Purpose Of Review: To provide updated information on preimplantation genetic testing for aneuploidy (PGT-A), focusing on its implications on prenatal diagnostic approaches after transferal of mosaic aneuploid embryos.
Recent Findings: PGT-A is a technology to screen for chromosome aneuploidy or major chromosome structural rearrangement in embryos before implantation using different cytogenetic analyses. PGT-A has been shown to reduce the negative effect of increasing maternal age on in-vitro fertilization (IVF) outcomes. PGT-A also encourages clinicians and patients to accept single embryo transfer after IVF-PGT-A to reduce the chance of multiple pregnancies. However, mosaic aneuploid embryo may be encountered following PGT-A. Recent discussions have focused on the consideration of transferal of mosaic aneuploid embryos in couples with no euploid embryo following multiple trials of IVF-PGT-A. A risk score for each chromosome has been developed to prioritize which mosaic embryos should be considered for transfer. However, there is a lack of long-term outcome data following mosaic aneuploid embryo transfer.
Summary: Recent advances in PGT-A increase the detection of embryos with mosaicism, which is associated with an increased risk of miscarriage, fetal mosaic aneuploidy, and uniparental disomy. Strategy in prenatal diagnostic testing after mosaic aneuploid embryo transfer is discussed in this review.
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http://dx.doi.org/10.1097/GCO.0000000000000521 | DOI Listing |
Reprod Fertil Dev
January 2025
Fertility & Research Centre, Discipline of Women health, School of Clinical Medicine and the Royal Hospital for Women, University of New South Wales, Sydney, NSW, Australia.
Pre-implantation genetic testing for aneuploidy (PGT-A) via embryo biopsy helps in embryo selection by assessing embryo ploidy. However, clinical practice needs to consider the invasive nature of embryo biopsy, potential mosaicism, and inaccurate representation of the entire embryo. This creates a significant clinical need for improved diagnostic practices that do not harm embryos or raise treatment costs.
View Article and Find Full Text PDFJ Assist Reprod Genet
January 2025
Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt.
PGT-A, what's it for? Considering the increase in fetal aneuploidies with a woman's age and the high number of miscarriages associated with fetal karyotype anomalies, the concept of selecting IVF embryos based on their karyotype in order to transfer only euploid embryos and eliminate aneuploid ones was proposed. Preimplantation genetic testing for aneuploidy (PGT-A) was then established, nearly 30 years ago, with the expectation that the transfer of euploid embryos would lead to a significant improvement in medically assisted reproduction (MAR) outcomes. PGT-A, what's wrong? Despite the practice and widespread use, PGT-A has not consistently proven its effectiveness.
View Article and Find Full Text PDFJ Assist Reprod Genet
January 2025
Reproductive Medicine Department, Villa Mafalda, Via Monte Delle Gioie 5, 00199, Rome, Italy.
Purpose: Analyze morphokinetic, morphology, and KIDscore™Day5 in different PGT-A classes, focusing on putative mosaicism level and type.
Methods: The single-center retrospective study analyzed 832 embryoscope-cultured blastocysts from cycles with at least one putative mosaic, conducted from 2020 to 2022. A P-value < 0.
Int J Fertil Steril
January 2025
Reproductive Immunoendocrinology Division, Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Indonesia - dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
Background: Chromosomal mosaicism, a phenomenon observed in a minority of embryos, showcases its prevalence and inherent unpredictability, leading to variations in embryo mosaic rates across different centers. This research endeavors to assess the prevalence of mosaicism and its characteristics within the scope of our preimplantation genetic testing-A (PGT-A) services in Indonesia. Specifically focusing on our center's experience since 2020, this study aims to elucidate mosaic rates among embryos in our care.
View Article and Find Full Text PDFJ Clin Med
December 2024
Collegium Medicum, WSB University, 41-300 Dąbrowa Górnicza, Poland.
: To assess the ploidy status of embryos via preimplantation genetic testing for aneuploidy (PGT-A), a biopsy of trophectoderm (TE) cells can be performed. However, this approach is considered invasive, and therefore the aim of this study was to identify the optimal sample type and sampling day for non-invasive or minimally invasive PGT-A (ni/miPGT-A) in terms of data quality and concordance rates with TE biopsies derived from the same embryos. : This study was performed using 239 embryo cultures.
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