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首例经胚胎植入前遗传学检测贝克威斯-恩德曼综合征后成功分娩健康男婴的病例报告。

First case report of a successful delivery of a healthy boy by preimplantation genetic testing for Beckwith-Wiedemann syndrome.

机构信息

Embryology Laboratory, Orchid Reproductive and Andrology Services, Dubai, UAE.

Medical Department, Orchid Reproductive and Andrology Services, Dubai, UAE.

出版信息

J Assist Reprod Genet. 2024 Oct;41(10):2771-2775. doi: 10.1007/s10815-024-03186-7. Epub 2024 Jun 27.

DOI:10.1007/s10815-024-03186-7
PMID:38935178
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11534936/
Abstract

PURPOSE

To showcase the successful use of ICSI with PGT-M to overcome Beckwith-Wiedemann syndrome (BWS)-related reproductive challenges, resulting in the birth of a healthy baby boy. By targeting the maternally inherited CDKN1C pathogenic gene variant, this report highlights the genetic interventions in BWS reproductive risk management.

METHODS

This case report describes a 41-year-old woman seeking fertility assistance after a previous pregnancy revealed a fetal anomaly related to BWS. Families with BWS recurrence face challenges, as maternally inherited CDKN1C pathogenic variants contribute to approximately 40% of genetic alterations, with a potential recurrence risk as high as 50%. Genetic analysis identified a pathogenic variant in the CDKN1C gene of the fetus that was maternally inherited. The pregnancy was terminated due to the fetal anomalies. The couple underwent intra-cytoplasmic sperm injection (ICSI) combined with preimplantation genetic testing for monogenic diseases (PGT-M) and preimplantation genetic testing for aneuploidy (PGT-A).

RESULTS

Two embryos from IVF with low-risk PGT-M and euploid status. One transferred via frozen embryo transfer (FET) in February 2023 resulted in the successful birth of a healthy baby boy. This study reports the first successful delivery of a healthy boy after PGT-M for the CDKN1C gene variant c.79_100delinsGTGACC, contributing to the limited literature on successful outcomes for BWS.

CONCLUSION

Utilizing PGT-M in combination with IVF can lead to favorable outcomes in managing BWS-associated reproductive challenges, offering insights into potential genetic interventions and successful birth.

摘要

目的

展示使用 ICSI 与 PGT-M 克服 Beckwith-Wiedemann 综合征(BWS)相关生殖挑战的成功案例,成功诞生了一名健康男婴。通过靶向母体遗传的 CDKN1C 致病性基因突变,本报告强调了 BWS 生殖风险管理中的遗传干预措施。

方法

本病例报告描述了一名 41 岁女性,她在之前的妊娠中发现胎儿存在与 BWS 相关的异常,寻求生育援助。BWS 复发的家庭面临挑战,因为母体遗传的 CDKN1C 致病性基因突变约占 40%,遗传风险高达 50%。基因分析确定胎儿携带 CDKN1C 基因的致病性突变,该突变由母体遗传。由于胎儿异常,妊娠终止。夫妇接受了卵胞浆内单精子注射(ICSI)联合单基因疾病植入前遗传学检测(PGT-M)和非整倍体植入前遗传学检测(PGT-A)。

结果

IVF 获得的两个胚胎均为低风险 PGT-M 和整倍体状态。其中一个于 2023 年 2 月通过冷冻胚胎移植(FET)进行移植,成功诞生了一名健康男婴。本研究报告了首例成功分娩携带 CDKN1C 基因变体 c.79_100delinsGTGACC 的健康男婴的案例,该基因变体对 BWS 成功结局的有限文献做出了贡献。

结论

将 PGT-M 与 IVF 结合使用可以为 BWS 相关生殖挑战的管理带来有利的结果,为潜在的遗传干预措施和成功分娩提供了新的见解。

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本文引用的文献

1
First report of a successful pregnancy by preimplantation genetic testing for Beckwith-Wiedemann syndrome.首例通过胚胎植入前遗传学检测技术(PGT)治疗贝克威斯-恩德曼综合征(BWS)成功妊娠的报告。
Taiwan J Obstet Gynecol. 2022 Jan;61(1):174-179. doi: 10.1016/j.tjog.2021.11.030.
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Diagnosis and Management of Beckwith-Wiedemann Syndrome.贝克威思-维德曼综合征的诊断与管理
Front Pediatr. 2020 Jan 21;7:562. doi: 10.3389/fped.2019.00562. eCollection 2019.
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Expert consensus document: Clinical and molecular diagnosis, screening and management of Beckwith-Wiedemann syndrome: an international consensus statement.专家共识文件:贝克威思-威德曼综合征的临床和分子诊断、筛查及管理:国际专家共识声明。
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Beckwith-Wiedemann syndrome.贝克威思-威德曼综合征。
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Beckwith-Wiedemann syndrome demonstrates a role for epigenetic control of normal development.贝克威思-维德曼综合征表明表观遗传控制在正常发育中发挥作用。
Hum Mol Genet. 2003 Apr 1;12 Spec No 1:R61-8. doi: 10.1093/hmg/ddg067.
7
Blastocyst score affects implantation and pregnancy outcome: towards a single blastocyst transfer.囊胚评分影响着床和妊娠结局:迈向单囊胚移植。
Fertil Steril. 2000 Jun;73(6):1155-8. doi: 10.1016/s0015-0282(00)00518-5.