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Verdyck P, Altarescu G, Santos-Ribeiro S, Vrettou C, Koehler U, Griesinger G, Goossens V, Magli C, Albanese C, Parriego M, Coll L, Ron-El R, Sermon K, Traeger-Synodinos J. Aneuploidy in oocytes from women of advanced maternal age: analysis of the causal meiotic errors and impact on embryo development. Hum Reprod 2023; 38:2526-2535. [PMID: 37814912 DOI: 10.1093/humrep/dead201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 09/06/2023] [Indexed: 10/11/2023] Open
Abstract
STUDY QUESTION In oocytes of advanced maternal age (AMA) women, what are the mechanisms leading to aneuploidy and what is the association of aneuploidy with embryo development? SUMMARY ANSWER Known chromosome segregation errors such as precocious separation of sister chromatids explained 90.4% of abnormal chromosome copy numbers in polar bodies (PBs), underlying impaired embryo development. WHAT IS KNOWN ALREADY Meiotic chromosomal aneuploidies in oocytes correlate with AMA (>35 years) and can affect over half of oocytes in this age group. This underlies the rationale for PB biopsy as a form of early preimplantation genetic testing for aneuploidy (PGT-A), as performed in the 'ESHRE STudy into the Evaluation of oocyte Euploidy by Microarray analysis' (ESTEEM) randomized controlled trial (RCT). So far, chromosome analysis of oocytes and PBs has shown that precocious separation of sister chromatids (PSSC), Meiosis II (MII) non-disjunction (ND), and reverse segregation (RS) are the main mechanisms leading to aneuploidy in oocytes. STUDY DESIGN, SIZE, DURATION Data were sourced from the ESTEEM study, a multicentre RCT from seven European centres to assess the clinical utility of PGT-A on PBs using array comparative genomic hybridization (aCGH) in patients of AMA (36-40 years). This included data on the chromosome complement in PB pairs (PGT-A group), and on embryo morphology in a subset of embryos, up to Day 6 post-insemination, from both the intervention (PB biopsy and PGT-A) and control groups. PARTICIPANTS/MATERIALS, SETTING, METHODS ESTEEM recruited 396 AMA patients: 205 in the intervention group and 191 in the control group. Complete genetic data from 693 PB pairs were analysed. Additionally, the morphology from 1034 embryos generated from fertilized oocytes (two pronuclei) in the PB biopsy group and 1082 in the control group were used for statistical analysis. MAIN RESULTS AND THE ROLE OF CHANCE Overall, 461/693 PB pairs showed abnormal segregation in 1162/10 810 chromosomes. The main observed abnormal segregations were compatible with PSSC in Meiosis I (MI) (n = 568/1162; 48.9%), ND of chromatids in MII or RS (n = 417/1162; 35.9%), and less frequently ND in MI (n = 65/1162; 5.6%). For 112 chromosomes (112/1162; 9.6%), we observed a chromosome copy number in the first PB (PB1) and second PB (PB2) that is not explained by any of the known mechanisms causing aneuploidy in oocytes. We observed that embryos in the PGT-A arm of the RCT did not have a significantly different morphology between 2 and 6 days post-insemination compared to the control group, indicating that PB biopsy did not affect embryo quality. Following age-adjusted multilevel mixed-effect ordinal logistic regression models performed for each embryo evaluation day, aneuploidy was associated with a decrease in embryo quality on Day 3 (adjusted odds ratio (aOR) 0.62, 95% CI 0.43-0.90), Day 4 (aOR 0.15, 95% CI 0.06-0.39), and Day 5 (aOR 0.28, 95% CI 0.14-0.58). LIMITATIONS, REASON FOR CAUTION RS cannot be distinguished from normal segregation or MII ND using aCGH. The observed segregations were based on the detected copy number of PB1 and PB2 only and were not confirmed by the analysis of embryos. The embryo morphology assessment was static and single observer. WIDER IMPLICATIONS OF THE FINDINGS Our finding of frequent unexplained chromosome copy numbers in PBs indicates that our knowledge of the mechanisms causing aneuploidy in oocytes is incomplete. It challenges the dogma that aneuploidy in oocytes is exclusively caused by mis-segregation of chromosomes during MI and MII. STUDY FUNDING/COMPETING INTEREST(S) Data were mined from a study funded by ESHRE. Illumina provided microarrays and other consumables necessary for aCGH testing of PBs. None of the authors have competing interests. TRIAL REGISTRATION NUMBER Data were mined from the ESTEEM study (ClinicalTrials.gov Identifier NCT01532284).
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Affiliation(s)
- P Verdyck
- Centre for Medical Genetics, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
- Research Group Reproduction and Genetics, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - G Altarescu
- Shaare-Zedek Medical Center, The Hebrew University School of Medicine, Jerusalem, Israël
| | - S Santos-Ribeiro
- IVI-RMA Lisboa, Lisbon, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - C Vrettou
- Laboratory of Medical Genetics, National and Kapodistrian University of Athens, 'Aghia Sophia' Children's Hospital, Athens, Greece
| | - U Koehler
- MGZ-Medizinisch Genetisches Zentrum, Munich, Germany
| | - G Griesinger
- Department of Gynecological Endocrinology and Reproductive Medicine, University Hospital of Schleswig-Holstein, Campus Luebeck, Lübeck, Germany
| | - V Goossens
- The European Society of Human Reproduction and Embryology, Strombeek-Bever, Belgium
| | - C Magli
- SISMER, Reproductive Medicine Unit, Bologna, Italy
| | - C Albanese
- SISMER, Reproductive Medicine Unit, Bologna, Italy
| | - M Parriego
- Department of Obstetrics, Gynecology and Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
| | - L Coll
- Department of Obstetrics, Gynecology and Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
| | - R Ron-El
- Shaare-Zedek Medical Center, The Hebrew University School of Medicine, Jerusalem, Israël
| | - K Sermon
- Research Group Reproduction and Genetics, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - J Traeger-Synodinos
- Laboratory of Medical Genetics, National and Kapodistrian University of Athens, 'Aghia Sophia' Children's Hospital, Athens, Greece
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Kakourou G, Kahraman S, Ekmekci GC, Tac HA, Kourlaba G, Kourkouni E, Sanz AC, Martin J, Malmgren H, Giménez C, Gold V, Carvalho F, Billi C, Chow JFC, Vendrell X, Kokkali G, Liss J, Steffann J, Traeger-Synodinos J. The clinical utility of PGD with HLA matching: a collaborative multi-centre ESHRE study. Hum Reprod 2019; 33:520-530. [PMID: 29432583 DOI: 10.1093/humrep/dex384] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 12/26/2017] [Indexed: 12/16/2022] Open
Abstract
STUDY QUESTION Has PGD-HLA been successful relative to diagnostic and clinical efficacy? SUMMARY ANSWER The diagnostic efficacy of PGD-HLA protocols was found lower in this study in comparison to published PGD-HLA protocols and to that reported for general PGD by ESHRE (78.5 vs 94.1% and vs 92.6%, respectively), while the clinical efficacy has proven very difficult to assess due to inadequate follow-up of both the ART/PGD and HSCT procedure outcomes. WHAT IS KNOWN ALREADY The first clinical cases for PGD-HLA were reported in 2001. It is now a well-established procedure, with an increasing number of cycles performed every year. However, PGD-HLA is still offered by relatively few PGD centres, the currently available data is fragmented and most reports on PGD-HLA applications are limited in number and scope. Published systematic details on methodology, diagnostic results, overall ART success and haematopoietic stem cell transplantation (HSCT) outcomes are limited, precluding an evaluation of the true clinical utility of PGD-HLA cycles. STUDY DESIGN, SIZE, DURATION This retrospective multi-centre cohort study aimed to investigate the diagnostic and clinical efficacy of the PGD-HLA procedure and the aspects of PGD-HLA cycles influencing positive outcomes: birth of genetically suitable donor-baby (or babies) and HSCT. In April 2014, 32 PGD centres (Consortium members and non-members) with published/known PGD-HLA activity were invited to participate. Between February and September 2015, 14 centres submitted their data, through a custom-designed secure database, with unique login access for each centre. Data parameters covered all aspects of PGD-HLA cycles (ART, embryology and genetic diagnosis), donor-babies born and HSCT. PARTICIPANTS/MATERIALS, SETTING, METHODS From 716 cycles submitted by 14 centres (performed between August 2001 and September 2015), the quality evaluation excluded 12 cycles, leaving 704, from 364 couples. The online database, based on REDCap, a free, secure, web-based data-capture application, was customized by Centre for Clinical Epidemiology and Outcomes Research (CLEO), Athens. Continuous variables are presented using mean, standard deviation, median and interquartile range, and categorical variables are presented as absolute and relative frequencies. MAIN RESULTS AND THE ROLE OF CHANCE The data included 704 HLA-PGD cycles. Mean maternal age was 33.5 years. Most couples (81.3%) requested HLA-typing with concurrent exclusion of a single monogenic disease (58.6% for beta-thalassaemia). In 92.5% couples, both partners were fertile, with an average 1.93 HLA-PGD cycles/couple. Overall, 9751 oocytes were retrieved (13.9/cycle) and 5532 embryos were analysed (7.9/cycle). Most cycles involved fresh oocytes (94.9%) and Day 3 embryo biopsy (85.3%). In 97.5% of cycles, the genotyping method involved PCR only. Of 4343 embryos diagnosed (78.5% of analysed embryos), 677 were genetically suitable (15.4% of those analysed for HLA alone, 11.6% of those analysed for HLA with exclusion of monogenic disease). Of the 364 couples, 56.6% achieved an embryo transfer (ET) and 598 embryos were transferred in 382 cycles, leading to 164 HCG-positive pregnancies (pregnancy rate/ET 41.3%, pregnancy rate/initiated cycle 23.3%) and 136 babies born (live birth rate/ET 34.3%, live birth rate/initiated cycle 19.3%) to 113 couples. Data analysis identified the following limitations to the overall success of the HLA-PGD procedure: the age of the mother undergoing the treatment cycle, the number of oocytes collected per cycle and genetic chance. HSCT was reported for 57 cases, of which 64.9% involved combined umbilical cord-blood and bone marrow transplantation from the HLA-identical sibling donor; 77.3% of transplants reported no complications. LIMITATIONS REASONS FOR CAUTION The findings of the study may be limited as not all PGD centres with PGD-HLA experience participated. Reporting bias on completion of the online database may be another potential limitation. Furthermore, the study is based on retrospective data collection from centres with variable practices and strategies for ART, embryology and genetic diagnosis. WIDER IMPLICATIONS OF THE FINDINGS This is the first multi-centre study evaluating the clinical utility of PGD-HLA, indicating variations in practice and outcomes throughout 15 years and between centres. The study highlights parameters important for positive outcomes and provides important information for both scientists and couples interested in initiating a cycle. Above all, the study underlines the need for better collaboration between all specialists involved in the ART-PGD/HLA procedure, as well as the need for comprehensive and prospective long-term data collection, and encourages all specialists to aim to properly evaluate and follow-up all procedures, with the ultimate aim to promote best practice and encourage patient informed decision making. STUDY FUNDING/COMPETING INTEREST(S) The study wishes to acknowledge ESHRE for funding the customization of the REDCap database. There are no competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- G Kakourou
- Department of Medical Genetics, Choremio Research Laboratory, National and Kapodistrian University of Athens, Thivon & Livadias, Athens 11527, Greece
| | - S Kahraman
- Istanbul Memorial Hospital, ART and Reproductive Genetics Unit, Piyale Pasa Bulvari, 34385 Okmeydani sisli-Instanbul, Turkey
| | - G C Ekmekci
- Istanbul Memorial Hospital, ART and Reproductive Genetics Unit, Piyale Pasa Bulvari, 34385 Okmeydani sisli-Instanbul, Turkey
| | - H A Tac
- Istanbul Memorial Hospital, ART and Reproductive Genetics Unit, Piyale Pasa Bulvari, 34385 Okmeydani sisli-Instanbul, Turkey
| | - G Kourlaba
- Center for Clinical Epidemiology and Outcomes Research (CLEO), 5 Chatzigianni Mexi 11528, Athens, Greece
| | - E Kourkouni
- Center for Clinical Epidemiology and Outcomes Research (CLEO), 5 Chatzigianni Mexi 11528, Athens, Greece
| | - A Cervero Sanz
- Igenomix, Parc Científic Universitat de Valéncia, Calle Catedrático Agustín Escardino 9, 46980 Paterna (València), Spain
| | - J Martin
- Igenomix, Parc Científic Universitat de Valéncia, Calle Catedrático Agustín Escardino 9, 46980 Paterna (València), Spain
| | - H Malmgren
- Stockholm PGD Center, Karolinska University Hospital, Karolinska Universitetssjukhuset, Karolinska vägen, 171 76 Solna, Sweden
| | - C Giménez
- Reprogenetics Spain, Carrer de Tuset, 23, 08006 Barcelona, Spain
| | - V Gold
- PGD Lab, Lis Fertility Institute, Lis Maternity and Women's Hospital, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv 6423906, Israel
| | - F Carvalho
- Department of Pathology, Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, R. Alfredo Allen, 4200-135 Porto, Portugal
| | - C Billi
- Preimplantation Diagnosis Department, Alfalab Private Diagnostic Laboratory Medical S.A., Anastasiou Georgiou 11, 115 24 Athens, Greece
| | - J F C Chow
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Tsan Yuk Hospital Preimplantation Genetic Diagnosis Laboratory, Tsan Yuk Hospital, 30 Hospital Road, Sai Ying Pun, Hong Kong
| | - X Vendrell
- Reproductive Genetics Unit, Sistemas Genómicos Ltd, Ronda G.Marconi 6, 46980 Paterna (València), Spain
| | - G Kokkali
- Genesis Athens Clinic, Reproductive Medicine Unit, 14 Papanikoli Str, Chalandri 15232, Athens, Greece
| | - J Liss
- Invicta Fertility and Reproductive Center, 10 Rajska St., 80-850 Gdansk, Poland
| | - J Steffann
- Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, INSERM UMR1163, Laboratoire de Génétique, APHP Hopital Necker-Enfants Malades, 149 rue de Sévres, 75743 PARIS CEDEX 15, Paris, France
| | - J Traeger-Synodinos
- Department of Medical Genetics, Choremio Research Laboratory, National and Kapodistrian University of Athens, Thivon & Livadias, Athens 11527, Greece
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Vrettou C, Kakourou G, Mamas T, Traeger-Synodinos J. Prenatal and preimplantation diagnosis of hemoglobinopathies. Int J Lab Hematol 2018; 40 Suppl 1:74-82. [DOI: 10.1111/ijlh.12823] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 03/01/2018] [Indexed: 12/19/2022]
Affiliation(s)
- C. Vrettou
- Department of Medical Genetics; National and Kapodistrian University of Athens; Athens Greece
| | - G. Kakourou
- Department of Medical Genetics; National and Kapodistrian University of Athens; Athens Greece
| | - T. Mamas
- Department of Medical Genetics; National and Kapodistrian University of Athens; Athens Greece
| | - J. Traeger-Synodinos
- Department of Medical Genetics; National and Kapodistrian University of Athens; Athens Greece
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Makis A, Georgiou I, Traeger-Synodinos J, Chaliasos N, Grosso M, Gambale A, Iolascon A. Diagnosis and molecular characterization of a novel α 0 -thalassemia deletion (-Kozani) found in a Greek child with unexplained microcytic hypochromic anemia. Int J Lab Hematol 2017; 39:e124-e126. [PMID: 28603861 DOI: 10.1111/ijlh.12690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 03/24/2017] [Indexed: 11/27/2022]
Affiliation(s)
- A Makis
- Child Health Department, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - I Georgiou
- Genetics and IVF Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - J Traeger-Synodinos
- Laboratory of Medical Genetics, National and Kapodistrian University of Athens, Athens, Greece
| | - N Chaliasos
- Child Health Department, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - M Grosso
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, CEINGE- Advanced Biotechnologies, Italy
| | - A Gambale
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, CEINGE- Advanced Biotechnologies, Italy
| | - A Iolascon
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, CEINGE- Advanced Biotechnologies, Italy
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Destouni A, Poulou M, Kakourou G, Vrettou C, Tzetis M, Traeger-Synodinos J, Kitsiou-Tzeli S. Single-cell high resolution melting analysis: A novel, generic, pre-implantation genetic diagnosis (PGD) method applied to cystic fibrosis (HRMA CF-PGD). J Cyst Fibros 2015; 15:163-70. [PMID: 26493493 DOI: 10.1016/j.jcf.2015.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 07/15/2015] [Accepted: 09/23/2015] [Indexed: 02/04/2023]
Abstract
BACKGROUND Institutions offering CF-PGD face the challenge of developing and optimizing single cell genotyping protocols that should cover for the extremely heterogeneous CF mutation spectrum. Here we report the development and successful clinical application of a generic CF-PGD protocol to facilitate direct detection of any CFTR nucleotide variation(s) by HRMA and simultaneous confirmation of diagnosis through haplotype analysis. METHODS A multiplex PCR was optimized supporting co-amplification of any CFTR exon-region, along with 6 closely linked STRs. Single cell genotypes were established through HRM analysis following melting of the 2nd round PCR products and were confirmed by STR haplotype analysis of the 1st PCR products. The protocol was validated pre-clinically, by testing 208 single lymphocytes, isolated from whole blood samples from 4 validation family trios. Fifteen PGD cycles were performed and 103 embryos were biopsied. RESULTS In 15 clinical PGD cycles, genotypes were achieved in 88/93 (94.6%) embryo biopsy samples, of which 57/88 (64.8%) were deemed genetically suitable for embryo transfer. Amplification failed at all loci for 10/103 blastomeres biopsied from poor quality embryos. Six clinical pregnancies were achieved (2 twin, 4 singletons). PGD genotypes were confirmed following conventional amniocentesis or chorionic villus sampling in all achieved pregnancies. CONCLUSIONS The single cell HRMA CF-PGD protocol described herein is a flexible, generic, low cost and robust genotyping method, which facilitates the analysis of any CFTR genotype combination. Single-cell HRMA can be beneficial to other clinical settings, for example the detection of single nucleotide variants in single cells derived from clinical tumor samples.
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Affiliation(s)
- A Destouni
- Department of Medical Genetics, University of Athens, St Sophia's Children's Hospital, Athens, Greece
| | - M Poulou
- Department of Medical Genetics, University of Athens, St Sophia's Children's Hospital, Athens, Greece.
| | - G Kakourou
- Department of Medical Genetics, University of Athens, St Sophia's Children's Hospital, Athens, Greece
| | - C Vrettou
- Department of Medical Genetics, University of Athens, St Sophia's Children's Hospital, Athens, Greece
| | - M Tzetis
- Department of Medical Genetics, University of Athens, St Sophia's Children's Hospital, Athens, Greece
| | - J Traeger-Synodinos
- Department of Medical Genetics, University of Athens, St Sophia's Children's Hospital, Athens, Greece
| | - S Kitsiou-Tzeli
- Department of Medical Genetics, University of Athens, St Sophia's Children's Hospital, Athens, Greece
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De Rycke M, Belva F, Goossens V, Moutou C, SenGupta SB, Traeger-Synodinos J, Coonen E. ESHRE PGD Consortium data collection XIII: cycles from January to December 2010 with pregnancy follow-up to October 2011. Hum Reprod 2015. [PMID: 26071418 DOI: 10.1093/humrep/dev122.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
STUDY QUESTION How do data in the 13th annual data collection (Data XIII) of the European Society of Human Reproduction and Embryology (ESHRE) PGD Consortium compare with the cumulative data for collections I-XII? SUMMARY ANSWER The 13th retrospective collection represents valuable data on PGD/PGS cycles, pregnancies and children: the main trend observed is the decrease in the routine implementation of PGS. WHAT IS KNOWN ALREADY Since 1999, the PGD Consortium has collected, analysed and published 12 data sets and an overview of the first 10 years of data collections. STUDY DESIGN, SIZE, DURATION Data were collected from each participating centre using a FileMaker Pro database (versions 5-11). Separate predesigned FileMaker Pro files were used for the cycles, pregnancies and baby records. The study documented cycles performed during the calendar year 2010 and follow-up of the pregnancies and babies born which resulted from these cycles (until October 2011). PARTICIPANTS/MATERIALS, SETTING, METHODS Data were submitted by 62 centres (full PGD Consortium members). The submitted data were thoroughly analysed to identify incomplete data entries and corrections were requested from the participating centres. Records remaining with incomplete or inconsistent data were excluded from the calculations. Corrections, calculations and tables were made by expert co-authors. MAIN RESULTS AND THE ROLE OF CHANCE For data collection XIII, 62 centres reported data for 5780 cycles with oocyte retrieval (OR), along with details of the follow-up on 1503 pregnancies and 1152 babies born. A total of 1071 OR were reported for chromosomal abnormalities, 108 OR for sexing for X-linked diseases, 1574 OR for monogenic diseases, 2979 OR for preimplantation genetic screening and 48 OR for social sexing. LIMITATIONS, REASONS FOR CAUTION The findings apply to the 62 participating centres and may not represent worldwide trends in PGD. WIDER IMPLICATIONS OF THE FINDINGS The annual data collections provide an important resource for data mining and for following trends in PGD practice. STUDY FUNDING/COMPETING INTERESTS None.
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Affiliation(s)
- M De Rycke
- Centre for Medical Genetics, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - F Belva
- Centre for Medical Genetics, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - V Goossens
- ESHRE Central Office, Meerstraat 60, 1852 Grimbergen, Belgium
| | - C Moutou
- Université de Strasbourg, Hôpitaux Universitaires de Strasbourg, Service de la Biologie de la Reproduction, CMCO, 19, Rue Louis Pasteur, BP120, 67303 Schiltigheim, France
| | - S B SenGupta
- UCL Centre for PG & D, Institute for Women's Health, University College London, London, UK
| | - J Traeger-Synodinos
- Laboratory of Medical Genetics, University of Athens, St. Sophia's Children's Hospital, 11527 Athens, Greece
| | - E Coonen
- PGD Working Group Maastricht, Department of Clinical Genetics, Maastricht University Medical Centre, PO Box 5800, 6202 AZ Maastricht, The Netherlands
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De Rycke M, Belva F, Goossens V, Moutou C, SenGupta SB, Traeger-Synodinos J, Coonen E. ESHRE PGD Consortium data collection XIII: cycles from January to December 2010 with pregnancy follow-up to October 2011. Hum Reprod 2015; 30:1763-89. [PMID: 26071418 DOI: 10.1093/humrep/dev122] [Citation(s) in RCA: 106] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 04/20/2015] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION How do data in the 13th annual data collection (Data XIII) of the European Society of Human Reproduction and Embryology (ESHRE) PGD Consortium compare with the cumulative data for collections I-XII? SUMMARY ANSWER The 13th retrospective collection represents valuable data on PGD/PGS cycles, pregnancies and children: the main trend observed is the decrease in the routine implementation of PGS. WHAT IS KNOWN ALREADY Since 1999, the PGD Consortium has collected, analysed and published 12 data sets and an overview of the first 10 years of data collections. STUDY DESIGN, SIZE, DURATION Data were collected from each participating centre using a FileMaker Pro database (versions 5-11). Separate predesigned FileMaker Pro files were used for the cycles, pregnancies and baby records. The study documented cycles performed during the calendar year 2010 and follow-up of the pregnancies and babies born which resulted from these cycles (until October 2011). PARTICIPANTS/MATERIALS, SETTING, METHODS Data were submitted by 62 centres (full PGD Consortium members). The submitted data were thoroughly analysed to identify incomplete data entries and corrections were requested from the participating centres. Records remaining with incomplete or inconsistent data were excluded from the calculations. Corrections, calculations and tables were made by expert co-authors. MAIN RESULTS AND THE ROLE OF CHANCE For data collection XIII, 62 centres reported data for 5780 cycles with oocyte retrieval (OR), along with details of the follow-up on 1503 pregnancies and 1152 babies born. A total of 1071 OR were reported for chromosomal abnormalities, 108 OR for sexing for X-linked diseases, 1574 OR for monogenic diseases, 2979 OR for preimplantation genetic screening and 48 OR for social sexing. LIMITATIONS, REASONS FOR CAUTION The findings apply to the 62 participating centres and may not represent worldwide trends in PGD. WIDER IMPLICATIONS OF THE FINDINGS The annual data collections provide an important resource for data mining and for following trends in PGD practice. STUDY FUNDING/COMPETING INTERESTS None.
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Affiliation(s)
- M De Rycke
- Centre for Medical Genetics, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - F Belva
- Centre for Medical Genetics, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - V Goossens
- ESHRE Central Office, Meerstraat 60, 1852 Grimbergen, Belgium
| | - C Moutou
- Université de Strasbourg, Hôpitaux Universitaires de Strasbourg, Service de la Biologie de la Reproduction, CMCO, 19, Rue Louis Pasteur, BP120, 67303 Schiltigheim, France
| | - S B SenGupta
- UCL Centre for PG & D, Institute for Women's Health, University College London, London, UK
| | - J Traeger-Synodinos
- Laboratory of Medical Genetics, University of Athens, St. Sophia's Children's Hospital, 11527 Athens, Greece
| | - E Coonen
- PGD Working Group Maastricht, Department of Clinical Genetics, Maastricht University Medical Centre, PO Box 5800, 6202 AZ Maastricht, The Netherlands
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Moutou C, Goossens V, Coonen E, De Rycke M, Kokkali G, Renwick P, SenGupta SB, Vesela K, Traeger-Synodinos J. ESHRE PGD Consortium data collection XII: cycles from January to December 2009 with pregnancy follow-up to October 2010. Hum Reprod 2014; 29:880-903. [PMID: 24619432 DOI: 10.1093/humrep/deu012] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION How do data in the 12th annual data collection (Data XII) of the European Society of Human Reproduction and Embryology Preimplantation Genetic Diagnosis (PGD) Consortium compare with the cumulative data for collections I-XI? SUMMARY ANSWER Since the beginning of the data collections, there has been a steady increase in the number of cycles, pregnancies and babies reported annually. WHAT IS KNOWN ALREADY The PGD Consortium has collected, analysed and published 11 previous data sets since 1997. STUDY DESIGN, SIZE, DURATION Data were collected from each participating centre using a pre-designed FileMaker Pro database (versions 5-10). Separate FileMaker Pro files were used for the cycles, pregnancies and baby records. The study documented cycles performed during the calendar year 2009 and follow-up of the pregnancies and babies born which resulted from these cycles (until October 2010). PARTICIPANTS/MATERIALS, SETTING, METHODS Data were submitted by 60 centres (full PGD Consortium members), and the blank files were distributed to each PGD Consortium member centre at the end of 2008. The submitted data were thoroughly analysed to identify incomplete data entries and corrections were requested from the participating centres. Records remaining with incomplete data were excluded from the calculations. Corrections, tables and calculations were made by expert co-authors. MAIN RESULTS AND THE ROLE OF CHANCE For data collection XII, 60 centres reported data for 6160 cycles with oocyte retrieval (OR), along with details of the follow-up on 1607 pregnancies and 1238 babies born. A total of 870 OR were reported for chromosomal abnormalities, 113 OR for sexing for X-linked diseases, 1597 OR for monogenic diseases, 3551 OR for preimplantation genetic screening and 29 OR for social sexing. LIMITATIONS, REASONS FOR CAUTION These data cannot include every PGD cycle performed annually, and only indicate the trends in PGD worldwide. WIDER IMPLICATION OF THE FINDINGS The annual data collections provide an extremely valuable resource for data mining and for following trends in PGD practice. STUDY FUNDING/COMPETING INTEREST(S) None.
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Affiliation(s)
- C Moutou
- Université de Strasbourg, Hôpitaux Universitaires de Strasbourg, Service de la Biologie de la Reproduction, CMCO, 19, Rue Louis Pasteur, BP120, 67303 Schiltigheim, France
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Traeger-Synodinos J, Coonen E, Goossens V, De Mouzon J, Shenfield F, Ruiz A, Goossens V, Ferraretti AP, Mardesic T, Pennings G, Pennings G, Shenfield F, de Mouzon J, Ruiz A, Ferraretti AP, Mardesic T, Goossens V. Session 09: ESHRE data reporting on PGD cycles and oocyte donation. Hum Reprod 2013. [DOI: 10.1093/humrep/det162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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10
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Lynch C, Tee N, Rouse H, Gordon A, Sati L, Zeiss C, Soygur B, Bassorgun I, Goksu E, Demir R, McGrath J, Groendahl ML, Thuesen L, Andersen AN, Loft A, Smitz J, Adriaenssens T, Vikesa J, Borup R, Mersy E, Kisters N, Macville MVE, Engelen JJM, Consortium SENN, Menheere PPCA, Geraedts JP, Coumans ABC, Frints SGM, Aledani T, Assou S, Traver S, Ait-ahmed O, Dechaud H, Hamamah S, Mizutani E, Suzumori N, Sugiyama C, Hattori Y, Sato T, Ando H, Ozaki Y, Sugiura-Ogasawara M, Wissing M, Kristensen SG, Andersen CY, Mikkelsen AL, Hoest T, Borup R, Groendahl ML, Velthut-Meikas A, Simm J, Metsis M, Salumets A, Palini S, Galluzzi L, De Stefani S, Primiterra M, Wells D, Magnani M, Bulletti C, Vogt PH, Frank-Herrmann P, Bender U, Strowitzki T, Besikoglu B, Heidemann P, Wunsch L, Bettendorf M, Jelinkova L, Vilimova S, Kosarova M, Sebek P, Volemanova E, Kruzelova M, Civisova J, Svobodova L, Sobotka V, Mardesic T, van de Werken C, Santos MA, Eleveld C, Laven JSE, Baart EB, Pylyp LY, Spinenko LA, Zukin VD, Perez-Sanz J, Matorras R, Arluzea J, Bilbao J, Gonzalez-Santiago N, Yeh N, Koff A, Barlas A, Romin Y, Manova-Todorova K, Hoz CDL, Mauri AL, Nascimento AM, Vagnini LD, Petersen CG, Ricci J, Massaro FC, Cavagna M, Pontes A, Oliveira JBA, Baruffi RLR, Franco JG, Wu EX, Ma S, Parriego M, Sole M, Boada M, Coroleu B, Veiga A, Kakourou G, Poulou M, Vrettou C, Destouni A, Traeger-Synodinos J, Kanavakis E, Yatsenko AN, Georgiadis AP, McGuire MM, Zorrilla M, Bunce KD, Peters D, Rajkovic A, Olszewska M, Kurpisz M, Gilbertson AZA, Ottolini CS, Summers MC, Sage K, Handyside AH, Thornhill AR, Griffin DK, Chung MK, Kim JW, Lee JH, Jeong HJ, Kim MH, Ryu MJ, Park SJ, Kang HY, Lee HS, Zimmermann B, Banjevic M, Hill M, Lacroute P, Dodd M, Sigurjonsson S, Lau P, Prosen D, Chopra N, Ryan A, Hall M, McAdoo S, Demko Z, Levy B, Rabinowitz M, Vereczeky A, Kosa ZS, Savay S, Csenki M, Nanassy L, Dudas B, Domotor ZS, Debreceni D, Rossi A, Alegretti JR, Cuzzi J, Bonavita M, Tanada M, Matunaga P, Fettback P, Rosa MB, Maia V, Hassun P, Motta ELA, Piccolomini M, Gomes C, Barros B, Nicoliello M, Matunaga P, Criscuolo T, Bonavita M, Alegretti JR, Miyadahira E, Cuzzi J, Hassun P, Motta ELA, Montjean D, Benkhalifa M, Berthaut I, Griveau JF, Morcel K, Bashamboo A, McElreavey K, Ravel C, Rubio C, Rodrigo L, Mateu E, Mercader A, Peinado V, Buendia P, Milan M, Delgado A, Al-Asmar N, Escrich L, Campos-Galindo I, Garcia-Herrero S, Poo ME, Mir P, Simon C, Reyes-Engel A, Cortes-Rodriguez M, Lendinez A, Perez-Nevot B, Palomares AR, Galdon MR, Ruberti A, Minasi MG, Biricik A, Colasante A, Zavaglia D, Iammarrone E, Fiorentino F, Greco E, Demir N, Ozturk S, Sozen B, Morales R, Lledo B, Ortiz JA, Ten J, Llacer J, Bernabeu R, Nagayoshi M, Tanaka A, Tanaka I, Kusunoki H, Watanabe S, Temel SG, Beyazyurek C, Ekmekci GC, Aybar F, Cinar C, Kahraman S, Nordqvist S, Karehed K, Akerud H, Ottolini CS, Griffin DK, Thornhill AR, Handyside AH, Gultomruk M, Tulay P, Findikli N, Yagmur E, Karlikaya G, Ulug U, Bahceci M, Bargallo MF, Arevalo MR, Salat MM, Barbat IV, Lopez JT, Algam ME, Boluda AB, de Oya GC, Tolmacheva EN, Kashevarova AA, Skryabin NA, Lebedev IN, Semaco E, Belo A, Riboldi M, Cuzzi J, Barros B, Luz L, Criscuolo T, Nobrega N, Matunaga P, Mazetto R, Alegretti JA, Bibancos M, Hassun P, Motta ELA, Serafini P, Neupane J, Vandewoestyne M, Heindryckx B, Deroo T, Lu Y, Ghimire S, Lierman S, Qian C, Deforce D, De Sutter P, Rodrigo L, Rubio C, Mateu E, Peinado V, Milan M, Viloria T, Al-Asmar N, Mercader A, Buendia P, Delgado A, Escrich L, Martinez-Jabaloyas JM, Simon C, Gil-Salom M, Capalbo A, Treff N, Cimadomo D, Tao X, Ferry K, Ubaldi FM, Rienzi L, Scott RT, Katzorke N, Strowitzki T, Vogt HP, Hehr A, Gassner C, Paulmann B, Kowalzyk Z, Klatt M, Krauss S, Seifert D, Seifert B, Hehr U, Minasi MG, Ruberti A, Biricik A, Lobascio M, Zavaglia D, Varricchio MT, Fiorentino F, Greco E, Rubino P, Bono S, Cotarelo RP, Spizzichino L, Biricik A, Colicchia A, Giannini P, Fiorentino F, Suhorutshenko M, Rosenstein-Tamm K, Simm J, Salumets A, Metsis M. Reproductive (epi)genetics. Hum Reprod 2013. [DOI: 10.1093/humrep/det220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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11
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Traeger-Synodinos J. Preimplantation genetic diagnosis, an alternative to conventional prenatal diagnosis of the hemoglobinopathies. Int J Lab Hematol 2013; 35:571-9. [DOI: 10.1111/ijlh.12086] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 01/28/2013] [Indexed: 12/01/2022]
Affiliation(s)
- J. Traeger-Synodinos
- Department of Medical Genetics; National and Kapodistrian University of Athens; St. Sophia's Children's Hospital; Athens Greece
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Harton G, Braude P, Lashwood A, Schmutzler A, Traeger-Synodinos J, Wilton L, Harper JC. ESHRE PGD consortium best practice guidelines for organization of a PGD centre for PGD/preimplantation genetic screening. Hum Reprod 2012. [DOI: 10.1093/humrep/des181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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13
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Goossens V, Traeger-Synodinos J, Coonen E, De Rycke M, Moutou C, Pehlivan T, Derks-Smeets IAP, Harton G. ESHRE PGD Consortium data collection XI: cycles from January to December 2008 with pregnancy follow-up to October 2009. Hum Reprod 2012; 27:1887-911. [PMID: 22572107 DOI: 10.1093/humrep/des106] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The 11th report of the European Society of Human Reproduction and Embryology Preimplantation Genetic Diagnosis Consortium is presented, documenting cycles collected for the calendar year 2008 and follow-up of the pregnancies and babies born until October 2009 which resulted from these cycles. Since the beginning of the data collections, there has been a steady increase in the number of cycles, pregnancies and babies reported annually. For data collection XI, 53 centres have participated, reporting on 5641 cycles to oocyte retrieval (OR), along with details of the follow-up on 1418 pregnancies and 1169 babies born. A total of 774 OR were reported for chromosomal abnormalities, 96 OR for sexing for X-linked diseases, 1363 OR for monogenic diseases, 3401 OR for preimplantation genetic screening and 5 OR for social sexing. Data XI is compared with the cumulative data for data collections I-X.
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Affiliation(s)
- V Goossens
- ESHRE Central Office, Meerstraat 60, 1852 Grimbergen, Belgium
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Harper JC, Wilton L, Traeger-Synodinos J, Goossens V, Moutou C, SenGupta SB, Pehlivan Budak T, Renwick P, De Rycke M, Geraedts JPM, Harton G. The ESHRE PGD Consortium: 10 years of data collection. Hum Reprod Update 2012; 18:234-47. [PMID: 22343781 DOI: 10.1093/humupd/dmr052] [Citation(s) in RCA: 222] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Since it was established in 1997, the ESHRE PGD Consortium has been collecting data from international preimplantation genetic diagnosis (PGD) centres. Ten papers have been published, including data from January 1997 to December 2007. METHODS The data collection originally used a hard-copy format, then an excel database and finally a FileMaker Pro database. The indications are divided into five categories: PGD for chromosome abnormalities, sexing for X-linked disease, PGD for single gene defects, preimplantation genetic screening (PGS) and PGD for social sexing. The main end-points are pregnancy outcome and follow-up of deliveries. RESULTS In data collection I, 16 centres contributed data, which increased to 57 centres by data X (average of 39 centres per data collection). These centres contributed data on over 27 000 cycles that reached oocyte retrieval. Of these cycles, 61% were for aneuploidy screening, 17% for single gene disorders, 16% for chromosomal abnormalities, 4% for sexing of X-linked disease and 2% for social sexing. Cumulatively, 5187 clinical pregnancies gave rise to 4140 deliveries and 5135 newborns (singletons: 3182, twins: 921, triplets: 37). CONCLUSIONS In this paper, we present an overview of the first 10 years of PGD data, highlighting trends. These include the introduction of laser-assisted biopsy, an increase in polar body and trophectoderm biopsy, new strategies, methodologies and technologies for diagnosis, including recently arrays, and the more frequent use of freezing biopsied embryos. The Consortium data reports represent a valuable resource for information about the practice of PGD.
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Affiliation(s)
- J C Harper
- UCL Centre for PG&D, Institute for Women' s Health, University College London, London, UK.
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Vitrier S, Bocken G, De Vos A, Tournaye H, Van de Velde H, Verheyen G, Christiansen K, Bungum L, Becker C, Bungum M, Harton G, Dreesen J, Destouni A, Degn B, Christensen MW, Moutou C, Sengupta S, Renwick P, Carvalho F, Davies S, Kanavakis E, Traeger-Synodinos J, Calvo I, Anarte C, Presilla N, De Las Heras M, Domingo A, Agirregoikoa JA, De Pablo JL, Barrenetxea G. PARAMEDICAL - LABORATORY. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
α-thalassaemia is an autosomal recessive disorder, in which there is impaired production of the a-globin chains of haemoglobin. It is associated with microcytic hypochromic anaemia, and a clinical phenotype varying from almost asymptomatic to a lethal haemolytic anaemia. It is probably the most common single gene disorder worldwide, and is especially frequent in populations originating from the Mediterranean region, SE Asia, Africa, Middle East and Indian subcontinent.
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Harton GL, De Rycke M, Fiorentino F, Moutou C, SenGupta S, Traeger-Synodinos J, Harper JC. ESHRE PGD consortium best practice guidelines for amplification-based PGD. Hum Reprod 2010. [PMID: 20966462 DOI: 10.1093/humrep/deq231.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
In 2005, the European Society for Human Reproduction and Embryology (ESHRE) PGD Consortium published a set of Guidelines for Best Practice PGD to give information, support and guidance to potential, existing and fledgling PGD programmes. The subsequent years have seen the introduction of a number of new technologies as well as the evolution of current techniques. Additionally, in light of recent advice from ESHRE on how practice guidelines should be written and formulated, the Consortium believed it was timely to revise and update the PGD guidelines. Rather than one document that covers all of PGD, as in the original publication, these guidelines are separated into four new documents that apply to different aspects of a PGD programme, i.e. Organization of a PGD centre, fluorescence in situ hybridization-based testing, Amplification-based testing and Polar Body and Embryo Biopsy for PGD/preimplantation genetic screening. Here, we have updated the sections that pertain to amplification-based PGD. Topics covered in this guideline include inclusion/exclusion criteria for amplification-based PGD testing, preclinical validation of tests, amplification-based testing methods, tubing of cells for analysis, set-up of local IVF centre and Transport PGD centres, quality control/quality assurance and diagnostic confirmation of untransferred embryos.
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Affiliation(s)
- G L Harton
- Reprogenetics LLC, Livingston, NJ 07039, USA.
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Harton G, Braude P, Lashwood A, Schmutzler A, Traeger-Synodinos J, Wilton L, Harper JC. ESHRE PGD consortium best practice guidelines for organization of a PGD centre for PGD/preimplantation genetic screening. Hum Reprod 2010; 26:14-24. [PMID: 20966460 DOI: 10.1093/humrep/deq229] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In 2005, the European Society for Human Reproduction and Embryology (ESHRE) PGD Consortium published a set of Guidelines for Best Practice PGD to give information, support and guidance to potential, existing and fledgling PGD programmes. Subsequent years have seen the introduction of new technologies as well as the evolution of current techniques. Additionally, in light of recent advice from ESHRE on how practice guidelines should be written/formulated, the Consortium believed it was timely to update the PGD guidelines. Rather than one document that covers all of PGD, the new guidelines are separated into four documents, including one relating to organization of the PGD centre and three relating to the methods used: DNA amplification, fluorescence in situ hybridization and biopsy/embryology. Here, we have updated the sections on organization of the PGD centre. One area that has continued to expand is Transport PGD, in which patients are treated at one IVF centre, whereas their gametes/embryos are tested elsewhere, at an independent PGD centre. Transport PGD/preimplantation genetic screening (PGS) has a unique set of challenges with respect to the nature of the sample and the rapid turn-around time required. PGS is currently controversial. Opinions of laboratory specialists and clinicians interested in PGD and PGS have been taken into account here. Current evidence suggests that PGS at cleavage stages is ineffective, but whether PGS at the blastocyst stage or on polar bodies might show improved delivery rates is still unclear. Thus, in this revision, PGS has been included. This document should assist everyone interested in PGD/PGS in developing the best laboratory and clinical practice possible.
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Affiliation(s)
- G Harton
- Reprogenetics LLC, Livingston, NJ 07039, USA.
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Harton GL, De Rycke M, Fiorentino F, Moutou C, SenGupta S, Traeger-Synodinos J, Harper JC. ESHRE PGD consortium best practice guidelines for amplification-based PGD. Hum Reprod 2010; 26:33-40. [PMID: 20966462 DOI: 10.1093/humrep/deq231] [Citation(s) in RCA: 173] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
In 2005, the European Society for Human Reproduction and Embryology (ESHRE) PGD Consortium published a set of Guidelines for Best Practice PGD to give information, support and guidance to potential, existing and fledgling PGD programmes. The subsequent years have seen the introduction of a number of new technologies as well as the evolution of current techniques. Additionally, in light of recent advice from ESHRE on how practice guidelines should be written and formulated, the Consortium believed it was timely to revise and update the PGD guidelines. Rather than one document that covers all of PGD, as in the original publication, these guidelines are separated into four new documents that apply to different aspects of a PGD programme, i.e. Organization of a PGD centre, fluorescence in situ hybridization-based testing, Amplification-based testing and Polar Body and Embryo Biopsy for PGD/preimplantation genetic screening. Here, we have updated the sections that pertain to amplification-based PGD. Topics covered in this guideline include inclusion/exclusion criteria for amplification-based PGD testing, preclinical validation of tests, amplification-based testing methods, tubing of cells for analysis, set-up of local IVF centre and Transport PGD centres, quality control/quality assurance and diagnostic confirmation of untransferred embryos.
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Affiliation(s)
- G L Harton
- Reprogenetics LLC, Livingston, NJ 07039, USA.
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Harper JC, Coonen E, De Rycke M, Harton G, Moutou C, Pehlivan T, Traeger-Synodinos J, Van Rij MC, Goossens V. ESHRE PGD Consortium data collection X: cycles from January to December 2007 with pregnancy follow-up to October 2008. Hum Reprod 2010; 25:2685-707. [PMID: 20813804 DOI: 10.1093/humrep/deq228] [Citation(s) in RCA: 117] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The 10th report of the European Society of Human Reproduction and Embryology (ESHRE) PGD Consortium is presented, documenting cycles collected for the calendar year 2007 and follow-up of the pregnancies and babies born until October 2008 which resulted from these cycles. Since the beginning of the data collections there has been a steady increase in the number of cycles, pregnancies and babies reported annually. For data collection X, 57 centres participated, reporting on 5887 cycles to oocyte retrieval (OR), along with details of the follow-up on 1516 pregnancies and 1206 babies born. A total of 729 OR were reported for chromosomal abnormalities, 110 OR for sexing for X-linked diseases, 1203 OR for monogenic diseases, 3753 OR for preimplantation genetic screening and 92 OR for social sexing. Data X is compared with the cumulative data for data collections I-IX.
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Affiliation(s)
- J C Harper
- UCL Centre for PG&D, Institute for Women's Health, University College London, 86-96 Chenies Mews, London, UK.
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Goossens V, Harton G, Moutou C, Traeger-Synodinos J, Van Rij M, Harper JC. ESHRE PGD Consortium data collection IX: cycles from January to December 2006 with pregnancy follow-up to October 2007. Hum Reprod 2009; 24:1786-810. [PMID: 19403563 DOI: 10.1093/humrep/dep059] [Citation(s) in RCA: 110] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The ninth report of the European Society of Human Reproduction and Embryology Preimplantation Genetic Diagnosis Consortium is presented documenting cycles collected for the calendar year 2006 and follow-up of the pregnancies and babies born until October 2007, which resulted from these cycles. Since the beginning of the data collections there has been a steady increase in the number of cycles, pregnancies and babies reported annually. For data collection IX, 57 centres have participated, reporting on 5858 cycles to oocyte retrieval (OR), along with details of the follow-up on 1437 pregnancies and 1206 babies born. Eight hundred and twelve ORs were reported for chromosomal abnormalities, 133 ORs for sexing for X-linked diseases, 931 ORs for monogenic diseases, 3900 ORs for preimplantation genetic screening and 82 ORs for social sexing. Data IX are compared with the cumulative data for data collections I-VIII.
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Affiliation(s)
- V Goossens
- ESHRE Central Office, Meerstraat 60, 1852 Grimbergen, Belgium
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Goossens V, Harton G, Moutou C, Scriven PN, Traeger-Synodinos J, Sermon K, Harper JC. ESHRE PGD Consortium data collection VIII: cycles from January to December 2005 with pregnancy follow-up to October 2006. Hum Reprod 2008; 23:2629-45. [PMID: 18641400 DOI: 10.1093/humrep/den238] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The eighth report of the European Society of Human Reproduction and Embryology PGD Consortium is presented documenting cycles collected for the calendar year 2005 and follow-up of the pregnancies and babies born until October 2006 which resulted from these cycles. For the first time, the delivery rates for each indication are presented and also the pregnancy rates for each centre are reported anonymously. Since the first data collections, there has been a steady increase in the number of cycles, pregnancies and babies reported annually. For data collection VIII, 39 centres have participated, reporting on 3488 cycles to oocyte retrieval (OR), along with details of the follow-up on 845 pregnancies and 670 babies born. Five hundred and twenty OR were reported for chromosomal abnormalities, 108 OR for sexing for X-linked diseases, 500 OR for monogenic diseases, 2275 OR for preimplantation genetic screening and 85 OR for social sexing. Data VIII is compared with the cumulative data for data collections I-VII.
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Affiliation(s)
- V Goossens
- ESHRE Central Office, Meerstraat 60, 1852 Grimbergen, Belgium
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Harper JC, de Die-Smulders C, Goossens V, Harton G, Moutou C, Repping S, Scriven PN, SenGupta S, Traeger-Synodinos J, Van Rij MC, Viville S, Wilton L, Sermon KD. ESHRE PGD consortium data collection VII: cycles from January to December 2004 with pregnancy follow-up to October 2005. Hum Reprod 2008; 23:741-55. [PMID: 18238908 DOI: 10.1093/humrep/dem354] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The seventh report of the ESHRE PGD Consortium is presented documenting cycles collected for the calendar year 2004 and follow-up of the pregnancies and babies born subsequent to these cycles up to October 2005. Since the beginning of the data collections, there has been a steady increase in the number of cycles, pregnancies and babies reported. For data collection VII, 45 centres have participated, reporting on 3358 cycles to oocyte retrieval (OR), 679 pregnancies and 528 babies born. Five hundred and fifty nine OR were reported for chromosomal abnormalities, 113 OR for sexing for X-linked diseases, 520 OR for monogenic diseases, 2087 OR for PGS, and 79 OR for social sexing. Data VII is compared with the cumulative data for data collections I-VI.
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Affiliation(s)
- J C Harper
- UCL Centre for PGD, Institute for Women's Health, University College London, 86-96 Chenies Mews, WC1E6HX London, UK.
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Voutoufianakis S, Psoni S, Vorgia P, Tsekoura F, Kekou K, Traeger-Synodinos J, Kitsiou S, Kanavakis E, Fryssira H. Coinheritance of mutated SMN1 and MECP2 genes in a child with phenotypic features of spinal muscular atrophy (SMA) type II and Rett syndrome. Eur J Paediatr Neurol 2007; 11:235-9. [PMID: 17276711 DOI: 10.1016/j.ejpn.2006.12.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2006] [Revised: 12/05/2006] [Accepted: 12/11/2006] [Indexed: 11/22/2022]
Abstract
Spinal muscular atrophy (SMA) is a neuromuscular autosomal recessive disease characterized by progressive muscle weakness and atrophy combined with motor neuron degeneration caused by mutations in the SMN 1 gene locus (5q11.2-13.2). Rett syndrome (RS) is an X-linked dominant neurodevelopmental disorder caused by mutations in MECP2 (Xq28) and characterized by normal development until 6-12 months of age, followed by regression with loss of acquired skills, gradual onset of microcephaly, stereotypic hand movements and psychomotor delay. We report a 6-year-old girl who, at 2 years of age, presented with hypotonia, psychomotor delay, amyotrophy and areflexia of the lower extremities. Molecular DNA analysis (PCR-RFLP's) for SMA type II revealed that both exons 7 and 8 of SMN 1 gene were deleted. Over the past 4 years, onset of stereotypic hand-washing movements, epileptic seizures, microcephaly, hyperventilation/breath-holding attacks and severe psychomotor delay raised the suspicion of the coexistence of RS. DNA analysis (DGGE and sequencing) identified the hotspot missense mutation R306C (c.916C>T) in exon 4 of the MECP2 gene. The coinheritance of SMA and RS, two rare monogenic syndromes in the same patient, has not been previously reported. Thorough clinical evaluation in combination with DNA analysis, allowed accurate diagnosis, providing valuable information for the genetic counseling of the family.
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Affiliation(s)
- S Voutoufianakis
- Pediatric Department of Venizelion General Hospital Iraklion, Crete, Greece
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26
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Kokkali G, Traeger-Synodinos J, Vrettou C, Stavrou D, Jones GM, Cram DS, Makrakis E, Trounson AO, Kanavakis E, Pantos K. Blastocyst biopsy versus cleavage stage biopsy and blastocyst transfer for preimplantation genetic diagnosis of beta-thalassaemia: a pilot study. Hum Reprod 2007. [PMID: 17261575 DOI: 10.1093/humrep/del506.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Trophectoderm biopsy at the blastocyst stage is an emerging approach in preimplantation genetic diagnosis (PGD). This study aimed to compare genotyping success and implantation rates in PGD cycles for beta-thalassaemia following biopsy at the cleavage versus the blastocyst stage, with transfer of blastocysts. METHODS This pilot study included 20 cycles: Group A: 10 cycles, day 3 blastomere biopsy, day 5 transfer; Group B: 10 cycles, day 5 trophectoderm biopsy, day 6 transfer. Standard-assisted reproduction and laser biopsy procedures were used. Biopsied cells were genotyped using real-time PCR multiplexed with fluorescent microsatellite analysis. RESULTS In Group A, 131 fertilized eggs developed to 101 embryos suitable for single blastomere biopsy; 76/101 blastomeres were diagnosed (75.2%), 30 unaffected blastocysts were transferred resulting in six pregnancies (eight fetal hearts, 26.7% implantation rate). In Group B, 128 fertilized eggs developed to 53 blastocysts for trophectoderm biopsy (four to five cells), with 50/53 blastocysts diagnosed (94.3%), 21 unaffected blastocysts transferred and 6 pregnancies initiated (10 fetal hearts, 47.6% implantation rate). Overall, nine pregnancies reached >10 weeks gestation and were confirmed unaffected by prenatal diagnosis, with 12 healthy babies born. CONCLUSIONS This pilot study suggests that trophectoderm biopsy and blastocyst transfer may be more advantageous than cleavage stage biopsy with respect to outcome of PGD for monogenic diseases.
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Affiliation(s)
- G Kokkali
- Centre for Human Reproduction, Genesis Hospital, Athens, Greece.
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27
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Kokkali G, Traeger-Synodinos J, Vrettou C, Stavrou D, Jones GM, Cram DS, Makrakis E, Trounson AO, Kanavakis E, Pantos K. Blastocyst biopsy versus cleavage stage biopsy and blastocyst transfer for preimplantation genetic diagnosis of β-thalassaemia: a pilot study. Hum Reprod 2007; 22:1443-9. [PMID: 17261575 DOI: 10.1093/humrep/del506] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Trophectoderm biopsy at the blastocyst stage is an emerging approach in preimplantation genetic diagnosis (PGD). This study aimed to compare genotyping success and implantation rates in PGD cycles for beta-thalassaemia following biopsy at the cleavage versus the blastocyst stage, with transfer of blastocysts. METHODS This pilot study included 20 cycles: Group A: 10 cycles, day 3 blastomere biopsy, day 5 transfer; Group B: 10 cycles, day 5 trophectoderm biopsy, day 6 transfer. Standard-assisted reproduction and laser biopsy procedures were used. Biopsied cells were genotyped using real-time PCR multiplexed with fluorescent microsatellite analysis. RESULTS In Group A, 131 fertilized eggs developed to 101 embryos suitable for single blastomere biopsy; 76/101 blastomeres were diagnosed (75.2%), 30 unaffected blastocysts were transferred resulting in six pregnancies (eight fetal hearts, 26.7% implantation rate). In Group B, 128 fertilized eggs developed to 53 blastocysts for trophectoderm biopsy (four to five cells), with 50/53 blastocysts diagnosed (94.3%), 21 unaffected blastocysts transferred and 6 pregnancies initiated (10 fetal hearts, 47.6% implantation rate). Overall, nine pregnancies reached >10 weeks gestation and were confirmed unaffected by prenatal diagnosis, with 12 healthy babies born. CONCLUSIONS This pilot study suggests that trophectoderm biopsy and blastocyst transfer may be more advantageous than cleavage stage biopsy with respect to outcome of PGD for monogenic diseases.
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Affiliation(s)
- G Kokkali
- Centre for Human Reproduction, Genesis Hospital, Athens, Greece.
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28
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Kolialexi A, Vrettou C, Traeger-Synodinos J, Burgemeister R, Papantoniou N, Kanavakis E, Antsaklis A, Mavrou A. Noninvasive prenatal diagnosis of β-thalassaemia using individual fetal erythroblasts isolated from maternal blood after enrichment. Prenat Diagn 2007; 27:1228-32. [DOI: 10.1002/pd.1881] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Sermon KD, Michiels A, Harton G, Moutou C, Repping S, Scriven PN, SenGupta S, Traeger-Synodinos J, Vesela K, Viville S, Wilton L, Harper JC. ESHRE PGD Consortium data collection VI: cycles from January to December 2003 with pregnancy follow-up to October 2004. Hum Reprod 2006; 22:323-36. [PMID: 17132677 DOI: 10.1093/humrep/del402] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The sixth report of the ESHRE PGD Consortium is presented, relating to cycles collected for the calendar year 2003 and follow-up of the pregnancies and babies born up to October 2004. Since the beginning of the data collections, there has been a steady rise in the number of cycles, pregnancies and babies reported. For this report, 50 centres participated, reporting on 2984 cycles, 501 pregnancies and 373 babies born. Five hundred and twenty-nine cycles were reported for chromosomal abnormalities, 516 cycles were reported for monogenic diseases, 137 cycles were reported for sexing for X-linked diseases, 1722 cycles were reported for preimplantation genetic screening (PGS) and 80 cycles were reported for social sexing. Data VI is compared to the cumulative data for data collections I-V.
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Affiliation(s)
- K D Sermon
- Centre for Medical Genetics, University Hospital and Medical School of the Dutch-speaking Brussels Free University, Brussels, Belgium.
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Harper JC, Boelaert K, Geraedts J, Harton G, Kearns WG, Moutou C, Muntjewerff N, Repping S, SenGupta S, Scriven PN, Traeger-Synodinos J, Vesela K, Wilton L, Sermon KD. ESHRE PGD Consortium data collection V: Cycles from January to December 2002 with pregnancy follow-up to October 2003. Hum Reprod 2005; 21:3-21. [PMID: 16172150 DOI: 10.1093/humrep/dei292] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The fifth report of the ESHRE PGD Consortium is presented (data collection V). For the first time, the cycle data were collected for one calendar year (2002) in the following October, so that data collection was complete for pregnancies and babies. The data were collected using a Filemaker Pro database and divided into referrals, cycles, pregnancies and babies. There are currently 66 active centres registered with the consortium; however, the data presented here were obtained from 43 centres and included 1603 referrals, 2219 cycles, 485 pregnancies and 382 babies born. The cycle data were divided into preimplantation genetic diagnosis (PGD) for inherited disorders (including chromosome abnormalities, sexing for X-linked disease and monogenic disorders), aneuploidy screening (PGS) and the use of PGD for social sexing. Data collection V is compared with the previous cumulative data collection (I-IV), which comprised 4058 PGD/PGS cycles that reached oocyte retrieval.
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Affiliation(s)
- J C Harper
- UCL Centre for PGD, Department of Obstetrics and Gynecology, University College London, 86-96 Chenies Mews, London WC1E 6HX, UK.
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Kokkali G, Vrettou C, Traeger-Synodinos J, Jones GM, Cram DS, Stavrou D, Trounson AO, Kanavakis E, Pantos K. Birth of a healthy infant following trophectoderm biopsy from blastocysts for PGD of beta-thalassaemia major. Hum Reprod 2005; 20:1855-9. [PMID: 15878929 DOI: 10.1093/humrep/deh893] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PGD is a well accepted reproductive choice for couples at genetic risk and involves the diagnosis and transfer of unaffected IVF embryos. PGD for monogenetic diseases is most commonly accomplished by the biopsy of one or two blastomeres from cleavage stage embryos, followed by PCR-based protocols. However, PCR-based DNA analysis of one or two cells is subject to several problems, including total PCR failure, or failure of one allele to amplify. Trophectoderm biopsy at the blastocyst stage enables the removal of more than two cells for diagnosis while being non-invasive to the inner cell mass which is destined for fetal development. The aim of this study was to develop a safe, reliable technique for the biopsy of trophectoderm cells from human blastocysts. This case report demonstrates that removal of trophectoderm cells prior to blastocyst transfer is compatible with implantation and development to term. Here we report successful PGD for beta-thalassaemia following trophectoderm cell biopsy from blastocysts and the birth of a healthy infant.
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Affiliation(s)
- G Kokkali
- Centre for Human Reproduction, Genesis Hospital, Halandri, Athens, Greece.
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32
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Talmaci R, Traeger-Synodinos J, Kanavakis E, Coriu D, Colita D, Gavrila L. Scanning of beta-globin gene for identification of beta-thalassemia mutation in Romanian population. J Cell Mol Med 2005; 8:232-40. [PMID: 15256071 PMCID: PMC6740280 DOI: 10.1111/j.1582-4934.2004.tb00278.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Beta-thalassemia is uncommon (0.5%) in the Romanian population, but it must be considered in the differential diagnosis of hypochromic anemia. The molecular characterization of beta-thalassemia is absolutely necessary for molecular diagnosis, as well as any genetic epidemiological study in this region. Molecular analyses consist of mutation detection by molecular scanning of beta-globin gene. This gene has 3 exons and 2 introns, involved in beta-thalassemic pathogenesis. Clinical application of DNA analysis on beta-thalassemic chromosomes allowed characterization of 29 persons with different beta-thalassemia mutations among 58 patients with anemia. The experimental strategy was based on sequential PCR amplification of most of the beta-globin gene and running on denaturing gradient gel electrophoresis of amplification products. Definitive characterization of mutations in samples identified with shifted DGGE patterns was performed ARMS-PCR and/or PCR-restriction enzyme analysis methods. Eight different beta-thalassemia alleles were identified, the most common being IVS I-110 (G-A) and cd 39 (C-T). Comparison of overall frequency of mutations in the neighboring countries, shows that these results are in the frame of overall distribution of these mutations in Mediterranean area, especially in Greece and in Bulgaria. Molecular diagnosis is useful for differentiating mild from severe alleles, for genetic counseling, as well as for mutation definition in carriers, identified by hematological analysis necessary for prenatal testing and genetic counseling.
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Affiliation(s)
- R Talmaci
- Human Genetics Department, Genetics Institute of Bucharest University, Aleea Portocalilor nr. 1-3, 76258, Bucharest, Romania
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33
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Traeger-Synodinos J, Vrettou C, Tzetis M, Destouni A, Davis S, Mastrominas M, Palmer G, Kokkali G, Pantos K, Kanavakis E. O▪71 Six years of PGD for β-haemoglobinopathies and cystic fibrosis in Greece. Reprod Biomed Online 2005. [DOI: 10.1016/s1472-6483(11)60292-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Karagianni C, Stabouli S, Roumeliotou K, Traeger-Synodinos J, Kavazarakis E, Gourgiotis D, Lambrou J, Kanavakis E. Severe hypertriglyceridaemia in diabetic ketoacidosis: clinical and genetic study. Diabet Med 2004; 21:380-2. [PMID: 15049943 DOI: 10.1111/j.1464-5491.2004.1111.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The lipoprotein lipase coding gene sequence was analysed on a 10-year-old girl with new-onset Type 1 diabetes mellitus (DM), ketoacidosis and severe hypertriglyceridaemia (TG > 112.9 mmol/l), revealing that the patient was a compound heterozygote for two mutations, D9N in exon 2 and S447X in exon 9. Although these two mutations usually do not considerably impair lipolytic enzyme activity, the combination of both in this patient may play a role in the development of severe hypertriglyceridaemia.
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Affiliation(s)
- C Karagianni
- Second Department of Pediatrics, University of Athens, Athens, Greece
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35
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Kanavakis E, Efthymiadou A, Strofalis S, Doudounakis S, Traeger-Synodinos J, Tzetis M. Cystic fibrosis in Greece: molecular diagnosis, haplotypes, prenatal diagnosis and carrier identification amongst high-risk individuals. Clin Genet 2003; 63:400-9. [PMID: 12752573 DOI: 10.1034/j.1399-0004.2003.00067.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Cystic fibrosis (CF) mutation analysis on 437 CF patients, characterized 80 different mutations (20 so far specific to our population) accounting for 91% of CF genes and generating 103 different genotypes. Eight mutations were common [F508del (53.4%), 621+1G>T (5.7%), G542X (3.9%), N1303K (2.6%), 2789+5G>A (1.7%), 2183AA>G (1.4%), E822X (1.4%), R1158X (1%)], 12 showed frequencies between 0.5% and 1%, while the remaining (60) were very rare (1 to 3 alleles). Denaturing gradient gel electrophoresis (DGGE) screening of 12 exons (3, 4, 7, 10, 11, 13, 14b, 16, 17b 20 and 21) detected 85.5% of CF alleles. Haplotypes for eight diallelic and three microsatellite markers have been characterized for the common, a few rare and novel Greek mutations. Results of 165 prenatal diagnoses (including 49 due to bowel hyperechogenicity), testing a total of 41 different parental genotypes, are reported. One hundred and sixteen prenatal tests resulted in 22 affected, 59 heterozygous, 34 normal fetuses and one incomplete diagnosis. Of the 49 echogenic bowel fetuses, 3 were heterozygotes. Carrier screening was initiated, with emphasis on individuals and couples in high-risk groups - with a family history of CF, one partner with CF, and couples with male infertility seeking in vitro fertilization (IVF). Mutation analysis on 672 individuals (120 couples, 91 unaffected CF siblings, 283 CF family relatives and 58 general population subjects), identified a total of 176 heterozygotes and 7 couples where both partners were CF heterozygotes. Prenatal diagnosis was performed in 4 cases and 3 were counseled on the availability of a prenatal test.
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Affiliation(s)
- E Kanavakis
- Medical Genetics, Athens University; Cystic Fibrosis Unit, 'Aghia Sophia' Children's Hospital, Athens, Greece
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36
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Abstract
Preimplantation genetic diagnosis (PGD) represents an alternative to prenatal diagnosis and allows selection of unaffected IVF embryos for establishing pregnancies in couples at risk for transmitting a genetic disorder.
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Affiliation(s)
- E Kanavakis
- Medical Genetics, University of Athens, Aghia Sophia Children's Hospital, Athens 11527, Greece.
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37
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Palmer GA, Traeger-Synodinos J, Davies S, Tzetis M, Vrettou C, Mastrominas M, Kanavakis E. Pregnancies following blastocyst stage transfer in PGD cycles at risk for beta-thalassaemic haemoglobinopathies. Hum Reprod 2002; 17:25-31. [PMID: 11756357 DOI: 10.1093/humrep/17.1.25] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Preimplantation genetic diagnosis (PGD) usually involves blastomere biopsy 3 days post-insemination (p.i.), followed by genetic analysis and transfer of unaffected embryos later on day 3 or 4. We evaluate a strategy involving embryo biopsy on day 3 p.i., genetic analysis on day 4 and, following culture in blastocyst sequential media, transfer of unaffected embryos on day 5 p.i. METHODS PGD cycles were initiated in 15 couples at risk of transmitting beta-thalassaemia major. Oocyte retrieval and ICSI were performed according to standard protocols. Embryo culture used blastocyst sequential media. Embryos were biopsied on day 3 p.i. using acid Tyrode's for zona drilling, and the single blastomeres were genotyped by a protocol involving nested polymerase chain reaction and denaturing gradient gel electrophoresis analysis. RESULTS Forty of 109 (37%) embryos biopsied on day 3 p.i. developed to blastocysts by day 5 p.i., with at least one blastocyst available for transfer in 12 cycles (80%). Genotype analysis characterized 51/109 (47%) embryos unaffected for beta-thalassaemia major, of which 28 were blastocysts. Transfer of 37 day 5 p.i. embryos (blastocysts and non blastocysts) initiated eight clinical pregnancies. Implantation rate per embryo transferred was 12/37 (32%). CONCLUSIONS Embryo biopsy on day 3, followed by delayed transfer until day 5 p.i. offers a novel and effective strategy to overcome the time limit encountered when performing PGD, without compromising embryo implantation.
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Affiliation(s)
- G A Palmer
- Embryogenesis Fertility Clinic, Kifissias Avenue, Athens 15125, Greece.
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38
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Geraedts JP, Harper J, Braude P, Sermon K, Veiga A, Gianaroli L, Agan N, Munné S, Gitlin S, Blenow E, de Boer K, Hussey N, Traeger-Synodinos J, Lee SH, Viville S, Krey L, Ray P, Emiliani S, Liu YH, Vermeulen S, Kanavakis E. Preimplantation genetic diagnosis (PGD), a collaborative activity of clinical genetic departments and IVF centres. Prenat Diagn 2001; 21:1086-92. [PMID: 11746169 DOI: 10.1002/pd.249] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Preimplantation genetic diagnosis (PGD) requires the combined efforts of geneticists and workers in the field of reproductive medicine. This was studied on the basis of a questionnaire, sent to 35 members of the PGD Consortium of the European Society of Human Reproduction and Embryology (ESHRE). A reply was obtained from 20 centres. They represent the majority of activities in the field of PGD in the world. It is obvious that many of the activities (in vitro fertilisation, embryo culture and biopsy) take place in IVF units while others (counselling and diagnosis) are the responsibility of genetic diagnostic centres. The distances between both units vary considerably. In all but one centre sex determination is offered. Aneuploidy screening is offered in 13 out of 20 centres. PGD of translocations and other structural chromosome abnormalities is offered in all but one centre. The number of monogenic diseases offered varies considerably. In comparison to prenatal diagnosis PGD is more expensive. The majority of these costs are due to the IVF or ICSI procedure. The charges for PGD vary between about 600 euro and 4000 euro. In 16 out of 20 centres the parents to be must sign an informed consent form.
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Affiliation(s)
- J P Geraedts
- Research Institute Growth and Development, Universiteit Maastricht, The Netherlands.
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39
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Traeger-Synodinos J, Papassotiriou I, Vrettou C, Skarmoutsou C, Stamoulakatou A, Kanavakis E. Erythroid marrow activity and functional anemia in patients with the rare interaction of a single functional a-globin and beta-globin gene. Haematologica 2001; 86:363-7. [PMID: 11325640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The degree of globin chain imbalance and tissue hypoxia are important determinants of clinical severity in thalassemia syndromes. Thus phenotypic expression may be modified by interaction of alpha- and beta-thalassemia defects, level and type of hemoglobin synthesized and oxygen release to the tissues. We evaluated hematology, erythroid marrow activity and functional anemia in patients with the rare interaction of a single a-globin gene and heterozygous beta-thalassemia (HbH/beta-thal trait). DESIGN AND METHODS In 7 patients characterized by DNA analysis to have HbH disease genotypes with beta-thalassemia trait, we assessed hematologic findings, serum transferrin receptor (sTfR), serum erythropoietin (Epo), red cell 2,3-disphosphoglycerate (2,3-DPG) and whole blood oxygen releasing capability. RESULTS Patients with HbH/beta-thal trait had moderate anemia, marked hypochromasia and microcytosis, normal or raised HbA2, and no electrophoretically/chromatographically detectable HbH. Epo and sTfR levels were significantly higher than in beta-thalassemia heterozygotes, but lower than in patients with HbH disease; 2,3-DPG levels were highest in HbH/beta-thal trait. Oxygen binding studies and simulations showed reduced oxygen affinity (P50) in HbH/beta-thal trait, resulting in increased oxygen release (O2R). INTERPRETATION AND CONCLUSIONS Hematologic findings and bone marrow activity in patients with HbH/b-thal trait were consistent with the modified globin chain imbalance and hemoglobin synthesis expected from interaction of HbH disease with heterozygous b-thalassemia, although this rare complex genotype may elude diagnosis based on hematology alone. Significantly higher red cell 2,3-DPG levels were an unexpected finding, and the consequent increase in oxygen release capability resulted in a compensated functional anemia relative to hemoglobin levels.
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Affiliation(s)
- J Traeger-Synodinos
- Medical Genetics, Athens University, Aghia Sophia Children's Hospital, Athens, Greece
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40
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Wajcman H, Lahary A, Promé D, Kister J, Riou J, Godart C, Préhu C, Traeger-Synodinos J, Papassotiriou I, Galactéros F. Hb Mont Saint Aignan [beta128(H6)Ala-->Pro]: a new unstable variant leading to chronic microcytic anemia. Hemoglobin 2001; 25:57-65. [PMID: 11300350 DOI: 10.1081/hem-100103070] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Hb Mont Saint-Aignan [beta128(H6)Ala-->Pro] is a mildly unstable variant, associated with hemolytic anemia, marked microcytosis and increased alpha/beta biosynthetic ratio (1.55 versus 1.1 +/- 0.1 in the control). The abnormal chain was isolated by selective precipitation with isopropanol and the structural modification determined by protein chemistry methods (reversed phase high performance liquid chromatography and mass spectrometry). Possible mechanisms underlying the beta(+)-thalassemia-like expression of this variant are discussed.
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MESH Headings
- Adult
- Amino Acid Sequence
- Amino Acid Substitution
- Anemia, Hemolytic, Congenital/blood
- Anemia, Hemolytic, Congenital/genetics
- Base Sequence
- Chromatography, High Pressure Liquid
- Codon/genetics
- Female
- Globins/biosynthesis
- Globins/genetics
- Hemoglobinopathies/blood
- Hemoglobinopathies/genetics
- Hemoglobins, Abnormal/chemistry
- Hemoglobins, Abnormal/genetics
- Hemoglobins, Abnormal/isolation & purification
- Humans
- Mass Spectrometry
- Middle Aged
- Molecular Sequence Data
- Mutation, Missense
- Oxygen/metabolism
- Pregnancy
- Pregnancy Complications, Hematologic/blood
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Affiliation(s)
- H Wajcman
- INSERM U 468 and Department of Biochemistry, H pital Henri Mondor, Créteil, France.
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41
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Papassotiriou I, Traeger-Synodinos J, Promé D, Kister J, Vrettou C, Xaidara A, Marden M, Stamoulakatou A, Wajcman H, Kanavakis E. Hb Sitia [beta128(H6)Ala-->Val]: an unstable variant with a substitution in the alpha1beta1 interface. Hemoglobin 2001; 25:45-56. [PMID: 11300349 DOI: 10.1081/hem-100103069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Hb Sitia [beta128(H6)Ala-->Val] was found in a Greek female with slightly reduced red blood cell indices. The abnormal hemoglobin was indistinguishable from Hb A by electrophoresis but eluted after Hb A on cation exchange high performance liquid chromatography. DNA sequence analysis revealed a GCT-->GTT mutation at codon 128, which is predicted to encode an Ala-->Val substitution. This was confirmed by mass spectrometry analyses of the beta-globin chain. Since alanine at beta128(H6) interacts with several amino acids of the alpha1beta1 contact, its replacement by a larger residue results in a mild instability of the molecule and slight modifications of the oxygen binding properties.
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Affiliation(s)
- I Papassotiriou
- Department of Clinical Biochemistry, Aghia Sophia Children's Hospital, Athens, Greece
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Harteveld CL, Traeger-Synodinos J, Ragusa A, Fichera M, Kanavakis E, Kattamis C, Giordano P, Schilirò G, Bernini LF. Different geographic origins of Hb Constant Spring [alpha(2) codon 142 TAA-->CAA]. Haematologica 2001; 86:36-8. [PMID: 11146568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The occurrence of Hb CS is usually limited to the geographic area which includes Southern China and South East Asia. In 1968 Hb CS was also found to occur in the Mediterranean area where it was originally described as Hb Athens. We investigated the independent origin of these termination codon mutations of the alpha 2-globin gene by determining the alpha-cluster haplotype and comparing the hematologic data from Hb CS-Hb H patients and their family members. DESIGN AND METHODS We studied one Hb CS-Hb H patient of Greek origin and a Sicilian family in which one individual was affected by Hb CS-Hb H. The haplotype of the Hb CS allele was determined and compared to the haplotype of an Hb CS-Hb H individual of Chinese origin. RESULTS The haplotype found for the Greek and Sicilian Hb CS was the same but differed significantly from the Asiatic Hb CS mutation. INTERPRETATION AND CONCLUSIONS The Hb CS mutation found in both Mediterranean patients arose independently in the Mediterranean area. The difference in clinical manifestation of the Hb CS-Hb H disease in both patients is less common but consistent with similar variation in the clinical expression of analogous Hb Icaria-Hb H disease patients.
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Affiliation(s)
- C L Harteveld
- Department of Human and Clinical Genetics, Leiden University Medical Center, Wassenaarseweg 72, 2333AL, Leiden, The Netherlands.
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Kanavakis E, Papassotiriou I, Karagiorga M, Vrettou C, Metaxotou-Mavrommati A, Stamoulakatou A, Kattamis C, Traeger-Synodinos J. Phenotypic and molecular diversity of haemoglobin H disease: a Greek experience. Br J Haematol 2000; 111:915-23. [PMID: 11122156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Haemoglobin H (Hb H) disease is the severest form of alpha-thalassaemia compatible with post-natal life and occurs when alpha-thalassaemia mutations interact to reduce alpha-globin synthesis to levels approximately equivalent to the output of a single alpha-globin gene. Hb H disease has variable clinical expression, mainly related to underlying genotypes. The spectrum of alpha-thalassaemia determinants in Greece appears greater than in any other population studied and, in 75 Greek Hb H disease patients, we found 12 alpha-thalassaemia mutations interacting to produce 15 Hb H disease genotypes. Evaluation of haematological, biochemical and clinical findings, and correlation with genotypes, defined genetic predictors of disease severity and factors involved in disease progression. In accordance with previous reports, patients with non-deletion alpha-thalassaemia mutations had more severe clinical expression. Additionally, we found that all patients with the most severe phenotypes had alpha-thalassaemic globin variants. Phenotypic severity was not simply related to the degree of alpha-globin deficiency: high Hb H levels were found to exacerbate anaemia by negatively influencing tissue oxygenation, and both Hb H and alpha-thalassaemic haemoglobin variants appear to reduce red cell survival within the bone marrow and circulation. Together with the long-term follow-up in many patients, this report provides comprehensive information for management of Hb H disease and appropriate family counselling.
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Affiliation(s)
- E Kanavakis
- First Department Paediatrics, University of Athens, Greece.
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44
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Traeger-Synodinos J, Papassotiriou I, Metaxotou-Mavrommati A, Vrettou C, Stamoulakatou A, Kanavakis E. Distinct phenotypic expression associated with a new hyperunstable alpha globin variant (Hb heraklion, alpha1cd37(C2)Pro>0): comparison to other alpha-thalassemic hemoglobinopathies. Blood Cells Mol Dis 2000; 26:276-84. [PMID: 11042028 DOI: 10.1006/bcmd.2000.0307] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Clinical phenotypes associated with abnormal globin chain biosynthesis may result in thalassemia (deficient quantity) or hemolytic anemia (abnormal hemoglobins). However, the phenotypic expression of hyperunstable hemoglobin variants often includes features of thalassemia, along with variable peripheral hemolysis. Hemoglobinopathies caused by highly unstable beta-chain variants have a dominant thalassemia-like phenotype, in which carriers have a clinical expression of thalassemia intermedia, but highly unstable alpha-globin variants are usually only phenotypically apparent when they interact with other alpha-thalassemia mutations. In a child with clinical and hematological features consistent with beta-thalassemia intermedia, DNA analysis excluded any beta-globin gene mutations but characterized a novel deletion cd37(C2)Pro>0 (Hb Heraklion) in the alpha1 globin gene, in trans to a common Mediterranean nondeletion alpha-thalassemia mutation (alpha(Hph)alpha). The deletion of proline at alpha37(C2) is predicted to result in severe instability of the variant hemoglobin, which on interaction with a synthesis-deficient alpha-thalassemia mutation causes a relatively severe dyserythropoietic anemia, representing an alternative phenotype associated with highly unstable alpha-chain variants. Hb Heraklion is the fourth highly unstable alpha-globin variant that we have observed in patients from Greece and Albania. Two variants involve the alpha2-globin gene: Hb Agrinio (alpha29(B10)Leu>Pro) and Hb Adana (alpha59(E8)Gly>Asp), and two the alpha1-gene: Hb Aghia Sophia (alpha62(E11)Val>0) and (Hb Heraklion a37(C2)Pro>0). Each has been observed on interaction with a different alpha-thalassemia mutation and the phenotypes associated with these highly unstable alpha-variants are presented.
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Affiliation(s)
- J Traeger-Synodinos
- First Department of Pediatrics, University of Athens, St. Sophia's Children's Hospital, Athens, 11527, Greece
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45
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Vrettou C, Kanavakis E, Traeger-Synodinos J, Metaxotou-Mavrommati A, Basiakos I, Maragoudaki E, Stamoulakatou A, Papassotiriou I, Kattamis C. Molecular studies of beta-thalassemia heterozygotes with raised Hb F levels. Hemoglobin 2000; 24:203-20. [PMID: 10975440 DOI: 10.3109/03630260008997528] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Hb F levels in beta-thalassemia heterozygotes are usually less than 2%, but amongst 1,059 patients studied, 73 (7%) had Hb F levels above 2.5% (2.6-14.0%). To investigate factors that may influence the increase of Hb F levels in these heterozygotes, we characterized the beta-thalassemia mutations and their chromosomal background, gamma-globin gene promoter variations, and alpha-globin genotypes. All 73 beta-thalassemia heterozygotes carried beta-thalassemia point mutations previously observed in the Greek population; gene mapping excluded b gene cluster deletions; only two cases had an additional gamma-globin gene (gammagammagamma/gammagamma). Five alpha-globin genes (alphaalphaalpha/alphaalpha) were detected in 17/73 cases (23%) as compared to a carrier rate of 1.76% in the general population. Molecular, hematological, and biosynthetic findings in these compound heterozygotes indicated that the raised Hb F levels were caused by cell selection due to ineffective erythropoiesis. In the remaining 56 simple beta-thalassemia heterozygotes, 11 beta-thalassemia mutations were observed, each on the expected haplotype(s), and analysis of the gamma gene promoters revealed three known polymorphisms (in linkage disequilibrium), with minimal influence on gamma-globin levels. However, the overall distribution of beta-thalassemia mutations in the 56 simple beta-thalassemia heterozygotes was significantly different (P<0.0002) compared to that in 986 simple beta-thalassemia heterozygotes with <2.5% Hb F, implicating an association between beta-thalassemia mutations and moderately increased Hb F levels, most notably codon 39 (C-->T), IVS-II-1 (G-->A), codon 6 (-A), and codon 8 (-AA), which accounted for 41/56 (73%) cases with >2.5% Hb F. In the remaining 15/56 (27%) cases, no common underlying globin genotypes could explain the raised Hb F levels. Overall, this study indicates that the control of Hb F levels in beta-thalassemia heterozygotes is heterogeneous and multi-factorial.
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Affiliation(s)
- C Vrettou
- First Department of Pediatrics, University of Athens, Aghia Sophia Children's Hospital, Greece
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46
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Mavroidis N, Traeger-Synodinos J, Kanavakis E, Drogari E, Matsaniotis N, Humphries SE, Day IN, Kattamis C. A high incidence of mutations in exon 6 of the low-density lipoprotein receptor gene in Greek familial hypercholesterolemia patients, including a novel mutation. Hum Mutat 2000; 9:274-6. [PMID: 9090532 DOI: 10.1002/(sici)1098-1004(1997)9:3<274::aid-humu10>3.0.co;2-#] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- N Mavroidis
- First Department of Pediatrics, University of Athens, St. Sophia's Children's Hospital, Greece
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47
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Kanavakis E, Vrettou C, Palmer G, Tzetis M, Mastrominas M, Traeger-Synodinos J. Preimplantation genetic diagnosis in 10 couples at risk for transmitting beta-thalassaemia major: clinical experience including the initiation of six singleton pregnancies. Prenat Diagn 1999; 19:1217-22. [PMID: 10660958 DOI: 10.1002/(sici)1097-0223(199912)19:13<1217::aid-pd723>3.0.co;2-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Preimplantation genetic diagnosis (PGD) offers couples at risk for transmitting an inherited disorder the possibility to avoid the need to terminate affected pregnancies, since it allows the selection of unaffected IVF embryos for transfer. PGD for monogenic diseases is most commonly accomplished by blastomere biopsy from cleavage stage embryos, followed by polymerase chain reaction (PCR)-based DNA analysis. However, PCR-based DNA analysis of single cells is subject to several problems including sample contamination, total PCR failure, or failure of one allele to amplify--a phenomenon known as allelic drop-out (ADO). Furthermore, the molecular heterogeneity of many monogenic diseases requires a diagnostic strategy capable of detecting a spectrum of mutations and compound genotypes. With the above considerations we developed an accurate and reliable strategy for analysis of beta-globin gene mutations, applicable for PGD for the wide spectrum of beta-thalassaemia major genotypes in the Greek population. The strategy involves nested PCR followed by denaturing gradient gel electrophoresis (DGGE) analysis. DGGE is an advantageous method for mutation detection since it facilitates simultaneous analysis of more than one mutation in a single PCR fragment, it identifies the presence of normal alleles and in addition can monitor the occurrence of ADO. This report describes the application of the DGGE-based diagnostic strategy in 11 clinical IVF/PGD cycles, in 10 couples at risk for transmitting beta-thalassaemia major. The transfer of at least one embryo diagnosed as unaffected for beta-thalassaemia major in nine couples has resulted in the initiation of six pregnancies. Four pregnancies have so far been confirmed as unaffected for beta-thalassaemia major by first or second-trimester prenatal diagnosis, two of which have resulted in the birth of two healthy babies. Three singleton pregnancies are still on-going and one ectopic pregnancy was terminated.
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Affiliation(s)
- E Kanavakis
- First Department of Pediatrics, Athens University, St Sophia's Children's Hospital, Greece.
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48
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Vrettou C, Palmer G, Kanavakis E, Tzetis M, Antoniadi T, Mastrominas M, Traeger-Synodinos J. A widely applicable strategy for single cell genotyping of beta-thalassaemia mutations using DGGE analysis: application to preimplantation genetic diagnosis. Prenat Diagn 1999; 19:1209-16. [PMID: 10660957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Preimplantation genetic diagnosis (PGD) allows the selection of unaffected IVF embryos for transfer in couples that are at risk for transmitting genetic diseases. For monogenic diseases, polymerase chain reaction (PCR)-based diagnosis is usually performed on single blastomeres. In Greece, up to 10 per cent of the population are carriers for beta-thalassaemia and related haemoglobinopathies, and more than 20 pathological mutations in the beta-globin gene have been described. In this study we report a strategy which includes a first round of PCR, allowing subsequent nested PCR and DGGE analysis for at least 95 per cent of beta-thalassaemia major genotypes in the Greek population. The use of DGGE for beta-globin genotype analysis is advantageous: it facilitates simultaneous analysis of more than one mutation in a single PCR fragment, it detects the presence of normal alleles and monitors the occurrence of allelic drop-out (ADO) through the expectation that heterozygous samples have more than one electrophoretic band on DGGE analysis. The optimization, accuracy and reliability of the method was evaluated by genotyping 325 single blastomeres, 110 amniocytes and 55 lymphocytes. Results confirmed that PCR efficiency and occurrence of ADO are improved by higher denaturation temperatures in the first cycles of first-round PCR, influenced by the size of the fragment amplified in the first round of PCR and additionally by the quality and type of cells being genotyped. The proposed strategy was accurate and reliable, and thus for application to PGD should ensure the transfer of unaffected embryos. Furthermore it is widely applicable in most of the populations worldwide where beta-thalassaemia is common.
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Affiliation(s)
- C Vrettou
- First Department of Pediatrics, Athens University, St Sophia's Children's Hospital, Greece
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49
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Maragoudaki E, Kanavakis E, Traeger-Synodinos J, Vrettou C, Tzetis M, Metaxotou-Mavrommati A, Kattamis C. Molecular, haematological and clinical studies of the -101 C --> T substitution of the beta-globin gene promoter in 25 beta-thalassaemia intermedia patients and 45 heterozygotes. Br J Haematol 1999; 107:699-706. [PMID: 10606872 DOI: 10.1046/j.1365-2141.1999.01788.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We report the clinical, haematological, biosynthetic and molecular data of 25 double heterozygote beta-thalassaemia intermedia patients and 45 beta-thalassaemia heterozygotes with the C --> T substitution at nucleotide position -101 from the Cap site, in the distal CACCC box of the beta-globin gene promoter. This mutation is considered the most common amongst the silent beta-thalassaemia mutations in Mediterranean populations. Of the 25 compound heterozygotes for the beta -101 C --> T and common severe beta-thalassaemia mutations, all but one had mild thalassaemia intermedia preserving haemoglobin levels around 9.5 g/dl and haemoglobin F levels < 25%. The only transfused patient was characterized to have an additional alpha-globin gene. Strict assessment of haematological and biosynthetic findings in the heterozygotes for the beta -101 C --> T mutation (excluding six cases with an alpha-globin gene defect) demonstrated that less than half of them had completely normal (silent) haematology; the remainder had either high haemoglobin A2 values (in the range of 3.7-5.1%) and/or low red cells indices and/or raised haemoglobin F values. The alpha/non-alpha-globin chain synthesis ratios were generally raised, with mean 1.44 (1.07-2.10). Amongst the parents of the compound heterozygotes, who were not selected for molecular analysis following haematological screening, half of the cases were completely silent. Interaction with severe beta-thalassaemia mutations always resulted in the clinical phenotype of mild non-transfusion-dependent thalassaemia intermedia.
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Affiliation(s)
- E Maragoudaki
- First Department of Paediatrics, Athens University, St Sophia's Children's Hospital, Athens, Greece
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50
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Traeger-Synodinos J, Harteveld CL, Kanavakis E, Giordano PC, Kattamis C, Bernini LF. Hb Aghia Sophia [alpha62(E11)Val-->0 (alpha1)], an "in-frame" deletion causing alpha-thalassemia. Hemoglobin 1999; 23:317-24. [PMID: 10569720 DOI: 10.3109/03630269909090747] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In this report we describe a case of Hb H disease due to the interaction of the --(MED 1) deletion with a new alpha(+)-thalassemia determinant. The molecular analysis of the proband's genomic DNA was carried out by polymerase chain reaction amplification and sequencing of both alpha genes of the alpha(+)-thalassemia chromosome and revealed a deletion of codon 62 of the alpha1 gene. This DNA triplet codes for a valine residue at the E11 alpha helix, which is located in the interior of the heme pocket. Substitutions of valine E11 with other amino acid residues in the alpha as well as beta polypeptide chains lead, in the heterozygous carrier, either to Hb M disease or to congenital non-spherocytic hemolytic anemia. We assume that the deletion of valine at alpha62(E11) disrupts the conformation of the alpha chain to such an extent that the mutated subunit is rapidly removed by proteolysis. The final result is an alpha-thalassemia phenotype rather than an unstable hemoglobin syndrome. This conclusion is supported by the apparent absence of an abnormal alpha chain in the peripheral blood of the patient.
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Affiliation(s)
- J Traeger-Synodinos
- First Department of Pediatrics Aghia Sophia Children Hospital Athens University, Greece
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