Evidence-based clinical prioritization of embryos with mosaic results: a systematic review and meta-analysis.
Assisted reproductive technology
In vitro fertilization
Mosaicism
Preimplantation genetic testing for aneuploidy (PGT-A)
Journal
Journal of assisted reproduction and genetics
ISSN: 1573-7330
Titre abrégé: J Assist Reprod Genet
Pays: Netherlands
ID NLM: 9206495
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
received:
21
04
2021
accepted:
09
07
2021
pubmed:
3
9
2021
medline:
3
3
2022
entrez:
2
9
2021
Statut:
ppublish
Résumé
The purpose of this review and meta-analysis is to standardize the practice of mosaic embryo transfer, based on the current available evidence. This is a systematic review and meta-analysis. Relevant studies published were comprehensively selected using PubMed, Medline, Embase, and CENTRAL until 5 March 2021. Prospective and retrospective studies reporting the genetic analysis and clinical outcomes of mosaic embryo transfer were included. Risk of bias assessment was based on the Newcastle-Ottawa scale for the non-randomized studies. The primary and secondary outcomes were combined ongoing pregnancy and live birth rate and miscarriage rate, respectively. There were no differences between low and high mosaic embryos when a cut-off of 40% was used in terms of OP/LBR and SAB. However, low mosaics with a cut-off of 50% compared to high mosaics showed a significantly higher OP/LBR in the NGS but not in the a-CGH group, and a significantly lower risk of SAB. No differences were noted between mosaic monosomies versus trisomies and single versus double mosaics for both OP/LBR and SAB. Finally, segmental mosaics showed a higher OP/LBR and a lower SAB compared to whole chromosomes, and single and double mosaics had a higher OP/LBR compared to complex mosaics. A cut-off of 50% in defining low versus high mosaic embryos is preferable to a threshold of 40% when using NGS platform. No priority was established for mosaic trisomies over monosomies. Single and double mosaics must be preferred over complex mosaics and segmental mosaics must be preferred over whole chromosome mosaics. These results should be interpreted in the context of specific chromosomes involved in the mosaicism.
Identifiants
pubmed: 34472017
doi: 10.1007/s10815-021-02279-x
pii: 10.1007/s10815-021-02279-x
pmc: PMC8609000
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
2849-2860Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
Prenat Diagn. 1994 May;14(5):345-61
pubmed: 8084856
Prenat Diagn. 1989 Aug;9(8):575-88
pubmed: 2798343
Curr Oncol. 2013 Apr;20(2):85-7
pubmed: 23559869
Prenat Diagn. 1993 Aug;13(8):723-40
pubmed: 8284290
Hum Reprod. 2008 Nov;23(11):2596-608
pubmed: 18664475
Fertil Steril. 2016 Nov;106(6):1414-1419.e5
pubmed: 27692437
Fertil Steril. 2020 Aug;114(2):246-254
pubmed: 32741460
Mol Cytogenet. 2017 Apr 26;10:14
pubmed: 28450889
Syst Biol Reprod Med. 2017 Jun;63(3):206-208
pubmed: 28306341
Lancet. 1991 Jun 22;337(8756):1491-9
pubmed: 1675367
Fertil Steril. 2012 Apr;97(4):943-7
pubmed: 22277764
N Engl J Med. 2015 Nov 19;373(21):2089-90
pubmed: 26581010
Fertil Steril. 2009 Sep;92(3):890-896
pubmed: 18829021
Reprod Biomed Online. 2018 Apr;36(4):442-449
pubmed: 29433970
Taiwan J Obstet Gynecol. 2019 Nov;58(6):872-876
pubmed: 31759546
Fertil Steril. 2018 Jan;109(1):77-83
pubmed: 29191449
Reprod Biol Endocrinol. 2020 May 29;18(1):57
pubmed: 32471441
Fertil Steril. 2019 Feb;111(2):280-293
pubmed: 30691630
Fertil Steril. 2017 May;107(5):1098-1106
pubmed: 28433375
Eur J Epidemiol. 2010 Sep;25(9):603-5
pubmed: 20652370
J Obstet Gynaecol Can. 2020 Nov;42(11):1437-1443.e1
pubmed: 32830099
Prenat Diagn. 1993 Mar;13(3):179-90
pubmed: 8506219
Reprod Biol Endocrinol. 2018 Jan 26;16(1):6
pubmed: 29373974
Reprod Biomed Online. 2019 Aug;39 Suppl 1:e1-e4
pubmed: 31421710
J Assist Reprod Genet. 2019 Jan;36(1):165-172
pubmed: 30246223
Prenat Diagn. 1992 May;12(5):443-66
pubmed: 1523211
Reprod Biomed Online. 2021 Jan;42(1):55-65
pubmed: 33153932
Hum Genet. 2017 Jul;136(7):805-819
pubmed: 28393271
Genes (Basel). 2020 Aug 21;11(9):
pubmed: 32825792
Nat Commun. 2016 Mar 29;7:11165
pubmed: 27021558
J Assist Reprod Genet. 2017 Aug;34(8):975-981
pubmed: 28577183
Fertil Steril. 2021 May;115(5):1212-1224
pubmed: 33685629
Eur J Med Genet. 2020 Feb;63(2):103741
pubmed: 31445143
Nat Cell Biol. 2021 Apr;23(4):314-321
pubmed: 33837289
Hum Reprod Update. 2019 Jan 1;25(1):15-33
pubmed: 30395265
Fertil Steril. 2016 May;105(5):1146-1149
pubmed: 26827669
J Clin Med. 2020 Jun 02;9(6):
pubmed: 32498291
Mol Hum Reprod. 2000 Nov;6(11):1055-62
pubmed: 11044470
Hum Reprod Update. 2020 Apr 15;26(3):313-334
pubmed: 32141501
Am J Med Genet A. 2004 Dec 15;131(3):232-9
pubmed: 15529330
Stem Cells Dev. 2013 Sep 1;22(17):2449-56
pubmed: 23557100
Prenat Diagn. 2016 Feb;36(2):154-62
pubmed: 26676536
Eur J Hum Genet. 2006 Mar;14(3):282-8
pubmed: 16418738
Hum Reprod. 2020 Mar 27;35(3):727-733
pubmed: 32155260
Fertil Steril. 2017 Jul;108(1):62-71.e8
pubmed: 28579407
Hum Reprod Update. 2014 Jul-Aug;20(4):571-81
pubmed: 24667481
Prenat Diagn. 1994 May;14(5):363-79
pubmed: 8084857
Fertil Steril. 2019 Jan;111(1):69-76
pubmed: 30424882