Using outcome data from one thousand mosaic embryo transfers to formulate an embryo ranking system for clinical use

Viotti, Manuel; Victor, Andrea; Barnes, Frank L.; Zouves, Christo; Besser, Andria G.; Grifo, James A.; Cheng, En‐Hui; Lee, Maw‐Sheng; Horcajadas, José A.; Corti, Laura; Fiorentino, Francesco; Spinella, Francesca; Minasi, Maria Giulia; Greco, Ermanno; Munné, Santiago

doi:10.1016/j.fertnstert.2020.11.041

Cited by 107 publications

(79 citation statements)

References 42 publications

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“…This prospective study concluded that embryos carrying a single segmental abnormality should be preferred, followed by those with less severe mosaicism (45% vs. 36.4% IR and 39.4% vs. 27.3% fetal heartbeat, respectively). Most recently, Viotti et al, 2021, presented their analysis which was based on multicenter data of 1000 transferred mosaic embryo outcomes [47]. Thus far, this is the largest dataset with mosaic embryo transfer outcomes.…”

Section: Mosaic Embryos and Pregnancy Outcomementioning

confidence: 99%

“…Munné et al, 2020, recommended a mosaic embryos' classification into a high-level and a low-level group and prioritized single segmental mosaics for transfer over other mosaic types [45]. Viotti et al, 2021, also identified a ranking system for mosaic embryos in the clinic [47]. An alternative set of recommendations has been proposed by Grati et al, 2018 [51].…”

Section: Criteria For Mosaic Embryo Transfermentioning

confidence: 99%

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Biological and Clinical Significance of Mosaicism in Human Preimplantation Embryos

Bouba

Hatzi

Ladias

et al. 2021

JDB

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Applications and indications of assisted reproduction technology are expanding, but every new approach is under scrutiny and thorough consideration. Recently, groups of assisted reproduction experts have presented data that support the clinical use of mosaic preimplantation embryos at the blastocyst stage, previously excluded from transfer. In the light of published contemporary studies, with or without clinical outcomes, there is growing evidence that mosaic embryos have the capacity for further in utero development and live birth. Our in-depth discussion will enable readers to better comprehend current developments. This expansion into the spectrum of ART practices requires further evidence and further theoretical documentation, basic research, and ethical support. Therefore, if strict criteria for selecting competent mosaic preimplantation embryos for further transfer, implantation, fetal growth, and healthy birth are applied, fewer embryos will be excluded, and more live births will be achieved. Our review aims to discuss the recent literature on the transfer of mosaic preimplantation embryos. It also highlights controversies as far as the clinical utilization of preimplantation embryos concerns. Finally, it provides the appropriate background to elucidate and highlight cellular and genetic aspects of this novel direction.

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Section: Mosaic Embryos and Pregnancy Outcomementioning

confidence: 99%

Section: Criteria For Mosaic Embryo Transfermentioning

confidence: 99%

Biological and Clinical Significance of Mosaicism in Human Preimplantation Embryos

Bouba

Hatzi

Ladias

et al. 2021

JDB

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“…These data provide much needed evidence-based guidelines for appropriate validation study for accurate detection of mosaic embryos in the clinic. Parameters obtained from this study were used for diagnosing more than 2000 mosaic embryos obtained in our clinic from May 2019 to December 2020 [36]. NGS-based PGT-A detected different types and level of mosaic embryos, including embryos with whole-chromosome mosaicism, segmental (or partial), complex or a combination of such aneuploidies and embryos with a percentage of aneuploidy cells ranging between 20% and 70%.…”

Section: Discussionmentioning

confidence: 99%

Cross-Validation of Next-Generation Sequencing Technologies for Diagnosis of Chromosomal Mosaicism and Segmental Aneuploidies in Preimplantation Embryos Model

Biricik¹,

Cotroneo²,

Minasi

et al. 2021

Life

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Detection of mosaic embryos is crucial to offer more possibilities of success to women undergoing in vitro fertilization (IVF) treatment. Next Generation Sequencing (NGS)-based preimplantation genetic testing are increasingly used for this purpose since their higher capability to detect chromosomal mosaicism in human embryos. In the recent years, new NGS systems were released, however their performance for chromosomal mosaicism are variable. We performed a cross-validation analysis of two different NGS platforms in order to assess the feasibility of these techniques and provide standard parameters for the detection of such aneuploidies. The study evaluated the performance of MiseqTM Veriseq (Illumina, San Diego, CA, USA) and Ion Torrent Personal Genome Machine PGMTM ReproSeq (Thermo Fisher, Waltham, MA, USA) for the detection of whole and segmental mosaic aneuploidies. Reconstructed samples with known percentage of mosaicism were analyzed with both platforms and sensitivity and specificity were determined. Both platforms had high level of specificity and sensitivity with a Limit Of Detection (LOD) at ≥30% of mosaicism and a showed a ≥5.0 Mb resolution for segmental abnormalities. Our findings demonstrated that NGS methodologies are capable of accurately detecting chromosomal mosaicism and segmental aneuploidies. The knowledge of LOD for each NGS platform has the potential to reduce false-negative and false-positive diagnoses when applied to detect chromosomal mosaicism in a clinical setting.

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“…The developmental patterns of mosaic embryos have yet to be understood. 1 The aim of this study is to determine whether low and high level mosaic embryos differ from euploid embryos in morphologic characteristics.…”

Section: Objectivementioning

confidence: 99%

The Morphology of Mosaicism: Characterizing Low- And High-Level Mosaic Embryos Compared to Euploid Embryos

Aharon

Alkon

Hernández-Nieto

et al. 2021

Fertility and Sterility

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150 saliva samples were obtained and correlated with number and size of follicles.Weak correlation (r¼ 0.37) was seen in salivary oestradiol to total number of follicles A more promising correlation (r¼ 0.42) was observed when total number of follicles were adjusted to above 14mm.No correlation was detected in progesterone levels to follicular growth. No relationship was observed in salivary oestradiol or progesterone to endometrial thickness.CONCLUSIONS: These preliminary results show promising findings for correlation of saliva oestradiol to follicular growth to be explored in larger studies.The limitations of saliva sample include discoloured saliva samples, which is likely secondary to poor sampling technique or failure to collect according to protocol, all of which can be mitigated with improved training and education.The ease of saliva sampling allows a reduction in intervention and thereby provides a more "patient-friendly" approach to IVF.IMPACT STATEMENT: Current status quo of serial serum monitoring should be challenged as excessive.This alternative method of monitoring of cycle response in place of serum testing, especially during mid-cycle stimulation at day 5 or 6, is worth exploring.These preliminary results call for larger studies and has potential to revolutionise development of home testing kits, especially in the era of a pandemic, thereby reducing clinic footfall and patient safety.References

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Using outcome data from one thousand mosaic embryo transfers to formulate an embryo ranking system for clinical use

Cited by 107 publications

References 42 publications

Biological and Clinical Significance of Mosaicism in Human Preimplantation Embryos

Biological and Clinical Significance of Mosaicism in Human Preimplantation Embryos

Cross-Validation of Next-Generation Sequencing Technologies for Diagnosis of Chromosomal Mosaicism and Segmental Aneuploidies in Preimplantation Embryos Model

The Morphology of Mosaicism: Characterizing Low- And High-Level Mosaic Embryos Compared to Euploid Embryos

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