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单基因疾病的植入前基因检测:巴西一家试管婴儿中心的经验

Preimplantation genetic testing for monogenic diseases: a Brazilian IVF centre experience.

作者信息

Zanetti Bianca Ferrarini, Braga Daniela Paes de Almeida Ferreira, Azevedo Matheus de Castro, Setti Amanda Souza, Figueira Rita Cássia Sávio, Iaconelli Assumpto, Borges Edson

机构信息

Fertility - Medical Group, São Paulo, SP - Brazil.

Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP - Brazil.

出版信息

JBRA Assist Reprod. 2019 Apr 30;23(2):99-105. doi: 10.5935/1518-0557.20180076.

Abstract

OBJECTIVE

To describe the cases of preimplantation genetic testing for monogenic diseases (PGT-M) in fertile couples who had undergone intracytoplasmic sperm injection (ICSI) cycles in a Brazilian fertilisation (IVF) centre and determine whether these cases were different from those reported from the European Society of Human Reproduction and Embryology (ESHRE).

METHODS

This retrospective collection included data obtained from ICSI-PGT-M cycles between 2011 and 2016. The disease indication, number of biopsied embryos, biopsy stage, diagnosed and affected embryos, and cycles with embryo to transfer as well as implantation, pregnancy and miscarriage rates were analysed and compared to cycles without genetic diagnosis (PGT) and with ESHRE PGD Consortium collection XIV-XV.

RESULTS

From 5,070 cycles performed, 72 had indications for PGT-M. The most common time for biopsy was cleavage-stage; 93% of the embryos had a diagnostic result, 59.4% of which were genetically transferable, resulting in 68% of the cycles with transferred embryos, a 22.1% implantation rate, and a 28.6% pregnancy rate. No differences in clinical outcomes of cycles with PGT-M or without PGT were observed. The day of biopsy and diagnostic success as well as implantation, pregnancy and miscarriage rates were similar to ESHRE collection.

CONCLUSIONS

Although the proportion of cases with PGT-M was low, its efficacy was similar to what was reported in the European collection and represents a viable alternative for families at risk of transmitting a genetic disorder to their offspring. The main difference between our and ESHRE collection were the disease indications, which reflected the admixed, multi-ethnic Brazilian population.

摘要

目的

描述在巴西一家体外受精(IVF)中心接受卵胞浆内单精子注射(ICSI)周期治疗的可育夫妇中,单基因疾病植入前基因检测(PGT-M)的病例情况,并确定这些病例是否与欧洲人类生殖与胚胎学会(ESHRE)报告的病例不同。

方法

这项回顾性研究收集了2011年至2016年间ICSI-PGT-M周期的数据。分析了疾病指征、活检胚胎数量、活检阶段、诊断出的和受影响的胚胎、有胚胎可供移植的周期以及着床率、妊娠率和流产率,并与未进行基因诊断(PGT)的周期以及ESHRE PGD联盟第十四至十五批收集的数据进行比较。

结果

在进行的5070个周期中,72个有PGT-M指征。最常见的活检时间是卵裂期;93%的胚胎有诊断结果,其中59.4%在基因上可用于移植,68%的周期有胚胎移植,着床率为22.1%,妊娠率为28.6%。观察到PGT-M周期和非PGT周期的临床结局没有差异。活检日期、诊断成功率以及着床率、妊娠率和流产率与ESHRE收集的数据相似。

结论

尽管PGT-M病例的比例较低,但其疗效与欧洲收集的数据报告相似,对于有将遗传疾病传给后代风险的家庭来说是一种可行的选择。我们的收集数据与ESHRE收集数据的主要差异在于疾病指征,这反映了巴西混合多民族的人口情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a203/6501745/98cd26efb5be/jbra-23-02-0099-g02.jpg

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