisation cycles. Forty-one cycles were excluded: 12 (no embryo for transfer), four (double ETs) and 25 (no biopsy). Sixty-three patients underwent 99 single euploid ETs (48 fresh, 51 frozen) resulting in 11 biochemical pregnancies, 36 clinical pregnancies (CP), and six miscarriages and 30 live births (LB). Frozen ET was more successful than fresh; respective live birth rate (LBR) and clinical pregnancy rate (CPR), 39.2% versus 20.8%, (P = 0.02), 45.1% versus 27.1% (P = 0.04). LBR and CPR were lower when 5-6 blastomeres were present at embryo biopsy, compared to embryos with ≥7 blastomeres: 15.4% versus 32.6% (P = 0.185) and 15.4% versus 39.5% (P = 0.074) respectively. Serum β human chorionic gonadotropin (βhCG) concentration was greater when a more developed embryo was biopsied (r = 0.448, P = 0.017 and r = 0.476, P = 0.118, fresh and frozen transfers, respectively). Embryo morphokinetic analysis demonstrated faster development to blastocyst stage when more cells were present at biopsy: mean 103.3, 102.2 and 96.0 h for biopsy at the 5-6, 7-8 or ≥9 cell stage respectively (P = 0.040 for difference between 7-8 cells vs ≥9). CONCLUSIONS After cleavage stage biopsy, frozen ET was more successful than fresh ET. Chance of conception and serum βhCG concentration correlated with number of cells present at time of biopsy.
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Affiliation(s)
- Jennifer C Pontré
- Fertility Specialists of Western Australia, Bethesda Hospital, Perth, Western Australia, Australia.,Division of Obstetrics and Gynaecology, King Edward Memorial Hospital, University of Western Australia, Perth, Western Australia, Australia
| | - John P Ryan
- Fertility Specialists of Western Australia, Bethesda Hospital, Perth, Western Australia, Australia.,Division of Obstetrics and Gynaecology, King Edward Memorial Hospital, University of Western Australia, Perth, Western Australia, Australia
| | - Andy Tan
- Fertility Specialists of Western Australia, Bethesda Hospital, Perth, Western Australia, Australia
| | - Roger J Hart
- Fertility Specialists of Western Australia, Bethesda Hospital, Perth, Western Australia, Australia.,Division of Obstetrics and Gynaecology, King Edward Memorial Hospital, University of Western Australia, Perth, Western Australia, Australia
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Chow JFC, Yeung WSB, Lee VCY, Lau EYL, Ng EHY. Evaluation of preimplantation genetic testing for chromosomal structural rearrangement by a commonly used next generation sequencing workflow. Eur J Obstet Gynecol Reprod Biol 2018; 224:66-73. [PMID: 29547808 DOI: 10.1016/j.ejogrb.2018.03.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 03/08/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES To evaluate the applicability of a commonly used next generation sequencing workflow in detecting unbalanced meiotic segregation products for reciprocal translocation and inversion carriers. STUDY DESIGN All preimplantation genetic testing treatment cycles performed for reciprocal translocation or inversion carriers from 2012 to April 2017 were included. Three hundreds and forty-two archived whole genome amplified DNA, which had previously analyzed by array comparative genomic hybridization (aCGH), were retrospectively analyzed by next generation sequencing (NGS). Concordance on overall diagnosis and segmental aneuploidies related to the translocation/inversion breakpoints between aCGH and NGS were determined. RESULTS Retrospective analysis of 287 blastomere biopsies and 55 trophectoderm (TE) biopsies showed that the concordance rate on the overall diagnosis between aCGH and NGS on abnormal samples was 100% (266/266), irrespective to the type of biopsy. The concordance rates of normal biopsies were 98.4% (61/62) on blastomere and 78.6% (11/14) on TE biopsies. NGS detected a de novo segmental aneuploidy on one blastomere biopsy and three possible low level mosaic aneuploidies on 3 TE biopsies, which were previously concluded as euploid by aCGH. Using the karyotype of reciprocal translocation/inversion carriers, size of anticipated segmental aneuploidies could be calculated and be used to predict the applicability of NGS before proceeding to treatment. CONCLUSION This is the first report to evaluate the applicability of a commercial NGS-based workflow for preimplantation testing for reciprocal translocations/inversions. Our study demonstrated that NGS can diagnose unbalanced translocation/inversion products with the same efficiency as aCGH. The applicability of NGS, with respect to individual karyotype, can be predicted before proceeding to treatment.
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Affiliation(s)
- Judy F C Chow
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - William S B Yeung
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong.
| | | | - Estella Y L Lau
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, Hong Kong
| | - Ernest H Y Ng
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
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Liss J, Pastuszek E, Pukszta S, Hoffmann E, Kuczynski W, Lukaszuk A, Lukaszuk K. Effect of next-generation sequencing in preimplantation genetic testing on live birth ratio. Reprod Fertil Dev 2018; 30:1720-1727. [DOI: 10.1071/rd17428] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 05/24/2018] [Indexed: 01/17/2023] Open
Abstract
The present study analysed live birth ratios in frozen embryo transfer (FET) cycles where embryo ploidy status was determined with preimplantation genetic testing (PGT) using next-generation sequencing (NGS). PGT was performed on trophectoderm cells biopsied at the blastocyst stage. The present prospective cohort study included 112 women undergoing frozen embryo transfer, with NGS PGT. The control group consisted of 85 patients who underwent the IVF procedure with FET planned for a subsequent cycle. The live birth rate per cycle was higher by ~18.5 percentage points in the investigated compared with control group (42.0% vs 23.5% respectively; P = 0.012). The differences between the study and control groups were also significant for clinical pregnancy (42.0% vs 23.5% respectively; P = 0.012), implantation (41.2% vs 22.2% respectively; P = 0.001) and pregnancy loss rates (9.6% vs 28.6% respectively; P = 0.027). The results show that PGT NGS is a useful method for embryo selection and it may be implemented in routine clinical practice with propitious results.
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31
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Zhang S, Lei C, Wu J, Zhou J, Sun H, Fu J, Sun Y, Sun X, Lu D, Zhang Y. The establishment and application of preimplantation genetic haplotyping in embryo diagnosis for reciprocal and Robertsonian translocation carriers. BMC Med Genomics 2017; 10:60. [PMID: 29041973 PMCID: PMC5646120 DOI: 10.1186/s12920-017-0294-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 10/02/2017] [Indexed: 01/11/2023] Open
Abstract
Background Preimplantation genetic diagnosis (PGD) is now widely used to select embryos free of chromosomal copy number variations (CNV) from chromosome balanced translocation carriers. However, it remains a difficulty to distinguish in embryos between balanced and structurally normal chromosomes efficiently. Methods For this purpose, genome wide preimplantation genetic haplotyping (PGH) analysis was utilized based on single nucleotide polymorphism (SNP) microarray. SNPs that are heterozygous in the carrier and, homozygous in the carrier’s partner and carrier’s family member are defined as informative SNPs. The haplotypes including the breakpoint regions, the whole chromosomes involved in the translocation and the corresponding homologous chromosomes are established with these informative SNPs in the couple, reference and embryos. In order to perform this analysis, a reference either a translocation carrier’s family member or one unbalanced embryo is required. The positions of translocation breakpoints are identified by molecular karyotypes of unbalanced embryos. The recombination of breakpoint regions in embryos could be identified. Results Eleven translocation families were enrolled. 68 blastocysts were analyzed, in which 42 were unbalanced or aneuploid and the other 26 were balanced or normal chromosomes. Thirteen embryos were transferred back to patients. Prenatal cytogenetic analysis of amniotic fluid cells was performed. The results predicted by PGH and karyotypes were totally consistent. Conclusions With the successful clinical application, we demonstrate that PGH was a simple, efficient, and popularized method to distinguish between balanced and structurally normal chromosome embryos. Electronic supplementary material The online version of this article (10.1186/s12920-017-0294-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shuo Zhang
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, 588 Fangxie Rd, Shanghai, 200011, China.,Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, 2005 Songhu Rd, Shanghai, 200438, China
| | - Caixia Lei
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, 588 Fangxie Rd, Shanghai, 200011, China.,Obstetrics and Gynecology Hospital, Fudan University, 588 Fangxie Rd, Shanghai, 200011, China
| | - Junping Wu
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, 588 Fangxie Rd, Shanghai, 200011, China.,Obstetrics and Gynecology Hospital, Fudan University, 588 Fangxie Rd, Shanghai, 200011, China
| | - Jing Zhou
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, 588 Fangxie Rd, Shanghai, 200011, China
| | - Haiyan Sun
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, 588 Fangxie Rd, Shanghai, 200011, China
| | - Jing Fu
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, 588 Fangxie Rd, Shanghai, 200011, China.,Obstetrics and Gynecology Hospital, Fudan University, 588 Fangxie Rd, Shanghai, 200011, China
| | - Yijuan Sun
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, 588 Fangxie Rd, Shanghai, 200011, China
| | - Xiaoxi Sun
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, 588 Fangxie Rd, Shanghai, 200011, China. .,Obstetrics and Gynecology Hospital, Fudan University, 588 Fangxie Rd, Shanghai, 200011, China.
| | - Daru Lu
- Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, 2005 Songhu Rd, Shanghai, 200438, China.
| | - Yueping Zhang
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, 588 Fangxie Rd, Shanghai, 200011, China. .,Obstetrics and Gynecology Hospital, Fudan University, 588 Fangxie Rd, Shanghai, 200011, China.
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Chen HF, Chen SU, Ma GC, Hsieh ST, Tsai HD, Yang YS, Chen M. Preimplantation genetic diagnosis and screening: Current status and future challenges. J Formos Med Assoc 2017; 117:94-100. [PMID: 28888353 DOI: 10.1016/j.jfma.2017.08.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 08/22/2017] [Indexed: 02/08/2023] Open
Abstract
Preimplantation genetic diagnosis (PGD) is a clinically feasible technology to prevent the transmission of monogenic inherited disorders in families afflicted the diseases to the future offsprings. The major technical hurdle is it does not have a general formula for all mutations, thus different gene locus needs individualized, customized design to make the diagnosis accurate enough to be applied on PGD, in which the quantity of DNA is scarce, whereas timely result is sometimes requested if fresh embryo transfer is desired. On the other hand, preimplantation genetic screening (PGS) screens embryo with aneuploidy and was also known as PGD-A (A denotes aneuploidy) in order to enhance the implantation rates as well as livebirth rates. In contrasts to PGD, PGS is still under ferocious debate, especially recent reports found that euploid babies were born after transferring the aneuploid embryos diagnosed by PGS back to the womb and only very few randomized trials of PGS are available in the literature. We have been doing PGD and/or PGS for more than 10 years as one of the core PGD/PGS laboratories in Taiwan. Here we provide a concise review of PGD/PGS regarding its current status, both domestically and globally, as well as its future challenges.
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Affiliation(s)
- Hsin-Fu Chen
- Department of Obstetrics and Gynecology, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan; Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shee-Uan Chen
- Department of Obstetrics and Gynecology, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan
| | - Gwo-Chin Ma
- Department of Genomic Medicine and Center for Medical Genetics, Changhua Christian Hospital, Changhua, Taiwan; Department of Genomic Science and Technology, Changhua Christian Hospital Healthcare System, Changhua, Taiwan; Institute of Biochemistry, Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan; Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Sung-Tsang Hsieh
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan; Department of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Horng-Der Tsai
- Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan
| | - Yu-Shih Yang
- Department of Obstetrics and Gynecology, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan; Department of Obstetrics and Gynecology, Fu-Jen Catholic University Hospital, New Taipei, Taiwan
| | - Ming Chen
- Department of Obstetrics and Gynecology, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan; Department of Genomic Medicine and Center for Medical Genetics, Changhua Christian Hospital, Changhua, Taiwan; Department of Genomic Science and Technology, Changhua Christian Hospital Healthcare System, Changhua, Taiwan; Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan; Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan; Department of Life Science, Tunghai University, Taichung, Taiwan.
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Natural selection between day 3 and day 5/6 PGD embryos in couples with reciprocal or Robertsonian translocations. J Assist Reprod Genet 2017; 34:1483-1492. [PMID: 28756497 DOI: 10.1007/s10815-017-1009-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 07/21/2017] [Indexed: 10/19/2022] Open
Abstract
PURPOSE For translocation carriers, preimplantation genetic diagnosis (PGD) provides the opportunity to distinguish between normal/balanced and unbalanced embryos prior to implantation and, as such, increases the likelihood of a successful ongoing pregnancy. The data presented here compares autosomal reciprocal and Robertsonian translocation segregation patterns in day 3 versus day 5/6 IVF-PGD embryos to determine if there is a difference in the chromosome segregation patterns observed at these developmental time points. METHODS A retrospective analysis on PGD translocation carriers at Monash IVF was performed. Segregation patterns were compared between day 3 and day 5/6 embryos to ascertain whether selection against malsegregants exists. RESULTS For reciprocal translocations, 1649 day 3 embryos (139 translocations) from 144 couples and 128 day 5/6 embryos (59 translocations) from 60 couples were analysed. Day 3 segregation analysis showed that 22.3% of embryos were normal/balanced (consistent with 2:2 alternate segregation) and 77.7% were unbalanced (malsegregation). Day 5/6 segregation analysis showed that 53.1% of embryos were normal/balanced and 46.9% were unbalanced. For Robertsonian translocations, 847 day 3 embryos (8 translocations) from 54 couples and 193 day 5/6 embryos (6 translocations) from 31 couples were analysed. Day 3 segregation analysis showed that 38.7% of embryos were normal/balanced (consistent with 2:1 alternate segregation) and 61.3% were unbalanced. Day 5/6 segregation analysis showed that 74.1% of embryos were normal/balanced and 25.9% were unbalanced. CONCLUSIONS This data demonstrates an increase in the proportion of genetically normal/balanced embryos at day 5/6 of development. This suggests a strong natural selection process between day 3 and day 5/6 in favour of normal/balanced embryos. These findings support performing PGD testing on day 5/6 of embryo development.
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Abstract
Preimplantation genetic diagnosis was first successfully performed in 1989 as an alternative to prenatal diagnosis for couples at risk of transmitting a genetic or chromosomal abnormality, such as cystic fibrosis, to their child. From embryos generated in vitro, biopsied cells are genetically tested. From the mid-1990s, this technology has been employed as an embryo selection tool for patients undergoing in vitro fertilisation, screening as many chromosomes as possible, in the hope that selecting chromosomally normal embryos will lead to higher implantation and decreased miscarriage rates. This procedure, preimplantation genetic screening, was initially performed using fluorescent in situ hybridisation, but 11 randomised controlled trials of screening using this technique showed no improvement in in vitro fertilisation delivery rates. Progress in genetic testing has led to the introduction of array comparative genomic hybridisation, quantitative polymerase chain reaction, and next generation sequencing for preimplantation genetic screening, and three small randomised controlled trials of preimplantation genetic screening using these new techniques indicate a modest benefit. Other trials are still in progress but, regardless of their results, preimplantation genetic screening is now being offered globally. In the near future, it is likely that sequencing will be used to screen the full genetic code of the embryo.
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Affiliation(s)
- Joyce C Harper
- Joyce Harper, Embryology, IVF and Reproductive Genetics Group, Institute for Women's Health, University College London, London, UK
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35
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Lai HH, Chuang TH, Wong LK, Lee MJ, Hsieh CL, Wang HL, Chen SU. Identification of mosaic and segmental aneuploidies by next-generation sequencing in preimplantation genetic screening can improve clinical outcomes compared to array-comparative genomic hybridization. Mol Cytogenet 2017; 10:14. [PMID: 28450889 PMCID: PMC5405548 DOI: 10.1186/s13039-017-0315-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 04/18/2017] [Indexed: 12/22/2022] Open
Abstract
Background Chromosomal mosaicism is observed as the presence of both euploid and aneuploid cells in a particular blastocyst. Recent studies have reported that the implantation rate of mosaic embryo transfer is remarkably lower than the euploid embryos. The superior capability of next-generation sequencing (NGS) to detect chromosomal mosaicism in preimplantation genetic screening (PGS) remains controversial, and several data displayed similar implantation and pregnancy rates using NGS or array comparative genomic hybridization (aCGH). Results In this study, the main inconsistency of aneuploidy detection and clinical performance between the NGS and aCGH were assessed. The phase I consisted of a parallel comparison in 182 blastocysts from 45 selected PGS patients for both the NGS and aCGH platforms. The phase II retrospectively compared the clinical outcomes of 90 patients with NGS-screened euploid embryo transfer to that of 129 patients with aCGH-screened euploid embryo transfer. The parallel comparison showed that the inconsistency of embryo euploidy was 11.8% (p = 0.01). Chromosomal mosaicism (10.7% with NGS vs. 3.9% with aCGH) and segmental aneuploidy (10.7% with NGS vs. 6.7% with aCGH) contributed to the discrepancy mainly. The chromosomally mosaic embryos (20%–50% of aneuploidy) and several embryos with segmental aneuploidy (≥10 Mbp) were hard to distinguish using the aCGH platform, but could be clearly identified using the NGS platform. After the first euploid embryo cryotransfer, the β-HCG(+) rate and implantation rate significantly increased in the PGS/NGS patients (HCG[+] rate: 73.3% in PGS/NGS vs. 60.5% in PGS/aCGH, p = 0.048; implantation rate: 53.2% in PGS/NGS vs. 45.0% in PGS/aCGH, p = 0.043). The clinical and ongoing pregnancy rates appeared higher in the NGS group, but did not reached statistical significance. Conclusions The results demonstrated that the NGS platform can identify embryos with chromosomal mosaicism and segmental aneuploidy more precisely than the aCGH platform, and the following clinical performance of NGS was more favorable.
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Affiliation(s)
- Hsing-Hua Lai
- Stork Fertility Center, Stork Ladies Clinic, Hsinchu, Taiwan
| | | | - Lin-Kin Wong
- Stork Fertility Center, Stork Ladies Clinic, Hsinchu, Taiwan
| | - Meng-Ju Lee
- Stork Fertility Center, Stork Ladies Clinic, Hsinchu, Taiwan
| | - Chia-Lin Hsieh
- Stork Fertility Center, Stork Ladies Clinic, Hsinchu, Taiwan
| | - Huai-Lin Wang
- Stork Fertility Center, Stork Ladies Clinic, Hsinchu, Taiwan
| | - Shee-Uan Chen
- Department of Obstetrics and Gynecology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
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Chen M, Chang SP, Ma GC, Lin WH, Chen HF, Chen SU, Tsai HD, Tsai FP, Shen MC. Preimplantation genetic diagnosis of hemophilia A. Thromb J 2016; 14:33. [PMID: 27766059 PMCID: PMC5056473 DOI: 10.1186/s12959-016-0098-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Preimplantation genetic diagnosis (PGD) is a powerful tool to tackle the transmission of monogenic inherited disorders in families carrying the diseases from generation to generation. It currently remains a challenging task, despite PGD having been developed over 25 years ago. The major difficulty is it does not have an easy and general formula for all mutations. Different gene locus needs individualized, customized design to make the diagnosis accurate enough to be applied on PGD, in which the quantity of DNA is scanty, whereas timely laboratory diagnosis is mandatory if fresh embryo transfer is desired occasionally. Indicators for outcome assessment of a successful PGD program include the successful diagnosis rate on blastomeres (Day 3 cleavage-stage embryo biopsy) or trophectoderm cells (Day 5/6 blastocyst biopsy), the implantation rate per embryo transferred, and the livebirth rate per oocyte retrieval cycle. Hemophilia A (HA) is an X-linked recessive bleeding disorder caused by various types of pathological defects in the factor VIII gene (F8). The mutation spectrum of the F8 is complex, according to our previous report, including large segmental intra-gene inversions, large segmental deletions spanning a few exons, point mutations, and total deletion caused by chromosomal structural rearrangements. In this review, the molecular methodologies used to tackle different mutants of the F8 in the PGD of HA are to be explained, and the experiences of successful use of amplification refractory mutation system-quantitative polymerase chain reaction (ARMS-qPCR) and linkage analysis for PGD of HA in our laboratory are also provided.
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Affiliation(s)
- Ming Chen
- Department of Genomic Medicine and Center for Medical Genetics, Changhua Christian Hospital, Changhua, Taiwan.,Department of Genomic Science and Technology, Changhua Christian Hospital Healthcare System, Changhua, Taiwan.,Department of Obstetrics and Gynecology, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan.,Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan.,Department of Life Science, Tunghai University, Taichung, Taiwan.,Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan
| | - Shun-Ping Chang
- Department of Genomic Medicine and Center for Medical Genetics, Changhua Christian Hospital, Changhua, Taiwan.,Department of Genomic Science and Technology, Changhua Christian Hospital Healthcare System, Changhua, Taiwan
| | - Gwo-Chin Ma
- Department of Genomic Medicine and Center for Medical Genetics, Changhua Christian Hospital, Changhua, Taiwan.,Department of Genomic Science and Technology, Changhua Christian Hospital Healthcare System, Changhua, Taiwan.,Institute of Biochemistry, Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan.,Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Wen-Hsian Lin
- Department of Genomic Medicine and Center for Medical Genetics, Changhua Christian Hospital, Changhua, Taiwan.,Department of Genomic Science and Technology, Changhua Christian Hospital Healthcare System, Changhua, Taiwan
| | - Hsin-Fu Chen
- Department of Obstetrics and Gynecology, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan
| | - Shee-Uan Chen
- Department of Obstetrics and Gynecology, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan
| | - Horng-Der Tsai
- Institute of Biochemistry, Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan
| | - Feng-Po Tsai
- Po-Yuan Women's Clinic and IVF Center, Changhua, Taiwan
| | - Ming-Ching Shen
- Department of Internal Medicine, and Thrombosis and Hemostasis Center, Changhua Christian Hospital, Changhua, Taiwan
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Breman AM, Chow JC, U'Ren L, Normand EA, Qdaisat S, Zhao L, Henke DM, Chen R, Shaw CA, Jackson L, Yang Y, Vossaert L, Needham RHV, Chang EJ, Campton D, Werbin JL, Seubert RC, Van den Veyver IB, Stilwell JL, Kaldjian EP, Beaudet AL. Evidence for feasibility of fetal trophoblastic cell-based noninvasive prenatal testing. Prenat Diagn 2016; 36:1009-1019. [PMID: 27616633 PMCID: PMC5129580 DOI: 10.1002/pd.4924] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 08/09/2016] [Accepted: 09/05/2016] [Indexed: 12/13/2022]
Abstract
Objective The goal was to develop methods for detection of chromosomal and subchromosomal abnormalities in fetal cells in the mother's circulation at 10–16 weeks' gestation using analysis by array comparative genomic hybridization (CGH) and/or next‐generation sequencing (NGS). Method Nucleated cells from 30 mL of blood collected at 10–16 weeks' gestation were separated from red cells by density fractionation and then immunostained to identify cytokeratin positive and CD45 negative trophoblasts. Individual cells were picked and subjected to whole genome amplification, genotyping, and analysis by array CGH and NGS. Results Fetal cells were recovered from most samples as documented by Y chromosome PCR, short tandem repeat analysis, array CGH, and NGS including over 30 normal male cells, one 47,XXY cell from an affected fetus, one trisomy 18 cell from an affected fetus, nine cells from a trisomy 21 case, three normal cells and one trisomy 13 cell from a case with confined placental mosaicism, and two chromosome 15 deletion cells from a case known by CVS to have a 2.7 Mb de novo deletion. Conclusion We believe that this is the first report of using array CGH and NGS whole genome sequencing to detect chromosomal abnormalities in fetal trophoblastic cells from maternal blood. © 2016 The Authors. Prenatal Diagnosis published by John Wiley & Sons, Ltd. What's already known about this topic?
Analysis of cell‐free DNA for noninvasive prenatal testing (NIPT) is widely practiced, and the frequency of amniocentesis and CVS has decreased. However, cell‐free NIPT is not adequate for detecting smaller deletions and duplications with high specificity, sensitivity, and positive predictive value. Although fetal nucleated red blood cells and trophoblastic cells are known to be present in the maternal circulation, it has not been possible to develop a reliable cytogenetic cell‐based form of NIPT.
What does this study add?
Fetal cytotrophoblasts were successfully recovered from maternal blood. Although a clinical test has not been validated, for the first time, the feasibility of using array comparative genomic hybridization and next generation sequencing to detect chromosomal and subchromosomal abnormalities is demonstrated. The results suggest the possibility of developing a cell‐based form of NIPT with ability to detect abnormalities with a similar accuracy as can currently be obtained with amniocentesis and CVS.
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Affiliation(s)
- Amy M Breman
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | | | | | - Elizabeth A Normand
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Sadeem Qdaisat
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Li Zhao
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - David M Henke
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Rui Chen
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Chad A Shaw
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Laird Jackson
- Department of Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Yaping Yang
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Liesbeth Vossaert
- Department of Molecular and Human Genetics, 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, Baylor College of Medicine, Houston, TX, USA.,Texas Children's Hospital, Houston, TX, USA
| | | | | | - Arthur L Beaudet
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA.,Texas Children's Hospital, Houston, TX, USA
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Kane SC, Willats E, Bezerra Maia e Holanda Moura S, Hyett J, da Silva Costa F. Pre-Implantation Genetic Screening Techniques: Implications for Clinical Prenatal Diagnosis. Fetal Diagn Ther 2016; 40:241-254. [DOI: 10.1159/000449381] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 08/23/2016] [Indexed: 11/19/2022]
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Pundir J, Magdalani L, El-Toukhy T. Outcome of preimplantation genetic diagnosis using FISH analysis for recurrent miscarriage in low-risk reciprocal translocation carriers. Eur J Obstet Gynecol Reprod Biol 2016; 203:214-9. [PMID: 27343738 DOI: 10.1016/j.ejogrb.2016.05.053] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 05/16/2016] [Accepted: 05/31/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess PGD outcome using FISH analysis in couples with a history of recurrent miscarriage associated with a parental carrier of reciprocal translocation. STUDY DESIGN Couples in whom one partner was a carrier of a reciprocal translocation and had a history of two or more miscarriages and a low risk of a live born offspring with an unbalanced chromosomal rearrangement, underwent PGD treatment between 2000 and 2012. RESULTS 91 couples started 171 fresh and 11 frozen PGD cycles. Of the fresh cycles, 162 (95%) reached oocyte retrieval and 107 (63%) had embryo transfer. In 14 cycles (8%), surplus embryos were cryopreserved. Pregnancy was achieved in 52 fresh PGD cycles, leading to 20 miscarriages and 32 live births. Eleven frozen embryo transfer cycles resulted in two miscarriages and three live births. The overall live birth rate was 19% per fresh and frozen PGD cycle started (35/182) and miscarriage rate was 39% per pregnancy (22/57). The cumulative live birth rate was 32% per couple (29/91). CONCLUSION After PGD for recurrent miscarriage in low-risk reciprocal translocation carriers, the miscarriage risk remains high and chance of live birth is low. For those translocation carriers, natural conception may be a better option.
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Affiliation(s)
- Jyotsna Pundir
- Centre of Preimplantation Genetic Diagnosis and Assisted Conception Unit, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, UK.
| | - Laurice Magdalani
- Centre of Preimplantation Genetic Diagnosis and Assisted Conception Unit, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, UK
| | - Tarek El-Toukhy
- Centre of Preimplantation Genetic Diagnosis and Assisted Conception Unit, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, UK
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Distribution patterns of segmental aneuploidies in human blastocysts identified by next-generation sequencing. Fertil Steril 2016; 105:1047-1055.e2. [DOI: 10.1016/j.fertnstert.2015.12.022] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 12/16/2015] [Accepted: 12/16/2015] [Indexed: 01/05/2023]
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Ma GC, Chen HF, Yang YS, Lin WH, Tsai FP, Lin CF, Chiu C, Chen M. A pilot proof-of-principle study to compare fresh and vitrified cycle preimplantation genetic screening by chromosome microarray and next generation sequencing. Mol Cytogenet 2016; 9:25. [PMID: 27006692 PMCID: PMC4802588 DOI: 10.1186/s13039-016-0238-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 03/16/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Single embryo transfer (SET) has been utilized as a strategy to reduce the chance of multifetal gestations in in vitro fertilization (IVF) but lower pregnancy rate remains a concern. Recent studies showed that favorable outcome regarding SET can be achieved by selecting embryos with "more normal" genetic components. We explored the use of rapid array comparative genomic hybridization (aCGH) to select blastocysts for fresh SET and compared with the protocols adopting vitrified (ultrarapidly frozen) embryo transfer cycle. Validation of the rapid protocol of aCGH and comparison of the result with the regular protocol of aCGH and next generation sequencing (NGS) are also performed. RESULTS First-time IVF patients with normal karyotype (n = 21) were enrolled for elective fresh SET cycle (n = 8; designated as fresh SET group) or vitrified embryo transfer cycle (n = 13; designated as vitrified ET group) coupling with comprehensive chromosomal screening by a 9-h rapid aCGH from Day 5 trophectoderm (TE) biopsy. In fresh SET group, 86 blastocysts (10.8 blastocysts/patient) were biopsied and analyzed. Aneuploidy was detected in 53.5 % (46/86) of the biopsied blastocysts. All patients had a single embryo transferred on the following day. The clinical pregnancy rate was 87.5 % (7/8) and the ongoing pregnancy rate was 62.5 % (5/8). In vitrified ET group, 58 blastocysts (4.5 blastocysts/patient) were biopsied and 56 blastocysts were analyzed. Aneuploidy was detected in 39.3 % (22/56) of biopsies. The patients accepted for SET or double embryos transfer (DET) in non-stimulated cycles. The clinical pregnancy rate and the ongoing pregnancy rate was 76.9 % (10/13) and 53.8 % (7/13) respectively. Spontaneous abortions occurred in both of the two patient groups. In the series of fresh SET group, no twin pregnancy was noted and at least one healthy baby had been born at gestational age (GA) 37(+6) weeks when submission. The results of PGS by rapid aCGH, regular aCGH and NGS were comparable in most occasions. CONCLUSION This study evaluates the use of rapid aCGH to select blastocysts for fresh SET and demonstrates its feasibility in a real clinical IVF program. A successful livebirth is achieved and the favorable outcome is superior to the protocol adopting vitrified ET cycle in our own setting. Additional studies are needed to verify this pilot data and validate its application in large randomized trials.
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Affiliation(s)
- Gwo-Chin Ma
- Department of Genomic Medicine and Center for Medical Genetics, Changhua Christian Hospital, Changhua, Taiwan.,Department of Genomic Science and Technology, Changhua Christian Hospital Healthcare System, Changhua, Taiwan.,Institute of Biochemistry, Microbiology and Immunology, Chung-Shan Medical University, Taichung, Taiwan.,Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Hsin-Fu Chen
- Department of Obstetrics and Gynecology, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu-Shih Yang
- Department of Obstetrics and Gynecology, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan
| | - Wen-Hsiang Lin
- Department of Genomic Medicine and Center for Medical Genetics, Changhua Christian Hospital, Changhua, Taiwan.,Department of Genomic Science and Technology, Changhua Christian Hospital Healthcare System, Changhua, Taiwan
| | | | - Chi-Fang Lin
- Department of Obstetrics and Gynecology, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan
| | - Chi Chiu
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming Chen
- Department of Genomic Medicine and Center for Medical Genetics, Changhua Christian Hospital, Changhua, Taiwan.,Department of Genomic Science and Technology, Changhua Christian Hospital Healthcare System, Changhua, Taiwan.,Department of Obstetrics and Gynecology, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan.,Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan.,Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan.,Department of Life Science, Tunghai University, Taichung, Taiwan
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Dahdouh EM, Balayla J, García-Velasco JA. Comprehensive chromosome screening improves embryo selection: a meta-analysis. Fertil Steril 2015; 104:1503-12. [DOI: 10.1016/j.fertnstert.2015.08.038] [Citation(s) in RCA: 119] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 08/26/2015] [Accepted: 08/26/2015] [Indexed: 02/03/2023]
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