EMBRYO SELECTION ON MORPHOKINETIC CRITERIA THROUGH TIME-LAPSE TECHNOLOGY ALONG WITH PREIMPLANTATION GENETIC TESTING (PGT) IN A COUPLE WITH RECURRENT PREGNANCY LOSS. CASE REPORT

  • Gabriela SIMIONESCU “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • B. DOROFTEI “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Simona CUMPATA Origyn Fertility Center, Iasi
  • Loredana NEMTANU Origyn Fertility Center, Iasi
  • I. IVANOV Origyn Fertility Center, Iasi
  • R. MAFTEI “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Delia GRAB “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Sabina NECULAI-VALEANU Origyn Fertility Center, Iasi
  • E. ANTON “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Abstract

In this paper we present the case of a couple with a history of recurrent pregnancy failure in the first trimester, a balanced Robertsonian translocation (45,XY,der(13;14)(q10;q10)) being identified in the male karyotype. The couple was referred to genetic counseling and underwent an in vitro fertilization (IVF) cycle associated with preimplantation genetic testing. The embryos were cultured in a time-lapse system and the morphokinetic parameters were assessed daily. From the five embryos which were appropriate from embryo biopsy and freezing, only one embryo was genetically suitable for embryo transfer. The frozen embryo transfer resulted in a pregnancy and successful birth of a female baby. In the era of human assisted reproduction, state of the art biotechnologies such as time-lapse embryo monitoring and PGT should be used in synergy in order to complement the overall picture and enhance the process of decision making in the quest of obtaining a healthy offspring.

Author Biographies

Gabriela SIMIONESCU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Mother and Child Medicine
“Cuza-Voda” Obstetrics and Gynecology Clinical Hospital, Iasi
Origyn Fertility Center, Iasi

B. DOROFTEI, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Mother and Child Medicine
“Cuza-Voda” Obstetrics and Gynecology Clinical Hospital, Iasi
Origyn Fertility Center, Iasi

I. IVANOV, Origyn Fertility Center, Iasi

Regional Institute of Oncology, Iasi
Department of Molecular Biology

R. MAFTEI, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department Morpho-Functional Sciences (I)
“Cuza-Voda” Obstetrics and Gynecology Clinical Hospital, Iasi
Origyn Fertility Center, Iasi

Delia GRAB, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Mother and Child Medicine
“Cuza-Voda” Obstetrics and Gynecology Clinical Hospital, Iasi
Origyn Fertility Center, Iasi

E. ANTON, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Mother and Child Medicine
“Cuza-Voda” Obstetrics and Gynecology Clinical Hospital, Iasi
Origyn Fertility Center, Iasi

References

1. Werner M, Reh A, Grifo J, et al. Characteristics of chromosomal abnormalities diagnosed after spon-taneous abortions in an infertile population. J Assist Reprod Genet 2012; 29: 817-820.
2. Hardy K, Hardy PJ. 1st trimester miscarriage: four decades of study. Transl Pediat 2015; 4(2): 189-200. doi:10.3978/j. issn.2224-4336.2015.03.05
3. Choi BH, Kim UH, Lee KS, KoCW. Various endocrine disorders in children with t(13;14)(q10;q10) Robertsonian translocation. Ann Pediatr Endocrinol Metab 2013; 18(3): 111-115.
4. Kar B, Sivamani S, Kundavi S, Varma TR. The importance of cytogenetics and associated molecular techniques in the management of patients carrying robertsonian translocation and their pregnancy outcome by intracytoplasmic sperm injection. J Obstet Gynaecol India 2018; 68(2): 93-97.
doi: 10.1007/s13224-017-0999
5. Basile N, Nogales M, Mdel C, Bronet F, Florensa M, Riqueiros M, Rodrigo L, et al. Increasing the
probability of selecting chromosomally normal embryos by time-lapse morphokinetics analysis. Fertil Steril 2014; 101: 699-704. (doi.org/10.1016/j.fertnstert.2013.12.005)
6. Zidi-Jrah I, Hajlaoui A, Mougou-Zerelli S, Kammoun M, Meniaoui I, Sallem A, et al.. Relationship between sperm aneuploidy, sperm DNA integrity, chromatin packaging, traditional semen parameters, and recurrent pregnancy loss. Fert Steril 2016; 105(1): 58-64.
7. Moraru E, Diaconu R, Anton E, Bozomitu I, Anton C, Ciobica Al, et al. Understanding the relevance of pain, depression and anxiety-like manifestations in the management of cystic fibrosis. Arch Bio Sci 2015; 67(3): 895-897.
8. ***The ESHRE Guideline Group on RPL, Atik RB, Christiansen OB, Elson J, Kolte AM, Lewis S et al.ESHRE guideline: recurrent pregnancy loss. Human Reprod Open, 2018, 2, (doi.org/10.1093/hropen/hoy004).
9. Ikuma S, Sato T, Sugiura-Ogasawara M, Nagayoshi M, Tanaka A, Takeda S. Preimplantation Genetic Diagnosisand Natural Conception: A Comparison of Live Birth Rates in Patients with Recurrent Pregnancy Loss Associated with Translocation. PlosOne, 2015, doi.org/10.1371/ journal. pone.0129958
10. Wong C, Chen AA, Behr B, Shen S. Time-lapse microscopy and image analysis in basic and clinical embryo development research. Reprod Biomed Online 2013; 26(2): 120-129.
doi: 10.1016/j.rbmo.2012.11.003
11. Simionescu G, Maftei R, Anton E, Valeanu S, Doroftei B. Time-Lapse Microscopy Role in Improving The Outcome Of IVF/ICSI Cycles By Monitoring And Selection Of Early Embryo. Management Intercultural 2016; XVIII (37): 345-349.
12. Rubio I, Galán A, Larreategui Z, Ayerdi F, Bellver J, Herrero J, et al. Clinical validation of embryo culture and selection by morphokinetic analysis: a randomized, controlled trial of the EmbryoScope. Fertil Steril 2014; 102: 1287-1294.
13. Campbell A, Fishel S, Bowman N, Duffy S, Sedler M, Thornton S. Retrospective analysis of outcomes after IVF using an aneuploidy risk model derived from time-lapse imaging without PGS. Reprod BioMed Online 2013a; 27 140-146. (doi.org/10.1016/j.rbmo.2013.04.013)
14. Chawla M, Fakih M, Shunnar A, Bayram A, Hellani A, Perumal V, et al. Morphokinetic analysis of cleavage stage embryos and its relationship to aneuploidy in a retrospective time-lapse imaging study. J Assist Reprod Genet 2015;32, 69–75. (doi.org/10.1007/s10815-014-0372-3)
15. Del Carmen Nogales M, Bronet F, Basile N, Martínez EM, Liñán A, Rodrigo L, et al. Type of chro-mosome abnormality affects embryo morphology dynamics. Fertil Steril 2017; 107 229–235 (doi.org/10.1016/j.fertnstert.2016.09.019)
16. Yang Z, Zhang J, Salem SA, Liu X, Kuang Y, Salem RD, et al. Selection of competent blastocysts for transfer by combining time-lapse monitoring and array CGH testing for patients undergoing preim-plantation genetic screening: a prospective study with sibling oocytes. BMC Medical Genomics 2014; 7, 38 (doi.org/10.1186/1755-8794-7-38)
17. Patel DV, Shah PB, Kotdawala AP, Herrero J, Rubio I, Banker MR. Morphokinetic behavior of eu-ploid and aneuploid embryos analyzed by time-lapse in embryoscope. J Hum Reprod Sci 2016; 9, 112-118 (doi.org/10.4103/0974-1208.183511)
18. Pribenszky C, Nilselid AM, Montag M. Time-lapse culture with morphokinetic embryoselection improves pregnancy and live birth chances and reduces early pregnancy loss: a meta-analysis. Reprod BioMed Online 2017; 35, 5; 511-520
19. Griffin DK and Ogru C. Chromosomal analysis in IVF: just how useful is it? Reprod 2018; 156, 1, 29-50 (doi.org/10.1530/REP-17-0683)
Published
2018-12-27