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Chang TY, Chen SW, Lin WH, Huang CE, Evans MI, Chung IF, Wu JW, Ma GC, Chen M. Comparison of Genetic Profiling between Primary Tumor and Circulating Tumor Cells Captured by Microfluidics in Epithelial Ovarian Cancer: Tumor Heterogeneity or Allele Dropout? Diagnostics (Basel) 2021; 11:diagnostics11061102. [PMID: 34208639 PMCID: PMC8234832 DOI: 10.3390/diagnostics11061102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/11/2021] [Accepted: 06/14/2021] [Indexed: 01/16/2023] Open
Abstract
Epithelial ovarian cancer (EOC) is a leading cause of cancer mortality among women but unfortunately is usually not diagnosed until advanced stage. Early detection of EOC is of paramount importance to improve outcomes. Liquid biopsy of circulating tumor cells (CTCs) is emerging as one of the promising biomarkers for early detection of solid tumors. However, discrepancies in terms of oncogenomics (i.e., different genetic defects detected) between the germline, primary tumor, and liquid biopsy are a serious concern and may adversely affect downstream cancer management. Here, we illustrate the potential and pitfalls of CTCs by presenting two patients of Stage I EOC. We successfully isolated and recovered CTCs by a silicon-based nanostructured microfluidics system, the automated Cell RevealTM. We examined the genomics of CTCs as well as the primary tumor and germline control (peripheral blood mononuclear cells) by whole exome sequencing. Different signatures were then investigated by comparisons of identified mutation loci distinguishing those that may only arise in the primary tumor or CTCs. A novel model is proposed to test if the highly variable allele frequencies, between primary tumor and CTCs results, are due to allele dropout in plural CTCs or tumor heterogeneity. This proof-of-principle study provides a strategy to elucidate the possible cause of genomic discrepancy between the germline, primary tumor, and CTCs, which is helpful for further large-scale use of such technology to be integrated into clinical management protocols.
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Affiliation(s)
- Ting-Yu Chang
- Department of Genomic Medicine, Changhua Christian Hospital, Changhua 50046, Taiwan;
- Department of Research, Changhua Christian Hospital, Changhua 50006, Taiwan
- Department of Bioscience Technology, Chung Yuan Christian University, Taoyuan 32023, Taiwan
| | - Sheng-Wen Chen
- Department of Electrical Engineering, National Chung Cheng University, Chiayi 62102, Taiwan;
- Cytoaurora Biotechnologies Inc., Hsinchu Science Park, Hsinchu 30261, Taiwan;
| | - Wen-Hsiang Lin
- Welgene Biotechnology Company, Nangang Business Park, Taipei 11503, Taiwan;
| | - Chung-Er Huang
- Cytoaurora Biotechnologies Inc., Hsinchu Science Park, Hsinchu 30261, Taiwan;
| | - Mark I. Evans
- Comprehensive Genetics, New York, NY 10065, USA;
- Department of Obstetrics and Gynecology, Icahn School of Medicine at Mt. Sinai, New York, NY 10029, USA
| | - I-Fang Chung
- Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan;
| | - Janne-Wha Wu
- Department of Electrical Engineering, National Chung Cheng University, Chiayi 62102, Taiwan;
- Department of Communications Engineering, National Chung Cheng University, Chiayi 62102, Taiwan
- Correspondence: (J.-W.W.); (G.-C.M.); (M.C.); Tel.: +886-5-272-0411 (ext. 33519) (J.-W.W.); +886-4-723-8595 (ext. 2319) (G.-C.M.); +886-4-723-8595 (ext. 2323) (M.C.)
| | - Gwo-Chin Ma
- Department of Genomic Medicine, Changhua Christian Hospital, Changhua 50046, Taiwan;
- Department of Research, Changhua Christian Hospital, Changhua 50006, Taiwan
- Department of Biomedical Engineering, Chung Yuan Christian University, Taoyuan 32023, Taiwan
- Correspondence: (J.-W.W.); (G.-C.M.); (M.C.); Tel.: +886-5-272-0411 (ext. 33519) (J.-W.W.); +886-4-723-8595 (ext. 2319) (G.-C.M.); +886-4-723-8595 (ext. 2323) (M.C.)
| | - Ming Chen
- Department of Genomic Medicine, Changhua Christian Hospital, Changhua 50046, Taiwan;
- Department of Research, Changhua Christian Hospital, Changhua 50006, Taiwan
- Department of Obstetrics and Gynecology, College of Medicine and Hospital, National Taiwan University, Taipei 100225, Taiwan
- Department of Biomedical Science, Dayeh University, Changhua 515006, Taiwan
- Department of Medical Sciences, National Tsing Hua University, Hsinchu 300044, Taiwan
- Correspondence: (J.-W.W.); (G.-C.M.); (M.C.); Tel.: +886-5-272-0411 (ext. 33519) (J.-W.W.); +886-4-723-8595 (ext. 2319) (G.-C.M.); +886-4-723-8595 (ext. 2323) (M.C.)
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Chen HF, Chen M, Ho HN. An overview of the current and emerging platforms for preimplantation genetic testing for aneuploidies (PGT-A) in in vitro fertilization programs. Taiwan J Obstet Gynecol 2021; 59:489-495. [PMID: 32653118 DOI: 10.1016/j.tjog.2020.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2020] [Indexed: 01/16/2023] Open
Abstract
Preimplantation genetic testing for aneuploidies (PGT-A) and PGT for monogenic disorders (PGT-M) have currently been used widely, aiming to improve IVF outcomes. Although with many years of unsatisfactory results, PGT-A has been revived because new technologies have been adopted, such as platforms to examine all 24 types of chromosomes in blastocysts. This report compiles current knowledge regarding the available PGT platforms, including quantitative PCR, array CGH, and next-generation sequencing. The diagnostic capabilities of are compared and respective advantages/disadvantages outlined. We also address the limitations of current technologies, such as assignment of embryos with balanced translocation. We also discuss the emerging novel PGT technologies that likely will change our future practice, such as non-invasive PGT examining spent culture medium. Current literature suggest that most platforms can effectively reach concordant results regarding whole-chromosome ploidy status of all 24 types of chromosomes. However, different platforms have different resolutions and experimental complexities; leading to different turnaround time, throughput and differential capabilities of detecting mosaicism, segmental mutations, unbalanced translocations, concurrent PGT-A and PGT-M etc. Based on these information, IVF staff can more appropriately interpret PGT data and counsel patients, and select suitable platforms to meet personalized needs. The present report also concisely discusses some crucial clinical outcomes by PGT, which can clarify the role of applying PGT in daily IVF programs. Finally the up-to-date information about the novel use of current technologies and the newly emerging technologies will also help identify the focus areas for the design of new platforms for PGT in the future.
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Affiliation(s)
- Hsin-Fu Chen
- Department of Obstetrics and Gynecology, College of Medicine and the Hospital, National Taiwan University, Taipei, Taiwan; Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Ming Chen
- Department of Medical Genetics, College of Medicine and the Hospital, National Taiwan University, Taipei, Taiwan; Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan; Department of Genomic Medicine and Center for Medical Genetics, Changhua Christian Hospital, Changhua, Taiwan.
| | - Hong-Nerng Ho
- Department of Obstetrics and Gynecology, College of Medicine and the Hospital, National Taiwan University, Taipei, Taiwan; Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Immunology, College of Medicine, National Taiwan University, Taiwan.
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A clinical counseling tool predicting supernumerary embryos after a fresh IVF cycle. J Assist Reprod Genet 2020; 37:1137-1145. [PMID: 32152909 DOI: 10.1007/s10815-020-01731-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 02/28/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE To identify factors predictive of having supernumerary embryos in a fresh IVF cycle and create a prediction model for clinical counseling. METHODS We utilized a multivariable Poisson regression to identify predictive factors and then entered these into a logistic regression model, calculating a risk index for each significant variable. The final model was tested using a receiver operating characteristic curve. RESULTS A total of 60,616 fresh transfer cycles were reported to the Society for Assisted Reproductive Technology in 2014. Of these, 47.17% produced supernumerary embryos. A multivariate Poisson regression identified factors predictive of having supernumerary embryos, with age and AMH being the most predictive. Clinical prediction models were developed with acceptable and excellent discrimination. 23.5% of our cohort did not achieve a live birth following their fresh transfer and had excess embryos cryopreserved for future attempts. CONCLUSION Our study suggests that in a minority of fresh IVF cycles in the USA, the fresh transfer is not successful, and there are excess embryos cryopreserved for future use. The likelihood of excess embryos beyond those that would be transferred can be predicted with satisfactory precision prior to initiation of the cycle and with improved precision after fresh embryo transfer. Providing patients with a realistic estimate of their chances of having excess embryos at an initial IVF consult especially those with suspected poor prognosis can be beneficial in determining whether to proceed with multiple embryo banking cycles as opposed to proceeding with a fresh transfer, and whether to opt for an enhanced embryo selection technique such as preimplantation genetic testing for aneuploidy (PGT-A).
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Liao CH, Chang MY, Ma GC, Chang SP, Lin CF, Lin WH, Chen HF, Chen SU, Lee YC, Chao CC, Chen M, Hsieh ST. Preimplantation Genetic Diagnosis of Neurodegenerative Diseases: Review of Methodologies and Report of Our Experience as a Regional Reference Laboratory. Diagnostics (Basel) 2019; 9:E44. [PMID: 31018485 PMCID: PMC6627755 DOI: 10.3390/diagnostics9020044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/02/2019] [Accepted: 04/09/2019] [Indexed: 12/31/2022] Open
Abstract
Preimplantation genetic diagnosis (PGD) has become a crucial approach in helping carriers of inherited disorders to give birth to healthy offspring. In this study, we review PGD methodologies and explore the use of amplification refractory mutation system quantitative polymerase chain reaction (ARMS-qPCR) and/or linkage analysis for PGD in neurodegenerative diseases that are clinically relevant with typical features, such as late onset, and which are severely debilitating. A total of 13 oocyte retrieval cycles were conducted in 10 cases with various neurodegenerative diseases. Among the 59 embryos analyzed, 49.2% (29/59) were unaffected and 50.8% (30/59) were affected. Of the 12 embryo transfer cycles, three resulted in pregnancy, and all pregnancies were delivered. The implantation rate and livebirth rate were 23.1% (3/13) per oocyte retrieval cycle and 25.0% (3/12) per embryo transfer cycle. Allele dropout (ADO) was noted in two embryos that were classified as unaffected by ARMS-qPCR but were evidenced as affected after prenatal diagnosis, rendering the false negative rate as 6.3% (2/32). Four among the 13 cycles underwent PGD by ARMS-qPCR coupled with linkage analysis, and all were correctly diagnosed. We conclude that PGD by ARMS-qPCR and/or linkage analysis is a feasible strategy, whereas ADO is a concern when ARMS-qPCR is used as the sole technology in PGD, especially in autosomal dominant diseases.
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Affiliation(s)
- Chun-Hua Liao
- Department of Pediatrics, National Taiwan University Children's Hospital, Taipei 10041, Taiwan.
| | - Ming-Yuh Chang
- Division of Pediatric Neurology, Department of Pediatrics, Changhua Christian Children's Hospital, Changhua 50050, Taiwan.
| | - Gwo-Chin Ma
- Department of Genomic Medicine and Center for Medical Genetics, Changhua Christian Hospital, Changhua 50046, Taiwan.
- Department of Genomic Science and Technology, Changhua Christian Hospital Healthcare System, Changhua Christian Hospital, Changhua 50046, Taiwan.
- Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung 40601, Taiwan.
| | - Shun-Ping Chang
- Department of Genomic Medicine and Center for Medical Genetics, Changhua Christian Hospital, Changhua 50046, Taiwan.
- Department of Genomic Science and Technology, Changhua Christian Hospital Healthcare System, Changhua Christian Hospital, Changhua 50046, Taiwan.
| | - Chi-Fang Lin
- Department of Obstetrics and Gynecology, College of Medicine and Hospital, National Taiwan University, Taipei 10041, Taiwan.
| | - Wen-Hsiang Lin
- Department of Genomic Medicine and Center for Medical Genetics, Changhua Christian Hospital, Changhua 50046, Taiwan.
- Department of Genomic Science and Technology, Changhua Christian Hospital Healthcare System, Changhua Christian Hospital, Changhua 50046, Taiwan.
| | - Hsin-Fu Chen
- Department of Obstetrics and Gynecology, College of Medicine and Hospital, National Taiwan University, Taipei 10041, Taiwan.
- Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei 10051, Taiwan.
| | - Shee-Uan Chen
- Department of Obstetrics and Gynecology, College of Medicine and Hospital, National Taiwan University, Taipei 10041, Taiwan.
| | - Yi-Chung Lee
- Department of Neurology, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
| | - Chi-Chao Chao
- Department of Neurology, National Taiwan University Hospital, Taipei 10048, Taiwan.
| | - Ming Chen
- Department of Genomic Medicine and Center for Medical Genetics, Changhua Christian Hospital, Changhua 50046, Taiwan.
- Department of Genomic Science and Technology, Changhua Christian Hospital Healthcare System, Changhua Christian Hospital, Changhua 50046, Taiwan.
- Department of Obstetrics and Gynecology, College of Medicine and Hospital, National Taiwan University, Taipei 10041, Taiwan.
- Department of Life Science, Tunghai University, Taichung 40704, Taiwan.
- Department of Molecular Biotechnology, Da-Yeh University, Changhua 51591, Taiwan.
| | - Sung-Tsang Hsieh
- Department of Neurology, National Taiwan University Hospital, Taipei 10048, Taiwan.
- Department of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei 10051, Taiwan.
- Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei 10051, Taiwan.
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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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Bouvier S, Paulmyer-Lacroix O, Molinari N, Bertaud A, Paci M, Leroyer A, Robert S, Dignat George F, Blot-Chabaud M, Bardin N. Soluble CD146, an innovative and non-invasive biomarker of embryo selection for in vitro fertilization. PLoS One 2017; 12:e0173724. [PMID: 28291830 PMCID: PMC5349662 DOI: 10.1371/journal.pone.0173724] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 02/24/2017] [Indexed: 11/21/2022] Open
Abstract
Although progress was made in in vitro fertilization (IVF) techniques, the majority of embryos transferred fail to implant. Morphology embryo scoring is the standard procedure for most of IVF centres for choosing the best embryo, but remains limited since even the embryos classified as "top quality" may not implant. As it has been shown that i) CD146 is involved in embryo implantation and ii) membrane form is shed to generate soluble CD146 (sCD146), we propose that sCD146 in embryo supernatants may constitute a new biomarker of embryo selection. Immunocytochemical staining showed expression of CD146 in early embryo stages and sCD146 was detected by ELISA and Western-blot in embryo supernatants from D2. We retrospectively studied 126 couples who underwent IVF attempt. The embryo culture medium from each transferred embryo (n = 222) was collected for measurement of sCD146 by ELISA. Significantly higher sCD146 concentrations were present in embryo supernatants that did not implant (n = 185) as compared to those that successfully implanted (n = 37) (1310 +/- 1152 pg.mL-1 vs. 845+/- 1173 pg.mL-1, p = 0.024). Sensitivity analysis performed on single embryo transfers (n = 71) confirmed this association (p = 0.0054). The computed ROC curve established that the optimal sCD146 concentration for embryo implantation is under 1164 pg.mL-1 (sensitivity: 76%, specificity: 48%, PPV: 25% and NPV: 92%). Over this sCD146 threshold, the implantation rate was significantly lower (9% with sCD146 levels >1164 pg.ml-1 vs. 22% with sCD146 levels ≤ 1164 pg.mL-1, p = 0.01). Among the embryos preselected by morphologic scoring, sCD146 determination could allow a better selection of the embryo(s), thus improving the success of elective single embryo transfer. This study establishes the proof of concept for the use of sCD146 as a biomarker for IVF by excluding the embryo with the highest sCD146 level. A multicentre prospective study will now be necessary to further establish its use in clinical practice.
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Affiliation(s)
| | - Odile Paulmyer-Lacroix
- Assisted Reproductive Center, Laboratory of Reproduction, CHU La Conception, AP-HM, Marseille and Laboratory of Histology-Embryology/Biology of Reproduction, Aix-Marseille University, Marseille, France
| | - Nicolas Molinari
- PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, Montpellier, France
| | | | - Marine Paci
- Assisted Reproductive Center, Laboratory of Reproduction, CHU La Conception, AP-HM, Marseille and Laboratory of Histology-Embryology/Biology of Reproduction, Aix-Marseille University, Marseille, France
| | | | | | | | | | - Nathalie Bardin
- Aix Marseille Univ, Inserm U1076, Marseille, France
- Immunology Laboratory, Pole de Biologie, CHU Conception Marseille, AP-HM, Marseille, France
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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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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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