PGD採用1st極體切片+CGH

PGD採用1st極體切片+Comparative genomic hybridization (CGH)基因篩檢可偵測卵細胞之基因異常

ICSI完成後再施行1st極體切片

http://humrep.oxfordjournals.org/content/23/8/1949.full

Birth of a healthy boy after a double factor PGD in a couple carrying a genetic disease and at risk for aneuploidy: Case Report

1. Albert Obradors1, 
2. Esther Fernández2, 
3. Maria Oliver-Bonet1, 
4. Mariona Rius1,
5. Alfonso de la Fuente2, 
6. Dagan Wells3, 
7. Jordi Benet1 and 
8. Joaquima Navarro1,4

+Author Affiliations

1. ¹Unitat de Biologia Cel·lular i Genètica Mèdica, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
2. ²Laboratoria de FIV, Fundación Jiménez Díaz, Plaza Reyes Católicos 2, Madrid, Spain
3. ³Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, UK

1. 4Correspondence address. Tel: +34-93-581-1773; Fax: +34-93-581-1025; E-mail:joaquima.navarro@uab.es

• Received January 18, 2008.
• Revision received March 31, 2008.
• Accepted April 17, 2008.

 

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Abstract

Preimplantation genetic diagnosis (PGD) for monogenic diseases is widely applied, allowing the transfer to the uterus of healthy embryos. PGD is also employed for the detection of chromosome abnormalities for couples at high risk of producing aneuploid embryos, such as advanced maternal (>35 years). A significant number of patients requesting PGD for monogenic diseases are also indicated for chromosome testing. We optimized and clinically applied a PGD protocol permitting both cytogenetic and molecular genetic analysis. A couple, carriers of two cystic fibrosis (CF) mutations (c.3849 + 10 KbC > T and c.3408C > A) with a maternal age of 38 years and two previously failed IVF–PGD cycles, was enrolled in the study. After ovarian stimulation, six oocytes were obtained. To detect abnormalities for all 23 chromosomes of the oocyte, the first polar body (1PB) was biopsied from five of the oocytes and analyzed using comparative genomic hybridization (CGH). CGH analysis showed that 1PB 1 and 1PB 4 were aneuploid (22X,−9,−13,+19 and 22X,−6, respectively), while 1PB 2, 1PB 3 and 1PB 6 were euploid. Blastomere biopsy was only applicable on embryos formed from Oocyte 3 and Oocyte 6. After whole-genome amplification with multiple displacement amplification, a multiplex PCR, amplifying informative short tandem repeats (D7S1799; D7S1817) and DNA fragments encompassing the mutation sites, was performed. MiniSequencing was applied to directly detect each mutation. Genetic diagnosis showed that Embryo 6 was affected by CF and Embryo 3 carried only the c.3849 + 10 KbC > T mutation. Embryo 3 was transferred achieving pregnancy and a healthy boy was born. This strategy may lead to increased pregnancy rates by allowing preferential transfer of euploid embryos.