To mask or not to mask mosaicism? The impact of reporting embryo mosaicism on reproductive potential.

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Abstrakt

Tytuł:: To mask or not to mask mosaicism? The impact of reporting embryo mosaicism on reproductive potential.
Autorzy:: Armstrong A; Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, UCLA, 200 Medical Plaza Driveway Suite 220, CA, 90095, Los Angeles, USA. .
Miller J; CooperSurgical, 3 Regent St, Livingston, NJ, 07039, USA.
Quinn M; Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Keck School of Medicine at University of Southern California, 2020 Zonal Avenue, IRD 534, CA, 90033, Los Angeles, USA.
Nguyen AV; Department of Urology, UCLA, 200 Medical Plaza Driveway Suite 140, CA, 90095, Los Angeles, USA.
Kwan L; Department of Urology, UCLA, 200 Medical Plaza Driveway Suite 140, CA, 90095, Los Angeles, USA.
Kroener L; Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, UCLA, 200 Medical Plaza Driveway Suite 220, CA, 90095, Los Angeles, USA.
Źródło:: Journal of assisted reproduction and genetics [J Assist Reprod Genet] 2022 Sep; Vol. 39 (9), pp. 2035-2042. Date of Electronic Publication: 2022 Jul 20.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: <2004- >: Amsterdam : Springer
Original Publication: New York : Plenum Press, c1992-
MeSH Terms:: Mosaicism*
Preimplantation Diagnosis*
Adolescent ; Adult ; Aneuploidy ; Blastocyst/pathology ; Female ; Genetic Testing ; High-Throughput Nucleotide Sequencing ; Humans ; Live Birth ; Middle Aged ; Pregnancy ; Young Adult
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Contributed Indexing:: Keywords: Embryos for transfer; Mosaic rates; Reporting mosaicism
Entry Date(s):: Date Created: 20220720 Date Completed: 20220916 Latest Revision: 20230902
Update Code:: 20240105
PubMed Central ID:: PMC9474961
DOI:: 10.1007/s10815-022-02576-z
PMID:: 35857256
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Purpose: To evaluate euploidy rates and probability of having at least one euploid embryo for transfer per cycle when mosaicism is reported compared to when it is masked.
Methods: Women age 18-46 years who underwent PGT-A with next generation sequencing of blastocyst biopsies were analyzed. When reported, mosaic embryos were classified as low-level, 20-40% mosaic, or high-level, 41-80% mosaic. When masked, low-level mosaics were categorized as euploid and high-level mosaics were considered aneuploid. Comparative analyses were performed with χ 2 tests and t-tests.
Results: A total of 22,504 PGT-A biopsy cycles from 18,401 patients were included. These cycles were from 293 different clinics with a mean of 1.22 cycles per patient. The majority of cycles (94.8%) reported mosaicism, and only 5.2% cycles were masked. The euploidy rate was significantly lower when mosaicism was reported versus masked (38.7% v 47.4%, p < 0.0001), which remained significant for age 40 years old and younger. The mosaic reporting cohort was less likely to have at least one euploid embryo for transfer (68.8%) compared to the masked cohort (75.7%) (p < 0.0001); however, this was no longer significant after stratification by age.
Conclusion: Mosaicism reporting shows an overall expected reduction in euploidy rate. In turn, the probability of having a euploid embryo to transfer depends on clinic transfer practices and patient preference. If mosaic embryos are not transferred, we observe a reduction in probability of having an embryo for transfer. Although the magnitude of these differences is small, our data show that mosaic reporting may contribute to embryo attrition rate.
(© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

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