Title

Preimplantation genetic diagnosis for a couple with recurrent pregnancy loss and triploidy

UMMS Affiliation

Department of Obstetrics and Gynecology

Date

11-28-2003

Document Type

Article

Medical Subject Headings

Abortion, Habitual; Adult; Chromosome Aberrations; Diploidy; Female; Fertilization in Vitro; Humans; In Situ Hybridization, Fluorescence; Karyotyping; Male; Meiosis; Oocytes; *Ploidies; Pregnancy; Preimplantation Diagnosis; Sperm Injections, Intracytoplasmic; Spermatozoa

Disciplines

Obstetrics and Gynecology

Abstract

BACKGROUND: Triploidy may arise from fertilization of a mature haploid egg by two haploid sperm or by failure of meiotic divisions yielding a diploid gamete. We encountered a couple with habitual abortion, in which the last two fetuses were documented as viable triploid.

METHODS: To avoid dispermic penetration and development of abnormal preembryos, insemination was done by intracytoplasmic sperm injection (ICSI) followed by fluorescence in situ hybridization (FISH) of biopsied blastomeres.

RESULTS: Tests of the husband's spermatozoa by FISH, revealed that only 2-3% of the sperm were disomic for chromosomes 16, 13, 21, X, and Y. No triple disomy was detected among chromosomes 16, 13 and 21, which makes it very unlikely that triploidy resulted from diploid spermatozoa. Following a controlled ovulation induction protocol, low quality oocytes with immature cumuli were revealed. After ICSI, five eggs became two pronuclei (2PN) zygotes and none of the other eggs developed a 3PN zygote. FISH was performed on chromosomes 16 and 21 in four preembryos developed to a 6-8 cell stage. Aneuploidy or mosaicism for each of these chromosomes was detected in one preembryo and later in two disaggregated blastocysts. FISH failed in one preembryo that became atretic after biopsy.

CONCLUSIONS: Although this case was unsuccessful in achieving embryo transfer and normal pregnancy, we detected many abnormal morphological features in the oocytes and chromosomal abnormalities in the cleaving preembryos. This protocol can be proposed to patients with recurrent pregnancy loss associated with chromosomal abnormalities in the fetus.

Rights and Permissions

Citation: Birth Defects Res A Clin Mol Teratol. 2003 Nov;67(11):946-50. Link to article on publisher's site

Related Resources

Link to Article in PubMed

PubMed ID

14745933