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一名患有X连锁显性色素失禁症的女性通过辅助生殖顺利分娩双胞胎,随后进行了植入前基因筛查。

A healthy delivery of twins by assisted reproduction followed by preimplantation genetic screening in a woman with X-linked dominant incontinentia pigmenti.

作者信息

Kim Myung Joo, Lyu Sang Woo, Seok Hyun Ha, Park Ji Eun, Shim Sung Han, Yoon Tae Ki

机构信息

Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University College of Medicine, Seoul, Korea.

Genetics Laboratory, Fertility Center of CHA Gangnam Medical Center, CHA University College of Medicine, Seoul, Korea.

出版信息

Clin Exp Reprod Med. 2014 Dec;41(4):168-73. doi: 10.5653/cerm.2014.41.4.168. Epub 2014 Dec 31.

Abstract

The purpose of this study is to report a successful twin pregnancy and delivery in a female patient with X-linked dominant incontinentia pigmenti (IP) who underwent assisted reproductive technology followed by preimplantation genetic screening (PGS). A 29-year-old female with IP had a previous history of recurrent spontaneous abortion. A molecular analysis revealed the patient had a de novo mutation, 1308_1309insCCCCTTG(p.Ala438ProfsTer26), in the inhibitor of the kappa B kinase gamma gene located in the Xq28 region. IVF/ICSI and PGS was performed, in which male embryos were sexed using array-based comparative genomic hybridization (aCGH). After IVF/ICSI and PGS using aCGH on seven embryos, two euploid male blastocysts were transferred with a 50% probability of a viable male pregnancy. The dizygotic twin pregnancy was confirmed and the amniocentesis results of each twin were normal with regard to the mutation found in the mother. The patient delivered healthy twin babies during the 37th week of gestation. This case shows the beneficial role of PGS in achieving a successful pregnancy through euploid male embryo gender selection in a woman with X-linked dominant IP with a history of multiple male miscarriages.

摘要

本研究的目的是报告一名患有X连锁显性色素失禁症(IP)的女性患者成功实现双胎妊娠并分娩的病例,该患者接受了辅助生殖技术并进行了植入前基因筛查(PGS)。一名患有IP的29岁女性既往有反复自然流产史。分子分析显示,该患者在位于Xq28区域的κB激酶γ基因抑制剂中有一个新发突变,即1308_1309insCCCCTTG(p.Ala438ProfsTer26)。进行了体外受精/卵胞浆内单精子注射(IVF/ICSI)和PGS,其中使用基于微阵列的比较基因组杂交(aCGH)对雄性胚胎进行性别鉴定。在对7个胚胎进行IVF/ICSI和使用aCGH的PGS后,移植了2个整倍体雄性囊胚,有活力的雄性妊娠概率为50%。确认了双卵双胎妊娠,且每个胎儿的羊水穿刺结果在母亲所发现的突变方面均正常。该患者在妊娠第37周时分娩出健康的双胞胎婴儿。本病例显示了PGS在一名有多次男性流产史的X连锁显性IP女性中,通过选择整倍体雄性胚胎性别来实现成功妊娠方面的有益作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/230a/4295944/47bcc0f00c49/cerm-41-168-g001.jpg

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