A frequent finding after preimplantation genetic diagnostic testing for aneuploidies using next-generation sequencing is an embryo that is putatively mosaic. The prevalence of this outcome remains unclear and varies with technical and external factors. Mosaic embryos can be classified by the percentage of cells affected, type of chromosome involvement (whole or segmental), number of affected chromosomes or affected cell type (inner mass cell, trophectoderm or both). The origin of mosaicism seems to be intrinsic as a post-zygotic mitotic error, but some external factors can play a role. As experience has increased with the transfer of mosaic embryos, clinical practice has gradually become more flexible in recent years. Nevertheless, clinical results show lower implantation, pregnancy and clinical pregnancy rates and higher miscarriage rates with mosaic embryo transfer when compared with the transfer of euploid embryos. Prenatal diagnosis is highly recommended after the transfer of mosaic embryos. This narrative review is intended to serve as reference material for practitioners in reproductive medicine who must manage a mosaic embryo result after preimplantation genetic testing for aneuploidies.
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http://dx.doi.org/10.1016/j.rbmo.2023.103664 | DOI Listing |
Hum Reprod
December 2024
IVIRMA Global Research Alliance, IVI Foundation, Health Research Institute La Fe, Valencia, Spain.
Study Question: Is it possible to predict an euploid chromosomal constitution and identify a transcriptomic profile compatible with extended embryonic development from RNA sequencing (RNA-Seq) data?
Summary Answer: It has been possible to obtain a karyotype comparable to preimplantation genetic testing for aneuploidy (PGT-A), in addition to a transcriptomic signature of embryos which might be suggestive of improved implantation capacity.
What Is Known Already: Conventional assessment of embryo competence, based on morphology and morphokinetic, lacks knowledge of molecular aspects and faces controversy in predicting ploidy status. Understanding the embryonic transcriptome is crucial, as gene expression influences development and implantation.
bioRxiv
December 2024
Department of Biology, Johns Hopkins University, Baltimore, MD, USA 21218.
Chromosome mis-segregation is common in human meiosis and mitosis, and the resulting aneuploidies are the leading cause of pregnancy loss. Preimplantation genetic testing for aneuploidy (PGT-A) seeks to prioritize chromosomally normal embryos for transfer based on genetic analysis of a biopsy of approximately five trophectoderm cells from blastocyst-stage fertilized (IVF) embryos. While modern PGT-A platforms classify these biopsies as aneuploid, euploid, or mosaic (possessing a mixture of normal and aneuploid cells), the underlying incidences of aneuploid, euploid, and mosaic embryos and the rates of meiotic and mitotic error that produced them remain largely unknown.
View Article and Find Full Text PDFElife
December 2024
Brussels Health Campus/Faculty of Medicine and Pharmacy, Research Group Genetics Reproduction and Development, Vrije Universiteit Brussel, Brussels, Belgium.
About 70% of human cleavage stage embryos show chromosomal mosaicism, falling to 20% in blastocysts. Chromosomally mosaic human blastocysts can implant and lead to healthy new-borns with normal karyotypes. Studies in mouse embryos and human gastruloids showed that aneuploid cells are eliminated from the epiblast by p53-mediated apoptosis while being tolerated in the trophectoderm.
View Article and Find Full Text PDFMed Anthropol Q
November 2024
Departamento de Antropologia Social, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
Since the 1990s, preimplantation tests within in vitro fertilization have promised to enhance the selection of embryos for uterine implantation. However, alongside ethical controversies, these diagnostic techniques often identify a high rate of mosaic embryos-those containing a mix of cells deemed normal and abnormal-creating one of the largest technical challenges related to the testing. These cases raise dilemmas for professionals in assisted reproduction and, more intensely, create challenges for individuals whose embryos are identified as mosaic.
View Article and Find Full Text PDFInt J Mol Sci
November 2024
Institute of Farm Animal Genetics, Friedrich-Loeffler-Institut, 31535 Neustadt, Germany.
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