A prospective study of non-invasive preimplantation genetic testing for aneuploidies (NiPGT-A) using next-generation sequencing (NGS) on spent culture media (SCM).

Autor: Yeung QSY; Assisted Reproductive Technology Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China., Zhang YX; Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China., Chung JPW; Assisted Reproductive Technology Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China., Lui WT; Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China., Kwok YKY; Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China., Gui B; Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, 518055, China.; Department of Genetics and Metabolism, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530002, Guangxi, China., Kong GWS; Assisted Reproductive Technology Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China., Cao Y; Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China., Li TC; Assisted Reproductive Technology Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China., Choy KW; Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China. richardchoy@cuhk.edu.hk.; Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, 518055, China. richardchoy@cuhk.edu.hk.
Jazyk: angličtina
Zdroj: Journal of assisted reproduction and genetics [J Assist Reprod Genet] 2019 Aug; Vol. 36 (8), pp. 1609-1621. Date of Electronic Publication: 2019 Jul 10.
DOI: 10.1007/s10815-019-01517-7
Abstrakt: Purpose: This study was to evaluate if spent culture media (SCM) of embryos could be used as a non-invasive tool to achieve aneuploidy screening. Ploidy calls, as well as concordance rates between PGT-A results from trophectoderm (TE) and SCM, were compared. Clinical outcomes of single euploid transfers were also evaluated.
Methods: The study was conducted from March 2017 to June 2018 in a university-based ART center. SCM of day 3 to the day(s) of TE biopsy of all biopsied blastocysts were collected for testing. PGT-A results of SCM were compared with the standard results of TE, with clinical relevance and outcomes examined.
Results: NiPGT-A using SCM gave a sensitivity of 81.6%, specificity of 48.3%, positive predictive value of 82.6%, and negative predictive value of 46.7% in ploidy calling. The concordance rates for autosomes and sex determination were 62.1% and 82.4%, respectively. There were 14 single embryo transfer cycles of euploids as determined by TE biopsy. Clinical outcomes not only confirmed 3 false positive results from SCM but also reflected the true ploidy status of the transferred embryo in one case. If ploidy calls were dichotomized without mosaic embryos, the sensitivity and NPV would increase to 91.0% and 66.7% (p = 0.60 and p = 0.25), respectively.
Conclusions: Cell-free DNA found in SCM could provide ploidy information of an embryo as in PGT-A from its TE. Given its potential to reflect the comprehensive chromosomal profile of the whole embryo, more research based on clinical outcomes is required to determine if SCM could be a reliable selection tool in PGT-A.
Databáze: MEDLINE
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