異常原核胚胎(1PN, 3PN), 若成長到囊胚，仍有69-85%染色體正常
1PN有69%染色體正常
3PN有85%染色體正常

Fertil Steril. 2017 Sep 15. pii: S0015-0282(17)31699-0. doi: 10.1016/j.fertnstert.2017.08.004. [Epub ahead of print]

Abnormally fertilized oocytes can result in healthy live births: improved genetic technologies for preimplantation genetic testing can be used to rescue viable embryos in in vitro fertilization cycles.

Capalbo A1, Treff N2, Cimadomo D3, Tao X2, Ferrero S4, Vaiarelli A4, Colamaria S4, Maggiulli R4, Orlando G4, Scarica C4, Scott R2, Ubaldi FM5, Rienzi L5.

Author information

Abstract

OBJECTIVE:

To test whether abnormally fertilized oocyte (AFO)-derived blastocysts are diploid and can be rescued for clinical use.

DESIGN:

Longitudinal-cohort study from January 2015 to September 2016 involving IVF cycles with preimplantation genetic testing for aneuploidy (PGT-A). Ploidy assessment was incorporated whenever a blastocyst from a monopronuclear (1PN) or tripronuclear zygote (2PN + 1 smaller PN; 2.1 PN) was obtained.

SETTING:

Private IVF clinics and genetics laboratories.

PATIENT(S):

A total of 556 women undergoing 719 PGT-A cycles.

INTERVENTION(S):

Conventional chromosome analysis was performed on trophectoderm biopsies by quantitative polymerase chain reaction. For AFO-derived blastocysts, ploidy assessment was performed on the same biopsy with the use of allele ratios for hetorozygous SNPs analyzed by means of next-generation sequencing (1:1 = diploid; 2:1 = triploid; loss of heterozygosity = haploid). Balanced-diploid 1PN- and 2.1PN-derived blastocysts were transferred in the absence of normally fertilized transferable embryos.

MAIN OUTCOME MEASURE(S):

Ploidy constitution and clinical value of AFO-derived blastocysts in IVF PGT-A cycles.

RESULT(S):

Of the 5,026 metaphase II oocytes injected, 5.2% and 0.7% showed 1PN and 2.1PN, respectively. AFOs showed compromised embryo development (P<.01). Twenty-seven AFO-derived blastocysts were analyzed for ploidy constitution. The 1PN-derived blastocysts were mostly diploid (n = 9/13; 69.2%), a few were haploid (n = 3/13; 23.1%), and one was triploid (n = 1/13; 7.7%). The 2.1PN-derived blastocysts were also mostly diploid (n = 12/14; 85.7%), and the remainder were triploid. Twenty-six PGT-A cycles resulted in one or more AFO-derived blastocysts (n = 26/719; 3.6%). Overall, eight additional balanced-diploid transferable embryos were obtained from AFOs. In three cycles, the only balanced-diploid blastocyst produced was from an AFO (n = 3/719; 0.4%). Three AFO-derived live births were achieved: one from a 1PN zygote and two from 2.1PN zygotes.

CONCLUSION(S):

Enhanced PGT-A technologies incorporating reliable ploidy assessment provide an effective tool to rescue AFO-derived blastocysts for clinical use.