Senba Hiroshi, Sueoka Kou, Sato Suguru, Higuchi Nobuhiko, Mizuguchi Yuki, Sato Kenji, Tanaka Mamoru
Department of Obstetrics and Gynecology Tachikawa Hospital Tachikawa Japan.
Department of Obstetrics and Gynecology School of Medicine, Keio University Tokyo Japan.
Reprod Med Biol. 2020 Apr 29;19(3):265-269. doi: 10.1002/rmb2.12327. eCollection 2020 Jul.
The objective is to clarify the practical problem of the preimplantation genetic testing (PGT) for myotonic dystrophy type 1 (DM1) in Japanese subjects.
For the 32 couples who consented to participate in PGT for DM1, CTG repeats number on the unaffected alleles was analyzed. Based on the allele combination, they were classified into 3 groups by the number of diagnostic allelic pattern; "full informative," "semi informative," and "noninformative." According to the Japan Society of Obstetrics and Gynecology (JSOG) principle, PGT was performed using the direct diagnosis to the 288 embryos from the 17 couples who received the ethical approval from both our institution and JSOG.
In the 32 couples, the frequency of CTG repeats on the unaffected alleles showed bimodal distribution. The "full informative," "semi informative," and "noninformative" couples accounted for 46.9% (15/32 couples), 46.9% (15/32 couples) and 6.2% (2/32 couples), respectively. The transferable embryos accounted for 28.9% (33/114 embryos) in the "full informative" couples, although it was limited to 12.6% (22/174 embryos) in the "semi informative" couples.
The loss of unaffected embryos which cannot be diagnosed as transferable was a clinically major problem and implied an increase in oocyte retrieval, especially for "semi informative" couples.
本研究旨在阐明日本人群中1型强直性肌营养不良症(DM1)胚胎植入前基因检测(PGT)的实际问题。
对于32对同意参与DM1的PGT的夫妇,分析其未受影响等位基因上的CTG重复次数。根据等位基因组合,按照诊断等位基因模式的数量将他们分为3组:“完全信息性”、“半信息性”和“无信息性”。根据日本妇产科学会(JSOG)的原则,对来自17对夫妇的288个胚胎进行直接诊断,这些夫妇均获得了本机构和JSOG的伦理批准。
在32对夫妇中,未受影响等位基因上CTG重复次数的频率呈双峰分布。“完全信息性”、“半信息性”和“无信息性”夫妇分别占46.9%(15/32对夫妇)、46.9%(15/32对夫妇)和6.2%(2/32对夫妇)。“完全信息性”夫妇中可移植胚胎占28.9%(33/114个胚胎),而“半信息性”夫妇中这一比例仅为12.6%(22/174个胚胎)。
无法诊断为可移植的未受影响胚胎的损失是一个临床主要问题,这意味着取卵次数增加,尤其是对于“半信息性”夫妇。