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Ozdemir F, Oner G, Kahraman S, Sahin Y, Yelke H. Preferred strategy for euploid single embryo transfer in advanced maternal age: Fresh versus frozen. Clin Exp Reprod Med 2024; 51:85-90. [PMID: 38263591 PMCID: PMC10914499 DOI: 10.5653/cerm.2023.06233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/20/2023] [Accepted: 08/28/2023] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVE The purpose of this study was to compare fresh and frozen-thawed euploid blastocyst transfer protocols following preimplantation genetic screening (PGS) in cases of advanced maternal age. METHODS A total of 330 patients were examined retrospectively. PGS was performed on the embryos of 146 patients for whom fresh transfers were chosen. In contrast, frozen-thawed euploid single embryo transfer (ET) was selected after PGS for 184 patients, and their embryos were vitrified. The percentage of euploid embryos and rates of implantation, pregnancy, and pregnancy continuity, as well as clinical and biochemical abortion rates, were compared. RESULTS The numbers of retrieved oocytes, metaphase II oocytes, and fertilized ova were greater in the frozen-thawed group. The percentages of euploid embryos were comparable between the fresh and frozen-thawed groups (32% vs. 34.8%, respectively). The rates of implantation (46.6%vs. 62.5%), pregnancy (50% vs. 66.8%), ongoing pregnancy (38.4% vs. 53.8%), and live birth percentage (37.0% vs. 53.8%) were significantly higher in the frozen-thawed group. However, no significant differences were found in the clinical and biochemical abortion rates. CONCLUSION The use of frozen-thawed single euploid ET is associated with increased implantation and pregnancy rates compared to fresh single euploid ET with PGS.
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Affiliation(s)
- Fatma Ozdemir
- Department of Obstetrics and Gynecology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Gokalp Oner
- Department of Obstetrics and Gynecology, Kayseri System Hospital, In Vitro Fertilisation Center, Kayseri, Turkey
| | - Semra Kahraman
- Department of Obstetrics and Gynecology, Sisli Memorial Hospital, In Vitro Fertilisation Center, Istanbul, Turkey
| | - Yucel Sahin
- Department of Obstetrics and Gynecology, Sisli Memorial Hospital, In Vitro Fertilisation Center, Istanbul, Turkey
| | - Hakan Yelke
- Department of Obstetrics and Gynecology, Sisli Memorial Hospital, In Vitro Fertilisation Center, Istanbul, Turkey
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Cimadomo D, Rienzi L, Conforti A, Forman E, Canosa S, Innocenti F, Poli M, Hynes J, Gemmell L, Vaiarelli A, Alviggi C, Ubaldi FM, Capalbo A. Opening the black box: why do euploid blastocysts fail to implant? A systematic review and meta-analysis. Hum Reprod Update 2023; 29:570-633. [PMID: 37192834 DOI: 10.1093/humupd/dmad010] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 03/22/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND A normal chromosomal constitution defined through PGT-A assessing all chromosomes on trophectoderm (TE) biopsies represents the strongest predictor of embryo implantation. Yet, its positive predictive value is not higher than 50-60%. This gap of knowledge on the causes of euploid blastocysts' reproductive failure is known as 'the black box of implantation'. OBJECTIVE AND RATIONALE Several embryonic, maternal, paternal, clinical, and IVF laboratory features were scrutinized for their putative association with reproductive success or implantation failure of euploid blastocysts. SEARCH METHODS A systematic bibliographical search was conducted without temporal limits up to August 2021. The keywords were '(blastocyst OR day5 embryo OR day6 embryo OR day7 embryo) AND (euploid OR chromosomally normal OR preimplantation genetic testing) AND (implantation OR implantation failure OR miscarriage OR abortion OR live birth OR biochemical pregnancy OR recurrent implantation failure)'. Overall, 1608 items were identified and screened. We included all prospective or retrospective clinical studies and randomized-controlled-trials (RCTs) that assessed any feature associated with live-birth rates (LBR) and/or miscarriage rates (MR) among non-mosaic euploid blastocyst transfer after TE biopsy and PGT-A. In total, 41 reviews and 372 papers were selected, clustered according to a common focus, and thoroughly reviewed. The PRISMA guideline was followed, the PICO model was adopted, and ROBINS-I and ROB 2.0 scoring were used to assess putative bias. Bias across studies regarding the LBR was also assessed using visual inspection of funnel plots and the trim and fill method. Categorical data were combined with a pooled-OR. The random-effect model was used to conduct the meta-analysis. Between-study heterogeneity was addressed using I2. Whenever not suitable for the meta-analysis, the included studies were simply described for their results. The study protocol was registered at http://www.crd.york.ac.uk/PROSPERO/ (registration number CRD42021275329). OUTCOMES We included 372 original papers (335 retrospective studies, 30 prospective studies and 7 RCTs) and 41 reviews. However, most of the studies were retrospective, or characterized by small sample sizes, thus prone to bias, which reduces the quality of the evidence to low or very low. Reduced inner cell mass (7 studies, OR: 0.37, 95% CI: 0.27-0.52, I2 = 53%), or TE quality (9 studies, OR: 0.53, 95% CI: 0.43-0.67, I2 = 70%), overall blastocyst quality worse than Gardner's BB-grade (8 studies, OR: 0.40, 95% CI: 0.24-0.67, I2 = 83%), developmental delay (18 studies, OR: 0.56, 95% CI: 0.49-0.63, I2 = 47%), and (by qualitative analysis) some morphodynamic abnormalities pinpointed through time-lapse microscopy (abnormal cleavage patterns, spontaneous blastocyst collapse, longer time of morula formation I, time of blastulation (tB), and duration of blastulation) were all associated with poorer reproductive outcomes. Slightly lower LBR, even in the context of PGT-A, was reported among women ≥38 years (7 studies, OR: 0.87, 95% CI: 0.75-1.00, I2 = 31%), while obesity was associated with both lower LBR (2 studies, OR: 0.66, 95% CI: 0.55-0.79, I2 = 0%) and higher MR (2 studies, OR: 1.8, 95% CI: 1.08-2.99, I2 = 52%). The experience of previous repeated implantation failures (RIF) was also associated with lower LBR (3 studies, OR: 0.72, 95% CI: 0.55-0.93, I2 = 0%). By qualitative analysis, among hormonal assessments, only abnormal progesterone levels prior to transfer were associated with LBR and MR after PGT-A. Among the clinical protocols used, vitrified-warmed embryo transfer was more effective than fresh transfer (2 studies, OR: 1.56, 95% CI: 1.05-2.33, I2 = 23%) after PGT-A. Lastly, multiple vitrification-warming cycles (2 studies, OR: 0.41, 95% CI: 0.22-0.77, I2 = 50%) or (by qualitative analysis) a high number of cells biopsied may slightly reduce the LBR, while simultaneous zona-pellucida opening and TE biopsy allowed better results than the Day 3 hatching-based protocol (3 studies, OR: 1.41, 95% CI: 1.18-1.69, I2 = 0%). WIDER IMPLICATIONS Embryo selection aims at shortening the time-to-pregnancy, while minimizing the reproductive risks. Knowing which features are associated with the reproductive competence of euploid blastocysts is therefore critical to define, implement, and validate safer and more efficient clinical workflows. Future research should be directed towards: (i) systematic investigations of the mechanisms involved in reproductive aging beyond de novo chromosomal abnormalities, and how lifestyle and nutrition may accelerate or exacerbate their consequences; (ii) improved evaluation of the uterine and blastocyst-endometrial dialogue, both of which represent black boxes themselves; (iii) standardization/automation of embryo assessment and IVF protocols; (iv) additional invasive or preferably non-invasive tools for embryo selection. Only by filling these gaps we may finally crack the riddle behind 'the black box of implantation'.
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Affiliation(s)
- Danilo Cimadomo
- IVIRMA Global Research Alliance, GENERA, Clinica Valle Giulia, Rome, Italy
| | - Laura Rienzi
- IVIRMA Global Research Alliance, GENERA, Clinica Valle Giulia, Rome, Italy
- Department of Biomolecular Sciences, University of Urbino "Carlo Bo", Urbino, Italy
| | - Alessandro Conforti
- Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy
| | - Eric Forman
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Columbia University Irving Medical Centre, New York, NY, USA
| | | | - Federica Innocenti
- IVIRMA Global Research Alliance, GENERA, Clinica Valle Giulia, Rome, Italy
| | - Maurizio Poli
- Centrum voor Kinderwens, Dijklander Hospital, Purmerend, The Netherlands
- Juno Genetics, Rome, Italy
| | - Jenna Hynes
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Columbia University Irving Medical Centre, New York, NY, USA
| | - Laura Gemmell
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Columbia University Irving Medical Centre, New York, NY, USA
| | - Alberto Vaiarelli
- IVIRMA Global Research Alliance, GENERA, Clinica Valle Giulia, Rome, Italy
| | - Carlo Alviggi
- Department of Public Health, Federico II University, Naples, Italy
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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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Gao FF, Chen L, Bo SP, Yao YX, Xu ZL, Ding QY, Zhang P, Lu SJ, Ren J. ChromInst: A single cell sequencing technique to accomplish pre-implantation comprehensive chromosomal screening overnight. PLoS One 2021; 16:e0251971. [PMID: 34015059 PMCID: PMC8136696 DOI: 10.1371/journal.pone.0251971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 05/07/2021] [Indexed: 11/18/2022] Open
Abstract
Next Generation Sequencing (NGS) is a powerful tool getting into the field of clinical examination. Its preliminary application in pre-implantation comprehensive chromosomal screening (PCCS) of assisted reproduction (test-tube baby) has shown encouraging outcomes that improves the success rate of in vitro fertilization. However, the conventional NGS library construction is time consuming. In addition with the whole genome amplification (WGA) procedure in prior, makes the single cell NGS assay hardly be accomplished within an adequately short turnover time in supporting fresh embryo implantation. In this work, we established a concise single cell sequencing protocol, ChromInst, in which the single cell WGA and NGS library construction were integrated into a two-step PCR procedure of ~ 2.5hours reaction time. We then validated the feasibility of ChromInst for overnight PCCS assay by examining 14 voluntary donated embryo biopsy samples in a single sequencing run of Miseq with merely 13M reads production. The good compatibility of ChromInst with the restriction of Illumina sequencing technique along with the good library yield uniformity resulted superior data usage efficiency and reads distribution evenness that ensures precisely distinguish of 6 normal embryos from 8 abnormal one with variable chromosomal aneuploidy. The superior succinctness and effectiveness of this protocol permits its utilization in other time limited single cell NGS applications.
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Affiliation(s)
- Fang-Fang Gao
- Department of Research and Development, Yikon Genomics (Suzhou) Company Limited, Suzhou, Jiangsu, PR China
| | - Li Chen
- Department of Reproductive Medicine, Affiliated Jinling Hospital, Medicine School of Nanjing University, Nanjing, PR China
| | - Shi-Ping Bo
- Department of Research and Development, Yikon Genomics (Suzhou) Company Limited, Suzhou, Jiangsu, PR China
| | - Ya-Xin Yao
- Department of Research and Development, Yikon Genomics (Suzhou) Company Limited, Suzhou, Jiangsu, PR China
| | - Zhong-Li Xu
- Department of Research and Development, Yikon Genomics (Suzhou) Company Limited, Suzhou, Jiangsu, PR China
| | - Qing-Yu Ding
- Department of Research and Development, Yikon Genomics (Suzhou) Company Limited, Suzhou, Jiangsu, PR China
| | - Peng Zhang
- Department of Research and Development, Yikon Genomics (Suzhou) Company Limited, Suzhou, Jiangsu, PR China
| | - Si-Jia Lu
- Department of Research and Development, Yikon Genomics (Suzhou) Company Limited, Suzhou, Jiangsu, PR China
| | - Jun Ren
- Department of Research and Development, Yikon Genomics (Suzhou) Company Limited, Suzhou, Jiangsu, PR China
- * E-mail:
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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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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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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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Roque M, Haahr T, Geber S, Esteves SC, Humaidan P. Fresh versus elective frozen embryo transfer in IVF/ICSI cycles: a systematic review and meta-analysis of reproductive outcomes. Hum Reprod Update 2018; 25:2-14. [DOI: 10.1093/humupd/dmy033] [Citation(s) in RCA: 212] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 10/04/2018] [Indexed: 01/15/2023] Open
Affiliation(s)
- Matheus Roque
- Department of Reproductive Medicine, ORIGEN—Center for Reproductive Medicine, Rio de Janeiro, RJ, Brazil
- Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Thor Haahr
- Department of Clinical Medicine, Aarhus University, Denmark and the Fertility Clinic Skive, Skive Regional Hospital, Resenvej 25, Skive, Denmark
| | - Selmo Geber
- Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
- Department of Reproductive Medicine, ORIGEN—Center for Reproductive Medicine, Belo Horizonte, MG, Brazil
| | - Sandro C Esteves
- Department of Clinical Medicine, Aarhus University, Denmark and the Fertility Clinic Skive, Skive Regional Hospital, Resenvej 25, Skive, Denmark
- ANDROFERT, Andrology and Human Reproduction Clinic, Campinas, SP, Brazil
- Department of Surgery, University of Campinas (UNICAMP), Campinas, Brazil
| | - Peter Humaidan
- Department of Clinical Medicine, Aarhus University, Denmark and the Fertility Clinic Skive, Skive Regional Hospital, Resenvej 25, Skive, Denmark
- ANDROFERT, Andrology and Human Reproduction Clinic, Campinas, SP, Brazil
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Schoolcraft W, Meseguer M. Paving the way for a gold standard of care for infertility treatment: improving outcomes through standardization of laboratory procedures. Reprod Biomed Online 2017; 35:391-399. [DOI: 10.1016/j.rbmo.2017.06.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 06/27/2017] [Accepted: 06/27/2017] [Indexed: 12/15/2022]
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10
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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: 30] [Impact Index Per Article: 4.3] [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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11
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Fedorova EM, Shlykova SA, Shunkina KV, Zaitceva OG, Lapina EN, Yanchuk TV, Kalugina AS. Outcomes of IVF cycles coupled with PGS by aCGH of embryos from donor and autologous oocytes, transferred after vitrification to women of advanced maternal age. Gynecol Endocrinol 2017; 33:737-740. [PMID: 28617148 DOI: 10.1080/09513590.2017.1318274] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
It is well documented that aneuploidy rate in preimplantation embryos increases with the mother's age, and at the same time the number of oocytes diminishes. Consequently, for patients of advanced maternal age two options are available to overcome these limitations: use of oocytes from young donors, or use of own oocytes coupled with preimplantation genetic screening (PGS) for 24 chromosomes. However, it is not clear which strategy might be more effective. The aim of this retrospective study was to evaluate outcomes of IVF cycles coupled with transfer of vitrified embryos from donor or autologous oocytes, both with or without PGS. Our results demonstrate that while after PGS clinical pregnancy, twin pregnancy and spontaneous abortion rates are similar for embryos from donor and autologous oocytes, these rates are dramatically worse in all cycles without PGS. Therefore, PGS can be recommended as a screening method to all patients of advanced maternal age even when donor oocytes are used.
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12
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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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13
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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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