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Identification of cryptic balanced translocations in couples with unexplained recurrent pregnancy loss based upon embryonic PGT-A results

  • Genetics
  • Published:
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Abstract

Purpose

The goal of this study is to determine whether any balanced translocation (BT) had been missed by previous karyotyping in patients with unexplained recurrent pregnancy loss (uRPL).

Methods

This case series included 48 uRPL-affected couples with normal karyotypes. The embryos from these couples have all undergone preimplantation testing for aneuploidies (PGT-A). Based on the PGT-A’s results, 48 couples could be categorized into two groups: 17 couples whose multiple embryos were detected with similar structural variations (SVs, segmental/complete) and 31 couples without such findings but who did not develop any euploid embryo despite at least three high-quality blastocysts being tested. The peripheral blood sample of each partner was then collected for mate-pair sequencing (MPseq) to determine whether any of them were BT carriers.

Results

MPseq analyses identified 13 BTs in the 17 couples whose multiple embryos had similar SVs detected (13/17, 76.47%) and three BTs in the 31 couples without euploid embryo obtained (3/31, 9.7%). Among the 16 MPseq-identified BTs, six were missed due to the limited resolution of G-banding karyotyping analysis, and the rest were mostly owing to the similar banding patterns and/or comparable sizes shared by the two segments exchanged.

Conclusion

A normal karyotype does not eliminate the possibility of carrying BT for couples with uRPL. The use of PGT-A allows us to perceive the “carrier couples” missed by karyotyping analysis, providing an increased risk of finding cryptic BTs if similar SVs are always detected on two chromosomes among multiple embryos. Nonetheless, certain carriers with translocated segments of sub-resolution may still go unnoticed.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

We appreciate Miss Zihan Chen for her invaluable help in sample preparation and all participants involved in this study.

Funding

This study was supported by the National Key R&D Program of China (2021YFC2700604), the Collaborative Research Fund (C4062-21GF), and the National Natural Science Foundation of China (82171648 and 32270678).

Author information

Author notes

  1. Shuo Li and Hongchang Li contributed equally to this work.

Authors and Affiliations

  1. Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China

    Shuo Li, Hongchang Li, Yuan Gao, Yang Zou, Xunqiang Yin, Zi-Jiang Chen, Zirui Dong & Junhao Yan

  2. Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China

    Shuo Li, Hongchang Li, Yuan Gao, Yang Zou, Xunqiang Yin, Zi-Jiang Chen & Junhao Yan

  3. Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China

    Shuo Li, Hongchang Li, Yuan Gao, Yang Zou, Xunqiang Yin, Zi-Jiang Chen & Junhao Yan

  4. Shandong Provincial Clinical Research Center for Reproductive Health, Shandong University, Jinan, China

    Shuo Li, Hongchang Li, Yuan Gao, Yang Zou, Xunqiang Yin, Zi-Jiang Chen & Junhao Yan

  5. National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China

    Shuo Li, Hongchang Li, Yuan Gao, Yang Zou, Xunqiang Yin, Zi-Jiang Chen & Junhao Yan

  6. Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai Jiao Tong University, Shanghai, China

    Zi-Jiang Chen

  7. Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

    Zi-Jiang Chen

  8. Department of Obstetrics & Gynecology, The Chinese University of Hong Kong, Hong Kong, China

    Kwong Wai Choy & Zirui Dong

  9. Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China

    Kwong Wai Choy & Zirui Dong

  10. The Chinese University of Hong Kong-Baylor College of Medicine Joint Center For Medical Genetics, Hong Kong, China

    Kwong Wai Choy

  11. Hong Kong Branches of Chinese National Engineering Research Centers-Center for Assisted Reproductive Technology and Reproductive Genetics, Hong Kong, China

    Kwong Wai Choy

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  1. Shuo Li
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  2. Hongchang Li
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  3. Yuan Gao
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Contributions

S. L., H. L., Z.-J. C., K. W. C., Z. D., and J. Y. designed the whole study. J. Y. recruited patients. S. L. collected samples and variant verification and data curation. H. Li contributed to FISH validation. Z. D. and K. W. C. completed MPseq, data analysis, and variant interpretation. Y. G., Y. Z., and X. Y. collected and analyzed the PGT results. S. L., H. L., K. W. C., Z. D., and J. Y. wrote the manuscript. All authors approved the final version of the manuscript.

Corresponding authors

Correspondence to Kwong Wai Choy, Zirui Dong or Junhao Yan.

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Li, S., Li, H., Gao, Y. et al. Identification of cryptic balanced translocations in couples with unexplained recurrent pregnancy loss based upon embryonic PGT-A results. J Assist Reprod Genet 41, 171–184 (2024). https://doi.org/10.1007/s10815-023-02999-2

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