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[两名罕见小额外标记染色体不孕患者的遗传分析及辅助生殖指导]

[Genetic analysis and assisted reproductive guidance for two infertile patients with rare small supernumerary marker chromosomes].

作者信息

Yi Duo, Yuan Shimin, Hu Liang, Gong Fei, Luo Keli, Hu Hao, Tan Yueqiu, Lu Guangxiu, Lin Ge, Cheng Dehua

机构信息

Reproductive and Genetic Hospital of Citic-Xiangya, Changsha, Hunan 410078, China.

出版信息

Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2024 May 10;41(5):519-525. doi: 10.3760/cma.j.cn511374-20230322-00152.

Abstract

OBJECTIVE

To carry out cytogenetic and molecular genetic analysis for two infertile patients carrying rare small supernumerary marker chromosomes (sSMC).

METHODS

Two infertile patients who received reproductive and genetic counseling at CITIC Xiangya Reproductive and Genetic Hospital on October 31, 2018 and May 10, 2021, respectively were selected as the study subjects. The origin of sSMCs was determined by conventional G banding, fluorescence in situ hybridization (FISH) and copy number variation sequencing (CNV-seq). Microdissection combined with high-throughput whole genome sequencing (MicroSeq) was carried out to determine the fragment size and genomic information of their sSMCs.

RESULTS

For patient 1, G-banded karyotyping and FISH revealed that he has a karyotype of mos47,XY,del(16)(p10p12),+mar[65]/46,XY,del(16)(p10p12)[6]/48,XY,del(16)(p10p12),+2mar[3].ish mar(Tel 16p-,Tel 16q-,CEP 16-,WCP 16+). CNV analysis has yielded a result of arr[GRCh37]16p12.1p11.2(24999364_33597595)×1[0.25]. MicroSeq revealed that his sSMC has contained the region of chromosome 16 between 24979733 and 34023115 (GRCh37). For patient 2, karyotyping and reverse FISH revealed that she has a karyotype of mos 47,XX,+mar[37]/46,XX[23].rev ish CEN5, and CNV analysis has yielded a result of seq[GRCh37]dup(5)(p12q11.2)chr5:g(45120001_56000000)dup[0.8]. MicroSeq results revealed that her sSMC has contained the region of chromosome 5 between 45132364 and 55967870(GRCh37). After genetic counseling, both couples had opted in vitro fertilization (IVF) treatment and preimplantation genetic testing (PGT).

CONCLUSION

For individuals harboring sSMCs, it is vital to delineate the origin and structural characteristics of the sSMCs for their genetic counseling and reproductive guidance. Preimplantation genetic testing after microdissection combined with high-throughput whole genome sequencing (MicroSeq-PGT) can provide an alternative treatment for carrier couples with a high genetic risk.

摘要

目的

对两名携带罕见小超数标记染色体(sSMC)的不孕患者进行细胞遗传学和分子遗传学分析。

方法

分别选取2018年10月31日和2021年5月10日在中信湘雅生殖与遗传专科医院接受生殖与遗传咨询的两名不孕患者作为研究对象。通过常规G显带、荧光原位杂交(FISH)和拷贝数变异测序(CNV-seq)确定sSMC的来源。进行显微切割联合高通量全基因组测序(MicroSeq)以确定其sSMC的片段大小和基因组信息。

结果

患者1,G显带核型分析和FISH显示其核型为mos47,XY,del(16)(p10p12),+mar[65]/46,XY,del(16)(p10p12)[6]/48,XY,del(16)(p10p12),+2mar[3]。ish mar(Tel 16p-,Tel 16q-,CEP 16-,WCP 16+)。CNV分析结果为arr[GRCh37]16p12.1p11.2(24999364_33597595)×1[0.25]。MicroSeq显示其sSMC包含16号染色体24979733至34023115之间的区域(GRCh37)。患者2,核型分析和反向FISH显示其核型为mos 47,XX,+mar[37]/46,XX[23]。rev ish CEN5,CNV分析结果为seq[GRCh37]dup(5)(p12q11.2)chr5:g(45120001_56000000)dup[0.8]。MicroSeq结果显示其sSMC包含5号染色体45132364至55967870之间的区域(GRCh37)。经过遗传咨询后,两对夫妇均选择体外受精(IVF)治疗和植入前基因检测(PGT)。

结论

对于携带sSMC的个体,明确sSMC的来源和结构特征对于其遗传咨询和生殖指导至关重要。显微切割联合高通量全基因组测序后的植入前基因检测(MicroSeq-PGT)可为遗传风险高的携带者夫妇提供一种替代治疗方案。

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