Use of array comparative genomic hybridization (array-CGH) for embryo assessment: clinical results
Use of array comparative genomic hybridization (array-CGH) for embryo assessment: clinical results
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DOI：
10.1016/j.fertnstert.2013.01.094
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发表时间：
2013-03-01
影响因子：
6.7
通讯作者：
Simon, Carlos
中科院分区：
文献类型：
--
作者：
Rubio, Carmen;Rodrigo, Lorena;Simon, Carlos
目的：回顾植入前遗传筛查后的临床结果。大多数胚胎活力评估方法涉及不同植入前发育阶段的形态学评估。囊胚形态与非整倍性之间的弱关联已被描述，支持了用于评估胚胎活力的植入前遗传筛查（PGS）的基础。通过在临床常规 PGS 中应用基于比较基因组杂交 (CGH) 的微阵列，生殖结果率已达到预期的改善。设计：对已发表的研究和自己未发表的数据进行审查。设置：大学附属私人机构。患者：在不同阶段接受 PGS 的 IVF 患者。干预措施：极体、卵裂阶段和囊胚活检的 PGS。主要结果指标：非整倍体、着床率和妊娠率。结果：对所有 24 条染色体进行分析后的临床结果比以前可用的技术荧光原位杂交 (FISH) 更高程度地改善了不同适应症的妊娠率和着床率，其中只能分析有限数量的染色体。结论：有关第 3 天活检的争议的大部分数据来自 FISH 周期，应进一步评估采用新阵列-CGH 技术的第 3 天活检的效用通过随机对照试验。目前的趋势是囊胚活检并进行新鲜移植或玻璃化冷冻以在非刺激周期中进行移植。 （Fertil Steril (R) 2013；99:1044-8。(C) 2013，美国生殖医学会。）
Objective: To review clinical outcomes after preimplantation genetic screening. Most methods of embryo viability assessment involve morphologic evaluation at different preimplantation developmental stages. A weak association between blastocyst morphology and aneuploidy has been described, supporting the basis for preimplantation genetic screening (PGS) for assessment of embryo viability. The expected improvement in reproductive outcome rates has been reached with the application of microarrays based on comparative genomic hybridization (CGH) in clinical routine PGS.Design: Review of published studies and own unpublished data.Setting: University-affiliated private institution.Patient(s): IVF patients undergoing PGS at different stages.Intervention(s): PGS with polar body, cleavage-stage, and blastocyst biopsies.Main Outcome Measure(s): Aneuploidy, implantation, and pregnancy rates.Results: The clinical outcome after analysis of all 24 chromosomes improved pregnancy and implantation rates for different indications to a higher degree than the previously available technology, fluorescence in situ hybridization (FISH), in which only a limited number of chromosomes could be analyzed.Conclusion(s): Most of the data regarding the controversy of day-3 biopsy come from FISH cycles, and the utility of day-3 biopsy with new array-CGH technology should be further evaluated through randomized controlled trials. The current trend is blastocyst biopsy with a fresh transfer or vitrification for transfer in a nonstimulated cycle. (Fertil Steril (R) 2013;99:1044-8. (C) 2013 by American Society for Reproductive Medicine.)