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Palacios-Verdú MG, Rodríguez-Melcón A, Rodríguez I, Racca A, Serra B, Albaiges G, Parriego M, Prats P. Prenatal screening after preimplantation genetic testing for aneuploidy: time to evaluate old strategies. Reprod Biomed Online 2023; 48:103761. [PMID: 38603981 DOI: 10.1016/j.rbmo.2023.103761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 11/10/2023] [Accepted: 11/28/2023] [Indexed: 04/13/2024]
Abstract
RESEARCH QUESTION How does first-trimester aneuploidy screening perform in pregnancies achieved through IVF with preimplantation genetic testing for aneuploidy (PGT-A) in a medical setting? DESIGN This retrospective cohort study was undertaken in a single tertiary care centre between January 2013 and June 2022. In total, 20,237 women had prenatal follow-up at the study centre and were included in the study. The women were divided into three groups: singleton pregnancies conceived through the transfer of a PGT-A-screened euploid embryo (n = 510); singleton pregnancies conceived through IVF without PGT-A (n = 3291); and singleton pregnancies conceived naturally (n = 16,436). RESULTS The conventional combined screening test for pregnancies conceived through IVF with PGT-A had specificity of 91%; sensitivity could not be calculated as there were no cases of fetal aneuploidy in this group. In 89.1% of pregnancies conceived through IVF with PGT-A with high risk for trisomy 21, 18 or 13, the result was related to advanced maternal age (>35 years at time of screening). CONCLUSIONS The current screening strategy for trisomies 21, 18 and 13 can generate unnecessary tests in pregnancies achieved through IVF with PGT-A. A new protocol is needed for these patients, with greater weight given to ultrasound markers.
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Affiliation(s)
- María Gabriela Palacios-Verdú
- Unit of Genomic Medicine, Department of Obstetrics, Gynaecology and Reproductive Medicine, Institut Universitari Quirón Dexeus, Barcelona, Spain.
| | - Alberto Rodríguez-Melcón
- Obstetrics Service, Department of Obstetrics, Gynaecology and Reproductive Medicine, Institut Universitari Quirón Dexeus, Barcelona, Spain
| | - Ignacio Rodríguez
- Epidemiological Unit, Department of Obstetrics, Gynaecology and Reproductive Medicine, Institut Universitari Quirón Dexeus, Barcelona, Spain
| | - Annalisa Racca
- Reproductive Medicine Service, Department of Obstetrics, Gynaecology and Reproductive Medicine, Institut Universitari Quirón Dexeus, Barcelona, Spain
| | - Bernat Serra
- Obstetrics Service, Department of Obstetrics, Gynaecology and Reproductive Medicine, Institut Universitari Quirón Dexeus, Barcelona, Spain
| | - Gerard Albaiges
- Obstetrics Service, Department of Obstetrics, Gynaecology and Reproductive Medicine, Institut Universitari Quirón Dexeus, Barcelona, Spain
| | - Mónica Parriego
- Reproductive Medicine Service, Department of Obstetrics, Gynaecology and Reproductive Medicine, Institut Universitari Quirón Dexeus, Barcelona, Spain
| | - Pilar Prats
- Obstetrics Service, Department of Obstetrics, Gynaecology and Reproductive Medicine, Institut Universitari Quirón Dexeus, Barcelona, Spain
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Palacios-Verdú MG, Segura-Puimedon M, Borralleras C, Flores R, Del Campo M, Campuzano V, Pérez-Jurado LA. Metabolic abnormalities in Williams-Beuren syndrome. J Med Genet 2015; 52:248-55. [PMID: 25663682 DOI: 10.1136/jmedgenet-2014-102713] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Williams-Beuren syndrome (WBS, OMIM-194050) is a neurodevelopmental disorder with multisystemic manifestations caused by a 1.55-1.83 Mb deletion at 7q11.23 including 26-28 genes. Reported endocrine and metabolic abnormalities include transient hypercalcaemia of infancy, subclinical hypothyroidism in ∼ 30% of children and impaired glucose tolerance in ∼ 75% of adult individuals. The purpose of this study was to further study metabolic alterations in patients with WBS, as well as in several mouse models, to establish potential candidate genes. METHODS We analysed several metabolic parameters in a cohort of 154 individuals with WBS (data available from 69 to 151 cases per parameter), as well as in several mouse models with complete and partial deletions of the orthologous WBS locus, and searched for causative genes and potential modifiers. RESULTS Triglyceride plasma levels were significantly decreased in individuals with WBS while cholesterol levels were slightly decreased compared with controls. Hyperbilirubinemia, mostly unconjugated, was found in 18.3% of WBS cases and correlated with subclinical hypothyroidism and hypotriglyceridemia, suggesting common pathogenic mechanisms. Haploinsufficiency at MLXIPL and increased penetrance for hypomorphic alleles at the UGT1A1 gene promoter might underlie the lipid and bilirubin alterations. Other disturbances included increased protein and iron levels, as well as the known subclinical hypothyroidism and glucose intolerance. CONCLUSIONS Our results show that several unreported biochemical alterations, related to haploinsufficiency for specific genes at 7q11.23, are relatively common in WBS. The early diagnosis, follow-up and management of these metabolic disturbances could prevent long-term complications in this disorder.
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Affiliation(s)
- María Gabriela Palacios-Verdú
- Genetics Unit, Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain Hospital del Mar Research Institute (IMIM), Barcelona, Spain Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
| | - Maria Segura-Puimedon
- Hospital del Mar Research Institute (IMIM), Barcelona, Spain Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain Institut für Integrative und Experimentelle Genomik, Universitat zu Lübeck, Lübeck, Germany
| | - Cristina Borralleras
- Genetics Unit, Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain Hospital del Mar Research Institute (IMIM), Barcelona, Spain Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
| | - Raquel Flores
- Genetics Unit, Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain Hospital del Mar Research Institute (IMIM), Barcelona, Spain Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
| | - Miguel Del Campo
- Hospital del Mar Research Institute (IMIM), Barcelona, Spain Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain Area de Medicina Molecular i Genètica, Hospital dew Vall d'Hebron, Barcelona, Spain
| | - Victoria Campuzano
- Genetics Unit, Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain Hospital del Mar Research Institute (IMIM), Barcelona, Spain Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
| | - Luis Alberto Pérez-Jurado
- Genetics Unit, Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain Hospital del Mar Research Institute (IMIM), Barcelona, Spain Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
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