The ESHRE PGD consortium: 10 years of data collection
ABSTRACT Since it was established in 1997, the ESHRE PGD Consortium has been collecting data from international preimplantation genetic diagnosis (PGD) centres. Ten papers have been published, including data from January 1997 to December 2007.
The data collection originally used a hard-copy format, then an excel database and finally a FileMaker Pro database. The indications are divided into five categories: PGD for chromosome abnormalities, sexing for X-linked disease, PGD for single gene defects, preimplantation genetic screening (PGS) and PGD for social sexing. The main end-points are pregnancy outcome and follow-up of deliveries.
In data collection I, 16 centres contributed data, which increased to 57 centres by data X (average of 39 centres per data collection). These centres contributed data on over 27 000 cycles that reached oocyte retrieval. Of these cycles, 61% were for aneuploidy screening, 17% for single gene disorders, 16% for chromosomal abnormalities, 4% for sexing of X-linked disease and 2% for social sexing. Cumulatively, 5187 clinical pregnancies gave rise to 4140 deliveries and 5135 newborns (singletons: 3182, twins: 921, triplets: 37).
In this paper, we present an overview of the first 10 years of PGD data, highlighting trends. These include the introduction of laser-assisted biopsy, an increase in polar body and trophectoderm biopsy, new strategies, methodologies and technologies for diagnosis, including recently arrays, and the more frequent use of freezing biopsied embryos. The Consortium data reports represent a valuable resource for information about the practice of PGD.
- SourceAvailable from: Pinar Tulay
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- " or normal embryo following PGD for translocations . The ESHRE consortium reported in their XII data collection that 25% embryos were transferable for patients undergoing PGD for both reciprocal and Robertsonian translocations ( Moutou et al . , 2014 ) that is in agreement with the 10 years of ESHRE collected results ( 26% transferable embryos ) ( Harper et al . , 2012 ) . These collective data illustrate that there is a low chance of finding a balanced or normal embryo for transfer from patients undergoing PGD for translocations ."
ABSTRACT: Summary This study aimed to investigate the optimum number of embryos to be biopsied in order to increase the likelihood of obtaining a balanced/normal embryo following preimplantation genetic diagnosis (PGD) by fluorescence in situ hybridisation (FISH) for translocation carriers. Patients with low number of fertilised oocytes (≤5) or low number of embryos available for PGD (<7) underwent multiple hormonal stimulation cycles and their embryos from each cycle were vitrified and accumulated to obtain at least three embryos for PGD. Fifty-seven PGD cycles were performed for translocation carriers by FISH on day 3 of embryo development. PGD and pregnancy outcomes were examined according to the number of embryos biopsied. The cancellation rates of embryo transfer for the reciprocal translocation carriers were 40% when more than eight embryos were biopsied and it was as high as 78% when low number of embryos (less than nine) were biopsied. For Robertsonian translocation carriers, when more than eight embryos were biopsied, there were no embryo transfer cancellations. This study showed that when there are more than nine embryos biopsied for PGD, the likelihood of obtaining a balanced embryo and positive pregnancy outcome is significantly higher (P < 0.05) in such the overall pregnancy rate was 63% for reciprocal and 86% for Robertsonian carriers. This was reduced to only 7% for reciprocal and 14% for Robertsonian translocation carriers when less than nine embryos were biopsied. One of the limitations of this study was that the analysis was performed by FISH and more studies should investigate the outcomes of embryo accumulation following comprehensive chromosome analysis.Zygote 01/2015; -1:1-8. DOI:10.1017/S0967199414000793 · 1.32 Impact Factor
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- "Genetic counselling was performed in a standardized way following the department protocol and included, amongst others, explanation of all procedures , complications, and risk of misdiagnosis. Couples were informed that live birth rate per started cycle is 15 – 20% and that not all oocyte retrievals lead to a transfer due to chromosomal imbalance in all embryos examined (Harper et al., 2012). In the study period, there were six different genetic counsellors. "
ABSTRACT: Do clinical characteristics of recurrent miscarriage couples with a chromosomal abnormality and who opt for PGD differ from couples that decline PGD after extensive genetic counselling? No differences in clinical characteristics are identified between recurrent miscarriage couples carrying a structural chromosomal abnormality who opt for PGD compared with those that decline PGD after extensive genetic counselling. Couples who have experienced two or more miscarriages (recurrent miscarriage) are at increased recurrence risk if one of the partners carries a structural chromosomal abnormality. PGD can be offered to avoid (another) miscarriage or pregnancy termination when (invasive) prenatal diagnosis shows an abnormal result. To date, no reports are available that describe reproductive decision-making after genetic counselling on PGD in these specific couples. Retrospective cohort study of 294 couples carrying a structural chromosomal abnormality seeking genetic counselling on PGD between 1996 and 2012. Participants were recurrent miscarriage couples carrying a structural chromosomal abnormality. They had been referred for genetic counselling to the only national licensed PGD centre. Clinical characteristics analysed included couple associated characteristics, characteristics concerning reproductive history and external characteristics such as type of physician that referred the couple for genetic counselling and the clinical geneticist performing the counselling on PGD. Of 294 couples referred for counselling on PGD, 26 were not accepted because they did not meet the criteria for IVF-PGD. The remaining cohort of 268 couples consisted of two-thirds female and one-third male carriers. Main PGD indications were reciprocal translocations (83.9%) and Robertsonian translocations (16.7%). Following genetic counselling, 76.9% of included couples chose PGD as their reproductive option, the others declined PGD. Reproductive choice is not influenced by sex of the translocation carrier (P = 0.499), type of chromosomal abnormality (P = 0.346), number of previous miscarriages (P = 0.882), history of termination of pregnancy (TOP) because of an unbalanced fetal karyotype (P = 0.800), referring physician (P = 0.208) or geneticist who performed the counselling (P = 0.410). This study only included recurrent miscarriage couples carrying a structural chromosomal abnormality, who were actually referred to a PGD clinic for genetic counselling. We lack information on couples who were not referred for PGD. Some of these patients may not have been informed on PGD at all, while others were not referred for counselling because they did not opt for PGD to start with. This study shows that reproductive choices in couples with recurrent miscarriage on the basis of a structural chromosomal abnormality are not influenced by characteristics of the couple itself, nor by their obstetric history or external characteristics. These findings suggest that a couples' intrinsic attitude towards PGD treatment is a major factor influencing their reproductive choice. Future research will focus on these personal motives that seem to push reproductive decision-making following genetic counselling in a given direction. G.K. is supported by the Stichting Fertility Foundation as a junior researcher. There are no conflicts of interest. TRIAL REGISTRATION NUMBER: N/A. © The Author 2014. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: email@example.com.Human Reproduction 11/2014; 30(2). DOI:10.1093/humrep/deu314 · 4.59 Impact Factor
Chapter: In Vitro Fertilization[Show abstract] [Hide abstract]
ABSTRACT: Since the first successful in vitro fertilization (IVF) cycle, there have been tremendous advancements in the technologies surrounding IVF. Specific genetic disorders such as parental chromosomal translocations or inversions and single gene mutations such as cystic fibrosis or fragile X, as well as abnormalities in the number of chromosomes, or aneuploidy, are major barriers to achieving a healthy live born infant. Preimplantation genetic diagnosis (PGD) for specific chromosomal or genetic disorders and preimplantation genetic screening (PGS) for determination of the number of chromosomes, are techniques that have been developed to prevent the uterine transfer of genetically abnormal embryos during IVF cycles. The purpose of preimplantation genetic testing (PGT), that is PGD or PGS, is to improve the likelihood of giving birth to a healthy baby. The clinical management of a patient who presents requesting PGT is complex. In order to successfully conduct a complete cycle of PGT, from patient counseling to embryo transfer and pregnancy evaluation, a multidisciplinary team of expert genetic counselors, IVF clinicians, and laboratory personnel, and genetic testing laboratory must work together. This chapter reviews the clinical situations that most commonly lead patients to present for PGT, patient counseling, how available testing is appropriately applied, utilization of PGT, and expected outcomes.In Vitro Fertilization, 01/2012: pages 115-143; , ISBN: 978-1-4419-9847-7