Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

Analysis of a Preimplantation Genetic Test for Aneuploidies in Embryos from Colombian Couples: A Report of Cases

Authors
1 Biological Sciences Department, Biomedical Sciences Research Group, Universidad Pedagógica y Tecnológica de Colombia, Tunja, Colombia
2 Biological Sciences Department, Biomedical Sciences Research Group, Universidad Pedagógica y Tecnológica de Colombia, Tunja, Colombia; Fertility and Sterility Colombian Center (CECOLFES), Bogotá, Colombia
3 Fertility and Sterility Colombian Center (CECOLFES), Bogotá, Colombia
4 Genesis Genetics Brasil, Laboratory PGD, Sao Paulo, Brazil
Abstract
Background: Assisted reproduction techniques (ARTs) and the preimplantation genetic test for aneuploidies (PGT-A) help couples with fertility problems to achieve a healthy live birth around the world. The aim of this study was to determine the rate of whole chromosomal copy number variations in embryos from couples undergoing ART and PGT-A, associations of chromosomal variations with embryo morphological parameters, and their relationship to maternal age. Methods: This study included a retrospective analysis of the number of whole chromosomal copies identified by aCGH in embryos from couples undergoing ART. Results: Seventy-six embryos from 29 couples using their own gametes were analyzed, of which 25 (32.9%) were chromosomally normal, and 51 (67.1%) were abnormal. Eleven embryos were evaluated from the group of couples with donated gametes, of which 5 (45.4%) embryos were chromosomally normal, and 6 (54.5%) embryos were abnormal. The main aneuploidies observed were trisomy X (7.8%), trisomy 21 (5.9%), trisomy 9 (3.9%), monosomy 11 (3.9%), monosomy 13 (3.9%) and monosomy X (3.9%), and the principal chromosomes affected were 19, X and 13. A significant association was found between the quality of the embryo and the genetic condition: embryos with euploidy and aneuploidy (p=0.046). Conclusion: The rate of aneuploidies from couples with their own gametes was 67.1% (51/76) and from couples with donated eggs and / or sperm was 54.5% (6/11). The quality of the embryo determinated by the morphological parameters was not associated with the embryo genetic status, and also there was no association between maternal age and aneuploidy rate.
Keywords

  1. Vanneste E, Voet T, Le Caignec C, Ampe M, Konings P, Melotte C, et al. Chromosome instability is common in human cleavage-stage embryos. Nat Med. 2009;15(5):577-83.
  2. Yao G, Xu J, Xin Z, Niu W, Shi S, Jin H, et al. Developmental potential of clinically discarded human embryos and associated chromosomal analysis. Sci Rep. 2016;6:23995.
  3. Oromendia AB, Amon A. Aneuploidy: implications for protein homeostasis and disease. Dis Model Mech. 2014;7(1):15-20.
  4. Williams BR, Amon A. Aneuploidy: cancer’s Fatal Flaw? Cancer Res. 2009;69(13):5289-91.
  5. Su Y, Li JJ, Wang C, Haddad G, Wang WH. Aneuploidy analysis in day 7 human blastocysts produced by in vitro fertilization. Reprod Biol Endocrinol. 2016;14:20.
  6. Fiorentino F, Bono S, Biricik A, Nuccitelli A, Cotroneo E, Cottone G, et al. Application of next-generation sequencing technology for comprehensive aneuploidy screening of blastocysts in clinical preimplantation genetic screening cycles. Hum Reprod. 2014;29(12):2802-13.
  7. Sunderam S, Kissin DM, Crawford SB, Folger SG, Jamieson DJ, Warner L, et al. Assited reproductive technology surveillance-United States, 2013. MMWR Surveill Summ. 2015;64(11):1-25.
  8. Sullivan-Pyke C, Dokras A. Preimplantation genetic screening and preimplantation genetic diagnosis. Obstet Gynecol Clin North Am. 2018;45(1):113-25.
  9. Zheng Z, Chen L, Yang T, Yu H, Wang H, Qin J. Multiple pregnancies achieved with IVF/ICSI and risk of specific congenital malformations: a meta-analysis of cohort studies. Reprod Biomed Online. 2018;36(4):472-82.
  10. Kissin DM, Jamieson DJ, Barfield WD. Monitoring health outcomes of assisted reproductive technology. New Eng J Med. 2014;371(1):91-3.
  11. Kang HJ, Melnick AP, Stewart JD, Xu K, Rosenwaks Z. Preimplantation genetic screening: who benefits? Fertil Steril. 2016;106(3):597-602.
  12. Friedenthal J, Maxwell SM, Munne S, Kramer Y, McCulloh DH, McCaffrey C, et al. Next generation sequencing for preimplantation genetic screening improves pregnancy outcomes compared with array comparative genomic hybridization in single thawed euploid embryo transfer cycles. Fertil Steril. 2018;109(4):627-32.
  13. Weissman A, Shoham G, Shoham Z, Fishel S, Leong M, Yaron Y. Preimplantation genetic screening: results of a worldwide web-based survey. Reprod Biomed Online. 2017;35(6):693-700.
  14. Dahdouh EM, Balayla J, Garcia-Velasco JA. Comprehensive chromosome screening improves embryo selection: a meta-analysis. Fertil Steril. 2015;104(6):1503-12.
  15. Minasi MG, Colasante A, Riccio T, Ruberti A, Casciani V, Scarselli F, et al. Correlation between aneuploidy, standard morphology evaluation and morphokinetic development in 1730 biopsied blastocysts: a consecutive case series study. Hum Reprod. 2016;31(10):2245-54.
  16. Treff NR, Zimmerman RS. Advances in preimplantation genetic testing for monogenic disease and aneuploidy. Annu Rev Genomics Hum Genet. 2017;18:189-200.
  17. Kaing A, Kroener LL, Tassin R, Li M, Liu L, Buyalos R, et al. Earlier day of blastocyst development is predictive of embryonic euploidy across all ages: essential data for physician decision-making and counseling patients. J Assist Reprod Genet. 2018;35(1):119-25.
  18. Scott RT Jr, Upham KM, Forman EJ, Hong KH, Scott KL, Taylor D, et al. Blastocyst biopsy with comprehensive chromosome screening and fresh embryo transfer significantly increases in vitro fertilization implantation and delivery rates: a randomized controlled trial. Fertil Steril. 2013;100(3):697-703.
  19. Franasiak JM, Forman EJ, Hong KH, Werner MD, Upham KM, Treff NR, et al. The nature of aneuploidy with increasing age of the female partner: a review of 15,169 consecutive trophectoderm biopsies evaluated with comprehensive chromosomal screening. Fertil Steril. 2014;101(3):656-63.e1.
  20. Minasi MG, Fiorentino F, Ruberti A, Biricik A, Cursio E, Cotroneo E, et al. Genetic diseases and aneuploidies can be detected with a single blastocyst biopsy: a successful clinical approach. Hum Reprod. 2017;32(8):1770-7.
  21. Fragouli E, Alfarawati S, Daphnis DD, Goodall NN, Mania A, Griffiths T, et al. Cytogenetic analysis of human blastocysts with the use of FISH, CGH and aCGH: scientific data and technical evaluation. Hum Reprod. 2011;26(2):480-90.
  22. Petracchi F, Colaci DS, Igarzabal L, Gadow E. Cytogenetic analysis of first trimester pregnancy loss. Int J Gynaecol Obstet. 2009;104(3):243-4.
  23. Gada Saxena S, Desai K, Shewale L, Ranjan P. Pre-implantation genetic screening using fluorescence in situ hybridization in couples of Indian ethnicity: is there a scope? J Hum Reprod Sci. 2014;7(1):25-9.
  24. Aleksandrova N, Shubina E, Ekimov A, Kodyleva T, Mukosey I, Makarova N, et al. Comparison of the results of preimplantation genetic screening obtained by a-CGH and NGS methods from the same embryos. Gynecol Endocrinol. 2016;32(sup2):1-4.
  25. Brezina PR, Anchan R, Kearns WG. Preimplantation genetic testing for aneuploidy: what technology should you use and what are the differences? J Assist Reprod Genet. 2016;33(7):823-32.
  26. Garcia-Herrero S, Cervero A, Mateu E, Mir P, Poo ME, Rodrigo L, et al. Genetic analysis of human preimplantation embryos. Curr Top Dev Biol. 2016;120:421-47.
  27. Liu J, Wang W, Sun X, Liu L, Jin H, Li M, et al. DNA microarray reveals that high proportions of human blastocysts from women of advanced maternal age are aneuploid and mosaic1. Biol Reprod. 2012;87(6):148.
  28. Al-Asmar N, Peinado V, Vera M, Remohí J, Pellicer A, Simón C, et al. Chromosomal abnormalities in embryos from couples with a previous aneuploid miscarriage. Fertil Steril. 2012;98(1):145-50.
  29. Goldman KN, Nazem T, Berkeley A, Palter S, Grifo JA. Preimplantation genetic diagnosis (PGD) for monogenic disorders: the value of concurrent aneuploidy screening. J Genet Couns. 2016;25(6):1327-37.
  30. Whitney JB, Schiewe MC, Anderson RE. Single center validation of routine blastocyst biopsy implementation. J Assist Reprod Genet. 2016;33(11):1507-13.
  31. Lai HH, Chuang TH, Wong LK, Lee MJ, Hsieh CL, Wang HL, et al. Identification of mosaic and segmental aneuploidies by next-generation sequencing in preimplantation genetic screening can improve clinical outcomes compared to array-comparative genomic hybridization. Mol Cytogenet. 2017;10:14.
  32. Harton G, Braude P, Lashwood A, Schmutzler A, Traeger-Synodinos J, Wilton L, et al. ESHRE PGD consortium best practice guidelines for organization of a PGD centre for PGD/preimplantation genetic screening. Hum Reprod. 2011;26(1):14-24.
  33. van Echten-Arends J, Mastenbroek S, Sikkema-Raddatz B, Korevaar JC, Heineman MJ, van der Veen F, et al. Chromosomal mosaicism in human preimplantation embryos: a systematic review. Hum Reprod Update. 2011;17(5):620-7.
  34. Forman EJ, Tao X, Ferry KM, Taylor D, Treff NR, Scott RT. Single embryo transfer with comprehensive chromosome screening results in improved ongoing pregnancy rates and decreased miscarriage rates. Hum Reprod. 2012;27(4):1217-22.
  35. Mir P, Mateu E, Mercader A, Herrer R, Rodrigo L, Vera M, et al. Confirmation rates of array-CGH in day-3 embryo and blastocyst biopsies for preimplantation genetic screening. J Assist Reprod Genet. 2016;33(1):59-66.
  36. Kotdawala A, Patel D, Herrero J, Khajuria R, Mahajan N, Banker M. Aneuploidy screening by array comparative genomic hybridization improves success rates of in vitro fertilization: a multicenter Indian study. J Hum Reprod Sci. 2016;9(4):223-9.
  37. Webster A, Schuh M. Mechanisms of aneuploidy in human eggs. Trends Cell Biol. 2017;27(1):55-68.
  38. Bazrgar M, Gourabi H, Eftekhari-Yazdi P, Vazirinasab H, Fakhri M, Hassani F, et al. The effect of prolonged culture of chromosomally abnormal human embryos on the rate of diploid cells. Int J Fertil Steril. 2016;9(4):563-73.
  39. Huang J, Zhao N, Wang X, Qiao J, Liu P. Chromosomal characteristics at cleavage and blastocyst stages from the same embryos. J Assist Reprod Genet. 2015;32(5):781-7.
  40. Lee A, Kiessling AA. Early human embryos are naturally aneuploid-can that be corrected? J Assist Reprod Genet. 2017;34(1):15-21.
  41. Goodrich D, Xing T, Tao X, Lonczak A, Zhan Y, Landis J, et al. Evaluation of comprehensive chromosome screening platforms for the detection of mosaic segmental aneuploidy. J Assist Reprod Genet. 2017;34(8):975-81.
  42. Demko ZP, Simon AL, McCoy RC, Petrov DA, Rabinowitz M. Effects of maternal age on euploidy rates in a large cohort of embryos analyzed with 24-chromosome single-nucleotide polymorphism-based preimplantation genetic screening. Fertil Steril. 2016;105(5):1307-13.
  43. Majumdar G, Majumdar A, Verma IC, Upadhyaya KC. Relationship between morphology, euploidy and implantation potential of cleavage and blastocyst stage embryos. J Hum Reprod Sci. 2017;10(1):49-57.
  44. Fesahat F, Montazeri F, Sheikhha MH, Saeedi H, Dehghani Firouzabadi R, Kalantar SM. Frequency of chromosomal aneuploidy in high quality embryos from young couples using preimplantation genetic screening. Int J Reprod Biomed (Yazd). 2017;15(5):297-304.
  45. Alfarawati S, Fragouli E, Colls P, Stevens J, Gutierrez-Mateo C, Schoolcraft WB, et al. The relationship between blastocyst morphology, chromosomal abnormality, and embryo gender. Fertil Steril. 2011;95(2):520-4.
  46. Franasiak JM, Forman EJ, Hong KH, Werner MD, Upham KM, Treff NR, et al. Aneuploidy across individual chromosomes at the embryonic level in trophectoderm biopsies: changes with patient age and chromosome structure. J Assist Reprod Genet. 2014;31(11):1501-9.
  47. Eaton JL, Hacker MR, Barrett CB, Thornton KL, Penzias AS. Influence of patient age on the association between euploidy and day-3 embryo morphology. Fertil Steril. 2010;94(1):365-7.
  48. Ubaldi FM, Cimadomo D, Capalbo A, Vaiarelli A, Buffo L, Trabucco E, et al. Preimplantation genetic diagnosis for aneuploidy testing in women older than 44 years: a multicenter experience. Fertil Steril. 2017;107(5):1173-80.
  49. Capalbo A, Rienzi L, Cimadomo D, Maggiulli R, Elliott T, Wright G, et al. Correlation between standard blastocyst morphology, euploidy and implantation: an observational study in two centers involving 956 screened blastocysts. Hum Reprod. 2014;29(6):1173-81.
  50. Mazzilli R, Cimadomo D, Vaiarelli A, Capalbo A, Dovere L, Alviggi E, et al. Effect of the male factor on the clinical outcome of intracytoplasmic sperm injection combined with preimplantation aneuploidy testing: observational longitudinal cohort study of 1,219 consecutive cycles. Fertil Steril. 2017;108(6):961-72.e3.
  51. Soler A, Morales C, Mademont-Soler I, Margarit E, Borrell A, Borobio V, et al. Overview of chromosome abnormalities in first trimester miscarriages: a series of 1,011 consecutive chorionic villi sample karyotypes. Cytogenet Genome Res. 2017;152(2):81-9.
  52. Freed D, Stevens EL, Pevsner J. Somatic mosaicism in the human genome. Genes (Basel). 2014;5(4):1064-94.