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      Chromosome screening using culture medium of embryos fertilised in vitro: a pilot clinical study

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          Abstract

          Background

          Previous studies from this as well as other research groups suggested that non-invasive chromosome screening (NICS) with embryo culture medium can be used to identify chromosomal ploidy and chromosomal abnormalities. We here report a series of clinical cases utilizing the technology.

          Methods

          A total of 45 couples underwent in vitro fertilisation during a period between February 2016 and February 2017. Karyotyping revealed normal chromosomes in both partners in 23 couples, and chromosomal rearrangements in at least one partner in 22 couples. Intracytoplasmic sperm injection (ICSI) was used for fertilization. NICS was carried out using embryo culture medium at the blastocyst stage via multiple annealing and looping-based amplification cycles, whole-genome amplification and next-generation sequencing.

          Results

          A total of 413 embryos were obtained; 170 blastocysts were subjected to NICS. The screening showed euploidy in 79 embryos, aneuploidy in 52 embryos, and mosaic ploidy for 33 embryos. The rate of euploidy was comparable in couples with normal karyotype (50.7%; 38/75) vs. chromosomal rearrangement (43.2%; 41/95). A total of 52 euploid embryos (50 oocyte retrieval cycles) were transferred in 43 women. Biochemical pregnancy rate was 72.0% (36/50). Clinical pregnancy rate was 58.0% (29/50). The rate of spontaneous miscarriage was 3/29 (none with chromosomal aneuploidy). A total of 27 healthy babies were delivered.

          Conclusions

          NICS could identify embryo chromosomal abnormalities in couples either with or without chromosomal rearrangement, with satisfying clinical outcomes.

          Electronic supplementary material

          The online version of this article (10.1186/s12967-019-1827-1) contains supplementary material, which is available to authorized users.

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          Most cited references22

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          The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting.

          Many variations in oocyte and embryo grading make inter-laboratory comparisons extremely difficult. This paper reports the proceedings of an international consensus meeting on oocyte and embryo morphology assessment. Background presentations about current practice were given. The expert panel developed a set of consensus points to define the minimum criteria for oocyte and embryo morphology assessment. It is expected that the definition of common terminology and standardization of laboratory practice related to embryo morphology assessment will result in more effective comparisons of treatment outcomes. This document is intended to be referenced as a global consensus to allow standardized reporting of the minimum data set required for the accurate description of embryo development.
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            Mouse model of chromosome mosaicism reveals lineage-specific depletion of aneuploid cells and normal developmental potential

            Most human pre-implantation embryos are mosaics of euploid and aneuploid cells. To determine the fate of aneuploid cells and the developmental potential of mosaic embryos, here we generate a mouse model of chromosome mosaicism. By treating embryos with a spindle assembly checkpoint inhibitor during the four- to eight-cell division, we efficiently generate aneuploid cells, resulting in embryo death during peri-implantation development. Live-embryo imaging and single-cell tracking in chimeric embryos, containing aneuploid and euploid cells, reveal that the fate of aneuploid cells depends on lineage: aneuploid cells in the fetal lineage are eliminated by apoptosis, whereas those in the placental lineage show severe proliferative defects. Overall, the proportion of aneuploid cells is progressively depleted from the blastocyst stage onwards. Finally, we show that mosaic embryos have full developmental potential, provided they contain sufficient euploid cells, a finding of significance for the assessment of embryo vitality in the clinic.
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              The origin, mechanisms, incidence and clinical consequences of chromosomal mosaicism in humans.

              Chromosomal mosaicism, the presence of two or more distinct cell lines, is prevalent throughout human pre- and post-implantation development and can lead to genetic abnormalities, miscarriages, stillbirths or live births. Due to the prevalence and significance of mosaicism in the human species, it is important to understand the origins, mechanisms and incidence of mosaicism throughout development. Literature searches were conducted utilizing Pubmed, with emphasis on human pre- and post-implantation mosaicism. Mosaicism persists in two separate forms: general and confined. General mosaicism is routine during human embryonic growth as detected by preimplantation genetic screening at either the cleavage or blastocyst stage, leading to mosaicism within both the placenta and fetus proper. Confined mosaicism has been reported in the brain, gonads and placenta, amongst other places. Mosaicism is derived from a variety of mechanisms including chromosome non-disjunction, anaphase lagging or endoreplication. Anaphase lagging has been implicated as the main process by which mosaicism arises in the preimplantation embryo. Furthermore, mosaicism can be caused by any one of numerous factors from paternal, maternal or exogenous factors such as culture media or possibly controlled ovarian hyperstimulation during in vitro fertilization (IVF). Mosaicism has been reported in as high as 70 and 90% of cleavage- and blastocyst-stage embryos derived from IVF, respectively. The clinical consequences of mosaicism depend on which chromosome is involved, and when and where an error occurs. Mitotic rescue of a meiotic error or a very early mitotic error will typically lead to general mosaicism while a mitotic error at a specific cell lineage point typically leads to confined mosaicism. The clinical consequences of mosaicism are dependent on numerous aspects, with the consequences being unique for each event. © The Author 2014. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
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                Author and article information

                Contributors
                wfangruix@163.com
                18762807806@163.com
                zhaoxin63147@163.com
                xiongfang58@163.com
                caiqin.8@163.com
                jianpingx999@126.com
                872276095@qq.com
                kysxq9364@163.com
                wxwhh72@163.com
                13861781770@163.com
                xiaoxiaomog@126.com
                yaobing@nju.edu.cn
                +86 51082725161 , cai760829@163.com
                Journal
                J Transl Med
                J Transl Med
                Journal of Translational Medicine
                BioMed Central (London )
                1479-5876
                8 March 2019
                8 March 2019
                2019
                : 17
                : 73
                Affiliations
                [1 ]ISNI 0000 0000 9255 8984, GRID grid.89957.3a, Centre for Reproductive Medicine, , Wuxi Maternity and Child Health Hospital Affiliated to Nanjing Medical University, ; Wuxi, 214002 Jiangsu China
                [2 ]ISNI 0000 0000 9255 8984, GRID grid.89957.3a, Wuxi Maternity and Child Health Hospital Affiliated to Nanjing Medical University, ; Wuxi, 214002 Jiangsu China
                [3 ]Centre for Reproductive Medicine, Hebei Maternity and Reproductive Hospital, Shijiazhuang, 050090 Hebei China
                [4 ]ISNI 0000 0001 2314 964X, GRID grid.41156.37, Reproductive Medical Center of Nanjing Jinling Hospital and the Collaborative Innovation Platform for Reproductive Biology and Technology, , Nanjing University School of Medicine, ; Nanjing, 210002 Jiangsu China
                Article
                1827
                10.1186/s12967-019-1827-1
                6408780
                30849973
                2a60d248-180e-4ff9-9618-5f6272f44433
                © The Author(s) 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 3 December 2018
                : 1 March 2019
                Funding
                Funded by: Major research projects of the Wuxi Health and Family Planning Commission
                Award ID: z201602
                Award Recipient :
                Funded by: Basic Research of Nanjing Medical University
                Award ID: 2015NJMUZD056
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2019

                Medicine
                non-invasive chromosome screening,assisted reproductive technology,chromosomal ploidy,next-generation sequencing,clinical outcome

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