ABSTRACT
BACKGROUND: Unsubstantiated concerns have been raised on the potential correlation between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination and infertility, leading to vaccine hesitancy in reproductive-aged population. Herein, we aim to evaluate the impact of inactivated SARS-CoV-2 vaccination on embryo ploidy, which is a critical indicator for embryo quality and pregnancy chance. METHODS: This was a retrospective cohort study of 133 patients who underwent preimplantation genetic testing for aneuploidy (PGT-A) cycles with next-generation sequencing technology from June 1st 2021 to March 17th 2022 at a tertiary-care medical center in China. Women fully vaccinated with two doses of Sinopharm or Sinovac inactivated vaccines (n = 66) were compared with unvaccinated women (n = 67). The primary outcome was the euploidy rate per cycle. Multivariate linear and logistic regression analyses were performed to adjust for potential confounders. RESULTS: The euploidy rate was similar between vaccinated and unvaccinated groups (23.2 ± 24.6% vs. 22.6 ± 25.9%, P = 0.768), with an adjusted ß of 0.01 (95% confidence interval [CI]: -0.08-0.10). After frozen-thawed single euploid blastocyst transfer, the two groups were also comparable in clinical pregnancy rate (75.0% vs. 60.0%, P = 0.289), with an adjusted odds ratio of 6.21 (95% CI: 0.76-50.88). No significant associations were observed between vaccination and cycle characteristics or other laboratory and pregnancy outcomes. CONCLUSIONS: Inactivated SARS-CoV-2 vaccination had no detrimental impact on embryo ploidy during in vitro fertilization treatment. Our finding provides further reassurance for vaccinated women who are planning to conceive. Future prospective cohort studies with larger datasets and longer follow-up are needed to confirm the conclusion.
Subject(s)
Humans , Female , Pregnancy , Adult , Preimplantation Diagnosis , COVID-19/prevention & control , Ploidies , Blastocyst , Fertilization in Vitro , Genetic Testing , Prospective Studies , Retrospective Studies , Vaccination , Pregnancy Rate , COVID-19 Vaccines , SARS-CoV-2 , AneuploidyABSTRACT
In the past few years, with the breakthrough development of DNA sequencing technology, preimplantation genetic testing (PGT) has been widely used as an important part of assisted reproductive technology (ART). The progress of next generation sequencing (NGS) technology and the improvement of resolution, as well as the comprehensive application of molecular diagnostic technology makes it possible to perform the extensive and comprehensive chromosome screening and the clinical valuable detection of small gene fragment missing and repetition simultaneously, which is of great significance in terms of improving the pregnancy rate and reducing the abortion rate, multiplets rate and malformation rate. The common PGT molecular diagnostic techniques involves fluorescence in situ hybridization (FISH), single nucleotide polymorphism array(SNP-array), quantitative polymerase chain reaction(qPCR) and NGS. And each of them has its own highlights in clinical application and there are many uncertainties that are difficult to control. Moreover, ethical concerns brought about by technological progress also need to be addressed.
ABSTRACT
This retrospective study demonstrates the clinical outcomes of patients with nonmosaic Klinefelter's syndrome (KS) who underwent preimplantation genetic testing (PGT) with frozen-thawed testicular spermatozoa. Microdissection testicular sperm extraction (micro-TESE) was performed for sperm retrieval. Next-generation sequencing (NGS) was conducted for embryo analysis. A total of 18 couples aged ≤35 years were included, and 22 oocyte retrieval cycles were completed. Euploidy was detected in 29 of 45 (64.4%) embryos. Additionally, the numbers of aneuploid and mosaic embryos detected were 8 (17.8%) and 8 (17.8%), respectively, regardless of a lack of sex chromosome abnormalities. Finally, 13 couples with euploid embryos completed 14 frozen embryo transfer (FET) cycles. Ten couples had clinical pregnancies, and 6 of them had already delivered 5 healthy babies and 1 monozygotic twin. There were also 4 ongoing pregnancies and 2 biochemical pregnancies, but no early pregnancy loss was reported. Based on our results, we speculate that for KS patients, when sperm can be obtained by micro-TESE, the cryopreservation strategy makes the ovarian stimulation procedure more favorable for female partners. The paternal genetic risk of sex chromosome abnormalities in their offspring is extremely low in men with KS. In addition to PGT, the intracytoplasmic sperm injection (ICSI) procedure is comparably effective but more economical for young nonmosaic KS couples. ICSI should be offered as an option for such couples, but monitoring by prenatal genetic diagnosis is recommended.
Subject(s)
Adult , Female , Humans , Pregnancy , High-Throughput Nucleotide Sequencing/methods , Klinefelter Syndrome/therapy , Outcome Assessment, Health Care/statistics & numerical data , Ovulation Induction/statistics & numerical data , Retrospective Studies , Sperm Injections, Intracytoplasmic/methodsABSTRACT
RESUMEN Objetivos: reportar el caso de una paciente con síndrome de Turner en mosaico, a quien se le realizó un tratamiento de reproducción asistida con análisis genético preimplantatorio para aneuploidias, logrando el nacimiento de una niña sana con cariotipo normal, y realizar una revisión de la literatura sobre la utilidad del diagnóstico genético preimplantatorio en las mujeres con síndrome de Turner. Materiales y métodos: se presenta el caso de una mujer de 27 años, con diagnóstico de síndrome de Turner en mosaico y con alteración secundaria en la reserva ovárica, atendida en centro de referencia para el manejo de infertilidad en Medellín, Colombia, a quien se le realizó un tratamiento de fertilización in vitro con análisis genético preimplan-tatorio para prevenir la transmisión del síndrome de Turner a su descendencia. Se realizó una búsqueda de la literatura en las bases de datos Medline vía PubMed, Clinical Key, OVID, Embase, Lilacs, SciE- LO y Oxford Journals, con los siguientes términos: "Turner Syndrome", "Mosaic Turner", "Preim- plantation Genetic Screening", "Preimplantation Genetic Testing", "Preimplantation Genetic Diagnosis", "Pregnancy", "Successful pregnancy". Como criterios de inclusión se consideraron artículos tipo series y reportes de casos, cohortes y artículos de revisión desde enero de 1980 hasta junio de 2017, que incluyeran mujeres con síndrome de Turner embarazadas por medio de técnicas de fertilización in vitro, con sus propios óvulos, y que hubiesen sido sometidas a biopsia embrionaria para diagnóstico genético preimplantatorio. La búsqueda se limitó a los idiomas español e inglés. Resultados: un estudio cumplió con los criterios de inclusión. Tanto en este reporte como en nuestro caso, las pacientes con síndrome de Turner en mosaico se sometieron a varios ciclos de inyección intracitoplasmática de espermatozoides (ICSI) con sus propios óvulos, luego se realizó biopsia em- brionaria para análisis genético preimplantatorio utilizando diferentes técnicas. En ambos casos se logró la transferencia al útero de embriones euploides con el posterior nacimiento de niñas sanas con cariotipo normal. Conclusión: Las pacientes con ST mosaico podrían beneficiarse de la biopsia embrionaria y análisis genético preimplantatorio para prevenir la transmisión del defecto genético a su descendencia.
ABSTRACT Objectives: To report the case of a patient with mosaic Turner syndrome who underwent assisted reproduction treatment with preimplantation genetic testing for aneuploidy and gave birth to a healthy baby girl with normal karyotype; and to conduct a review of the literature on the usefulness of preimplantation genetic diagnosis in women with Turner syndrome. Materials and methods: A case of a 27 year-old woman diagnosed with mosaic Turner syndrome and secondary altered ovarian reserve, seen in a referral center for infertility management in Medellín, Colombia. The patient underwent in vitro fertilization followed by pre-implantation genetic testing to prevent transmission of Turner syndrome to her progeny. A literature search was conducted in the Medline via PubMed, Clinical Key, OVID, Embase, Lilacs, SciELO and Oxford Journals data- bases using the following terms: "Turner Syndrome," "Mosaic Turner," "Preimplantation Genetic Screening," "Preimplantation Genetic Testing," "Preimplantation Genetic Diagnosis," "Pregnancy," "Successful pregnancy." Inclusion criteria were case series and case reports, cohort studies and review articles published between January 1980 and June 2017 that included women with Turner syndrome achieving pregnancy by means of in vitro fertilization techniques with their own oocytes and who had undergone embryo biopsy for preimplantation genetic diagnosis. The search was limited to articles in Spanish and English. Results: one study met the inclusion criteria. Both in this report and in our case, patients with mosaic Turner syndrome underwent several cycles of intracytoplasmic sperm injection (ICSI) with their own eggs, then performed embryonic biopsy for preimplantation genetic analysis using different techniques. In both cases, euploid embryos were transferred to the uterus with the subsequent birth of healthy girls with normal karyotype. Conclusion: Patients with mosaic Turner syndrome could benefit from preimplantation biopsy and genetic analysis to prevent transmission of the genetic defect to their progeny.
Subject(s)
Humans , Female , Infant, Newborn , Turner Syndrome , Preimplantation Diagnosis , Ovarian Reserve , AneuploidyABSTRACT
OBJECTIVE: To investigate the effects of GnRH agonist and antagonist protocols on preimplantation genetic testing outcomes of chromosomal translocation carriers.METHODS: The clinical data of 226 patients with chromosomal translocation were analyzed retrospectively between Jan. 2015 and Dec. 2017 in Shengjing Hospital Affiliated to China Medical University.The patients were divided into GnRH agonist group(174 cases)and GnRH antagonist group(52 cases),then the duration of gonadotropin stimulation,dosage of gonadotropin used,embryonic quality,normal and balanced embryo numbers,per transfer cyclepregnancy rate,abortion rate and continuous pregnancy rate and accumulated pregnancy rate were analyzed.RESULTS: There were no statistical differences in the number of retrieved oocytes,number of MⅡ oocytes,fertilization rate,cleavage rate,blastocyst formation rate,number of high-quality embryo,number of blastocyst biopsy,normal and balanced embryo numbers,per transfer cycle pregnancy rate,abortion rate,continuous pregnancy rate or accumulated pregnancy rate between GnRH agonist group and GnRH antagonist group(P>0.05).The duration of gonadotropin stimulation(9 d vs. 10 d)and dosage of gonadotropin(2100 U vs. 2400 U)used in the GnRH antagonist group were significantly less than the GnRH agonist group(P<0.05).CONCLUSION: There are no significant differences in embryo quality or pregnancy rate between the GnRH agonist group and antagonist group during preimplantation genetic testing,but the GnRH antagonist group have an advantage in Gn duration and dosage.
ABSTRACT
Since the first report of preimplantation genetic diagnosis success in clinical in 1989,it is technological development that has been the driving force of preimplantation genetic testing(PGT).As the early stage prenatal diagnosis, PGT is used in the setting of assisted reproduction to differentiate the genetically normal embryos from pathogenic mutations or chromosomal anomalies in order to increase the rates of fruitful pregnancy.PGT involves technologies of assisted reproduction, molecular detection and genetic counseling.The aim of this review is to, from the perspective of laboratory medicine, summarize the utilization and progress of molecular strategies in the field of PGT,and explore its future development.(Chin J Lab Med,2018,41:270-274)