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在具有相互易位或罗伯逊易位的夫妇中,对第 3 天和第 5/6 天 PGD 胚胎进行自然选择。

Natural selection between day 3 and day 5/6 PGD embryos in couples with reciprocal or Robertsonian translocations.

机构信息

Monash IVF, Suite 1, 252 Clayton Rd, Clayton, VIC, 3168, Australia.

出版信息

J Assist Reprod Genet. 2017 Nov;34(11):1483-1492. doi: 10.1007/s10815-017-1009-0. Epub 2017 Jul 29.

DOI:10.1007/s10815-017-1009-0
PMID:28756497
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5699989/
Abstract

PURPOSE

For translocation carriers, preimplantation genetic diagnosis (PGD) provides the opportunity to distinguish between normal/balanced and unbalanced embryos prior to implantation and, as such, increases the likelihood of a successful ongoing pregnancy. The data presented here compares autosomal reciprocal and Robertsonian translocation segregation patterns in day 3 versus day 5/6 IVF-PGD embryos to determine if there is a difference in the chromosome segregation patterns observed at these developmental time points.

METHODS

A retrospective analysis on PGD translocation carriers at Monash IVF was performed. Segregation patterns were compared between day 3 and day 5/6 embryos to ascertain whether selection against malsegregants exists.

RESULTS

For reciprocal translocations, 1649 day 3 embryos (139 translocations) from 144 couples and 128 day 5/6 embryos (59 translocations) from 60 couples were analysed. Day 3 segregation analysis showed that 22.3% of embryos were normal/balanced (consistent with 2:2 alternate segregation) and 77.7% were unbalanced (malsegregation). Day 5/6 segregation analysis showed that 53.1% of embryos were normal/balanced and 46.9% were unbalanced. For Robertsonian translocations, 847 day 3 embryos (8 translocations) from 54 couples and 193 day 5/6 embryos (6 translocations) from 31 couples were analysed. Day 3 segregation analysis showed that 38.7% of embryos were normal/balanced (consistent with 2:1 alternate segregation) and 61.3% were unbalanced. Day 5/6 segregation analysis showed that 74.1% of embryos were normal/balanced and 25.9% were unbalanced.

CONCLUSIONS

This data demonstrates an increase in the proportion of genetically normal/balanced embryos at day 5/6 of development. This suggests a strong natural selection process between day 3 and day 5/6 in favour of normal/balanced embryos. These findings support performing PGD testing on day 5/6 of embryo development.

摘要

目的

对于易位携带者,胚胎植入前遗传学诊断(PGD)提供了在植入前区分正常/平衡和不平衡胚胎的机会,从而增加了成功进行妊娠的可能性。本文比较了第 3 天和第 5/6 天体外受精 - PGD 胚胎中常染色体相互易位和罗伯逊易位的分离模式,以确定在这些发育时间点观察到的染色体分离模式是否存在差异。

方法

对 Monash IVF 的 PGD 易位携带者进行了回顾性分析。比较第 3 天和第 5/6 天胚胎的分离模式,以确定是否存在对错误分离的选择。

结果

对于相互易位,分析了 144 对夫妇的 1649 个第 3 天胚胎(139 个易位)和 60 对夫妇的 128 个第 5/6 天胚胎(59 个易位)。第 3 天的分离分析显示,22.3%的胚胎为正常/平衡(与 2:2 交替分离一致),77.7%为不平衡(错误分离)。第 5/6 天的分离分析显示,53.1%的胚胎为正常/平衡,46.9%为不平衡。对于罗伯逊易位,分析了 54 对夫妇的 847 个第 3 天胚胎(8 个易位)和 31 对夫妇的 193 个第 5/6 天胚胎(6 个易位)。第 3 天的分离分析显示,38.7%的胚胎为正常/平衡(与 2:1 交替分离一致),61.3%为不平衡。第 5/6 天的分离分析显示,74.1%的胚胎为正常/平衡,25.9%为不平衡。

结论

这些数据表明,在发育的第 5/6 天,正常/平衡胚胎的比例增加。这表明在第 3 天和第 5/6 天之间存在强烈的自然选择过程,有利于正常/平衡的胚胎。这些发现支持在胚胎发育的第 5/6 天进行 PGD 检测。

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Can Comprehensive Chromosome Screening Technology Improve IVF/ICSI Outcomes? A Meta-Analysis.全面染色体筛查技术能否改善体外受精/卵胞浆内单精子注射结局?一项荟萃分析。
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Impact of blastocyst biopsy and comprehensive chromosome screening technology on preimplantation genetic screening: a systematic review of randomized controlled trials.囊胚活检与综合染色体筛查技术对植入前基因筛查的影响:随机对照试验的系统评价
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