Skip to main content
Log in

Healthy live births from transfer of low-mosaicism embryos after preimplantation genetic testing for aneuploidy

  • Assisted Reproduction Technologies
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

This study evaluated the potential viability of embryos with low mosaicism level (< 50%) by comparing the clinical outcomes of single mosaic versus euploid blastocyst transfer. In addition, the live birth outcomes for various types of mosaicism with respect to abnormalities in chromosome structure and content were analyzed.

Methods

This study included patients who underwent in vitro fertilization with preimplantation genetic testing for aneuploidy (PGT-A). The PGT-A cycles performed through next-generation sequencing with single euploid or mosaic embryo transfers were included. We collected 299 frozen single embryo transfer cycles—216 single euploid and 83 mosaic—between July 2016 and July 2018. This study analyzed clinical outcomes, including fetal karyotyping by using amniocentesis, gestational age at delivery, and live birth weight after single mosaic embryo transfer.

Results

The average birth weight of infants in the euploid and mosaic blastocyst transfer groups was 3146.2 and 2997.7 g, respectively. The karyotyping results of prenatal diagnosis in all pregnant women were normal. Our study indicated that mosaic embryos can develop into euploid healthy infants with various levels or types of mosaicism. No significant difference was observed between infants from euploid and mosaic blastocyst transfers.

Conclusion

If patients have no euploid embryos, mosaic embryos can be transferred as they have potential for implantation and development into euploid healthy infants. This study is invaluable for counseling clinical results after single mosaic embryo transfers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Hyde KJ, Schust DJ. Genetic considerations in recurrent pregnancy loss. Cold Spring Harb Perspect Med. 2015;5:a023119.

    Article  Google Scholar 

  2. Colls P, Escudero T, Cekleniak N, Sadowy S, Cohen J, Munné S. Increased efficiency of preimplantation genetic diagnosis for infertility using ‘no result rescue’. Fertil Steril. 2007;88:53–61.

    Article  Google Scholar 

  3. Garrisi JG, Colls P, Ferry KM, Zheng X, Garrisi MG, Munné S. Effect of infertility, maternal age, and number of previous miscarriages on the outcome of preimplantation genetic diagnosis for idiopathic recurrent pregnancy loss. Fertil Steril. 2009;92:288–95.

    Article  Google Scholar 

  4. Mastenbroek S, Twisk M, van Echten-Arends J, Sikkema-Raddatz B, Korevaar JC, Verhoeve HR, et al. In vitro fertilization with preimplantation genetic screening. N Engl J Med. 2007;357:9–17.

    Article  CAS  Google Scholar 

  5. Scott RT Jr, Ferry K, Su J, Tao X, Scott K, Treff NR. Comprehensive chromosome screening is highly predictive of the reproductive potential of human embryos: a prospective, blinded, non selection study. Fertil Steril. 2012;97:870–5.

    Article  Google Scholar 

  6. Grifo JA, Hodes-Wertz B, Lee HL, Amperloquio E, Clarke-Williams M, Adler A. Single thawed euploid embryo transfer improves IVF pregnancy, miscarriage, and multiple gestation outcomes and has similar implantation rates as egg donation. J Assist Reprod Genet. 2013;30:259–64.

    Article  Google Scholar 

  7. Maxwell SM, Colls P, Hodes-Wertz B, McCulloh DH, McCaffrey C, Wells D, et al. Why do euploid embryos miscarry? A case-control study comparing the rate of aneuploidy within presumed euploid embryos that resulted in miscarriage or live birth using next-generation sequencing. Fertil Steril. 2016;106:1414–9 e5.

    Article  CAS  Google Scholar 

  8. McCoy RC, Demko ZP, Ryan A, Banjevic M, Hill M, Sigurjonsson S, et al. Evidence of Selection against Complex Mitotic-Origin Aneuploidy during Preimplantation Development. PLoS Genet. 2015;22:e1005601.

    Article  Google Scholar 

  9. Greco E, Minasi MG, Fiorentino F. Healthy babies after intrauterine transfer of mosaic Aneuploid blastocysts. N Engl J Med. 2015;373:2089–90.

    Article  Google Scholar 

  10. Munné S, Blazek J, Large M, Martinez-Ortiz PA, Nisson H, Liu E, et al. Detailed investigation into the cytogenetic constitution and pregnancy outcome of replacing mosaic blastocysts detected with the use of high-resolution next-generation sequencign. Fertil Steril. 2017;108:62–71.e8.

    Article  Google Scholar 

  11. Fragouli E, Alfarawati S, Spath K, Babariya D, Tarozzi N, Borini A, et al. Analysis of implantation and ongoing pregnancy rates following the transfer of mosaic diploid-aneuploid blastocysts. Hum Genet. 2017;136:805–19.

    Article  CAS  Google Scholar 

  12. PGDIS Position statement on chromosome mosaicism and preimplantation aneuploidy testing at the blastocyst stage 2018. [http://www.pgdis.org/docs/ newsletter_071816.html].

  13. Ethics Committee of the American Society for Reproductive Medicine. Transferring embryos with genetic anomalies detected in preimplantation testing: an Ethics Committee Opinion. Fertil Steril. 2017;107:1130–5.

    Article  Google Scholar 

  14. Chen HH, Huang CC, Cheng EH, Lee TH, Chien LF, Lee MS. Optimal timing of blastocyst vitrification after trophectoderm biopsy for preimplantation genetic screening. PLoS One. 2017;12:e0185747.

    Article  Google Scholar 

  15. Gardner DK, Lane M, Stevens J, Schlenker T, Schoolcraft WB. Blastocyst score affects implantation and pregnancy outcome: towards a single blastocyst transfer. Fertil Steril. 2000;73:1155–8.

    Article  CAS  Google Scholar 

  16. Gutnisky C, Alvarez GM, Cetica PD, Dalvit GC. Evaluation of the Cryotech Vitrification Kit for bovine embryos. Cryobiology. 2013;67(3):391–3.

    Article  CAS  Google Scholar 

  17. Lee CI, Chen CH, Huang CC, Cheng EH, Chen HH, Ho ST, et al. Embryo morphokinetics is potentially associated with clinical outcomes of single embryo transfers in preimplantation genetic testing for aneuploidy cycles. Reprod BioMed Online. 2019;39:569–79.

    Article  CAS  Google Scholar 

  18. Munn'e S, Wells D. Detection of mosaicism at blastocyst stage with the use of high-resolution next-generation sequencing. Fertil Steril. 2017;107:1085–91.

    Article  Google Scholar 

  19. Cheng EH, Chen W, Chang SY, Huang JJ, Huang CC, Huang LS, et al. Blastocoel volume is related to successful establishment of human embryonic stem cell lines. Reprod Biomed Online. 2008;17:436–44.

    Article  CAS  Google Scholar 

  20. Goodrich D, Xing T, Tao X, Lonczak A, Zhan Y, Landis J, et al. Evaluation of comprehensive chromosome screening platforms for the detection of mosaic segmental aneuploidy. J Assist Reprod Genet. 2017;34:975–81.

    Article  Google Scholar 

  21. Gleicher N, Orvieto R. Is the hypothesis of preimplantation genetic screening (PGS) still supportable? A review. J Ovarian Res. 2017;10(1):21.

    Article  Google Scholar 

  22. Orvieto R, Shuly Y, Brengauz M, Feldman B. Should pre-implantation genetic screening be implemented to routine clinical practice? Gynecol Endocrinol. 2016;32:506–8.

    Article  Google Scholar 

  23. Barzrgar M, Gourabi H, Valojerdi MR, Yazdi PE, Beharvand H. Self-correction of chromosomal abnormalities in human preimplantation embryos and embryonic stem cells. Stem Cells Dev. 2013;22:2449–56.

    Article  Google Scholar 

  24. Munné S, Grifo J, Wells D. Mosaicism: “survival of the fittest” versus “no embryo left behind”. Fertil Steril. 2016;105:1146–9.

    Article  Google Scholar 

  25. Alvarado-Cruz I, Alegría-Torres JA, Montes-Castro N, Jiménez-Garza O, Quintanilla-Vega B. Environmental epigenetic changes, as risk factors for the development of diseases in children: a systematic review. Ann Glob Health. 2018;27:212–24.

    Article  Google Scholar 

  26. Schoolcraft WB, Katz-Jaffe MG. Comprehensive chromosome screening of trophectoderm with vitrification facilitates elective single-embryo transfer for infertile women with advanced maternal age. Fertil Steril. 2013;100:615–9.

    Article  Google Scholar 

  27. Lee HL, McCulloh DH, Hodes-Wertz B, Adler A, McCaffrey C, Grifo JA. In vitro fertilization with preimplantation genetic screening improves implantation and live birth in women age 40 through 43. J Assist Reprod Genet. 2015;32:435–44.

    Article  Google Scholar 

  28. Mastenbroek S, Twisk M, van der Veen F, Repping S. Preimplantation genetic screening: a systematic review and meta-analysis of RCTs. Hum Reprod Update. 2011;17:454–66.

    Article  CAS  Google Scholar 

  29. Orvieto R. Preimplantation genetic screening- the required RCT that has not yet been carried out. Reprod Biol Endocrinol. 2016;24:35.

    Article  Google Scholar 

  30. Sachdev NM, Ribustello L, Liu E, McCulloh DH, Grifo JA, Munn'e S. The rate of mosaic embryos from donor eggs as detected by next generation sequencing (NGS) varies by IVF laboratory. Fertil Steril. 2016;106(Suppl):e156–7.

    Article  Google Scholar 

  31. Kushnir VA, Darmon SK, Barad DH, Gleicher N. Degree of mosaicism in trophectoderm does not predict pregnancy potential: a corrected analysis of pregnancy outcomes following transfer of mosaic embryos. Reprod Biol Endocrinol. 2018;26:6.

    Article  Google Scholar 

  32. Victor AR, Tyndall JC, Brake AJ, Lepkowsky LT, Murphy AE, Griffin DK, et al. One hundred mosaic embryos transferred prospectively in a single clinic: exploring when and why they result in healthy pregnancies. Fertil Steril. 2019;111:280–93.

    Article  Google Scholar 

  33. Zheng H, Jin H, Liu L, Liu J, Wang WH. Application of next-generation sequencing for 24-chromosome aneuploidy screening of human preimplantation embryos. Mol Cytogenet. 2015;8:38.

    Article  Google Scholar 

  34. Gleicher N, Vidali A, Braverman J, Kushnir VA, Albertini DF, Barad DH. Further evidence against use of PGS in poor prognosis patients: report of normal births after transfer of embryos reported as aneuploid. Fertil Steril. 2015;104(Suppl 3):e9.

    Google Scholar 

  35. Goldberg JD, Wohlferd MM. Incidence and outcome of chromosomal mosaicism found at the time of chorionic villus sampling. Am J Obstet Gynecol. 1997;176:1349–54.

    Article  CAS  Google Scholar 

  36. Munne S, Magli C, Adler A, Wright G, de Boer K, Mortimer D, et al. Treatment- related chromosome abnormalities in human embryos. Hum Reprod. 1997;12:780–4.

    Article  CAS  Google Scholar 

  37. Munné S, Alikani M, Ribustello L, Colls P, Martínez-Ortiz PA, Referring Physician Group, et al. Euploidy rates in donor egg cycles significantly differ between fertility centers. Hum Reprod. 2017;32:743–9.

    Article  Google Scholar 

  38. Varga K, Tóth N, Bogár EB, Csontos L, Szabó K, Debreceni D, et al. The demise of preimplantation genetic testing for aneuploidy (PGT-A) in Hungary and its effect on patient care. Eur J Med Genet. 2019;62:103669.

    Article  Google Scholar 

  39. Sacchi L, Albani E, Cesana A, Smeraldi A, Parini V, Fabiani M, et al. Preimplantation genetic testing for aneuploidy improves clinical, gestational, and neonatal outcomes in advanced maternal age patients without compromising cumulative live-birth rate. J Assist Reprod Genet. 2019;36:2493–504.

    Article  Google Scholar 

  40. Sato T, Sugiura-Ogasawara M, Ozawa F, Yamamoto T, Kato T, Kurahashi H, Kuroda T, Aoyama N, Kato K, Kobayashi R, Fukuda A, Utsunomiya T, Kuwahara A, Saito H, Takeshita T, Irahara M. Preimplantation genetic testing for aneuploidy: a comparison of live birth rates in patients with recurrent pregnancy loss due to embryonic aneuploidy or recurrent implantation failure. Hum Reprod. 2019;34:2340–8.

Download references

Acknowledgements

We thank Yi-Ping Pai, Yi-Chun Chen, Hui-Hsin Shih and Yi-Ping Lin, for their assistance with the laboratory techniques. Support: NSC 101-2314-B-040-007, CSH-2015-D003 and MOST 106-3114-B-040-001.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tsung-Hsien Lee.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

ESM 1

(DOCX 130 kb)

ESM 2

(DOCX 18 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lee, CI., Cheng, EH., Lee, MS. et al. Healthy live births from transfer of low-mosaicism embryos after preimplantation genetic testing for aneuploidy. J Assist Reprod Genet 37, 2305–2313 (2020). https://doi.org/10.1007/s10815-020-01876-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10815-020-01876-6

Keywords

Navigation