Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, No. 567, Tongzipo West Road, Yuelu District, Changsha, 410008, Hunan, China.
Hospital of Hunan Guangxiu, Hunan Normal University School of Medicine, Changsha, China.
J Assist Reprod Genet. 2023 Oct;40(10):2333-2342. doi: 10.1007/s10815-023-02916-7. Epub 2023 Sep 1.
To investigate the feasibility of the application of conventional in vitro fertilization (cIVF) for couples undergoing preimplantation genetic testing for aneuploidies (PGT-A) with non-male factor infertility.
To evaluate the efficiency of sperm whole-genome amplification (WGA), spermatozoa were subjected to three WGA protocols: Picoplex, ChromInst, and multiple displacement amplification (MDA). In the clinical studies, 641 couples who underwent PGT-A treatment for frozen embryos between January 2016 and December 2021 were included to retrospectively compare the chromosomal and clinical outcomes of cIVF and intracytoplasmic sperm injection (ICSI). Twenty-six couples were prospectively recruited for cIVF and PGT-A treatment between April 2021 and April 2022; parental contamination was analyzed in biopsied samples; and 12 aneuploid embryos were donated to validate the PGT-A results.
Sperm DNA failed to amplify under Picoplex and ChromInst conditions but could be amplified using MDA. In frozen PGT-A cycles, no significant differences in the average rates of euploid, mosaic, and aneuploid embryos per cycle between the cIVF-PGT-A and ICSI-PGT-A groups were observed. The results of the prospective study that recruited couples for cIVF-PGT-A treatment showed no paternal contamination and one case of maternal contamination in 150 biopsied trophectoderm samples. Among the 12 donated embryos with whole-chromosome aneuploidy, 11 (91.7%) presented uniform chromosomal aberrations, which were in agreement with the original biopsy results.
Under the Picoplex and ChromInst WGA protocols, the risk of parental contamination in the cIVF-PGT-A cycles was low. Therefore, applying cIVF to couples with non-male factor infertility who are undergoing PGT-A is feasible.
探讨在非男性因素不孕进行胚胎植入前遗传学检测非整倍体(PGT-A)的夫妇中应用常规体外受精(cIVF)的可行性。
为评估精子全基因组扩增(WGA)的效率,对精子进行了三种 WGA 方案:Picoplex、ChromInst 和多重置换扩增(MDA)。在临床研究中,纳入了 641 对夫妇,他们在 2016 年 1 月至 2021 年 12 月期间接受了冷冻胚胎的 PGT-A 治疗,以回顾性比较 cIVF 和胞浆内精子注射(ICSI)的染色体和临床结局。2021 年 4 月至 2022 年 4 月期间,前瞻性纳入 26 对夫妇进行 cIVF 和 PGT-A 治疗;对活检样本进行了父母污染分析;并捐赠了 12 个非整倍体胚胎以验证 PGT-A 结果。
Picoplex 和 ChromInst 条件下精子 DNA 扩增失败,但使用 MDA 可以扩增。在冷冻 PGT-A 周期中,cIVF-PGT-A 和 ICSI-PGT-A 组之间每个周期的整倍体、嵌合体和非整倍体胚胎的平均率没有显著差异。前瞻性研究招募了接受 cIVF-PGT-A 治疗的夫妇,在 150 个活检滋养外胚层样本中,未发现父系污染,仅有 1 例母系污染。在具有全染色体非整倍性的 12 个捐赠胚胎中,有 11 个(91.7%)呈现出一致的染色体异常,与原始活检结果一致。
在 Picoplex 和 ChromInst WGA 方案下,cIVF-PGT-A 周期中父母污染的风险较低。因此,对非男性因素不孕且正在进行 PGT-A 的夫妇应用 cIVF 是可行的。