Cell-free DNA analysis in preimplantation genetic testing.
F&S SCIENCE 2023;
4:7-16. [PMID:
36758901 DOI:
10.1016/j.xfss.2023.01.001]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/09/2023] [Accepted: 01/24/2023] [Indexed: 02/10/2023]
Abstract
Detection of chromosomal aneuploidies and monogenic disorders in preimplantation embryos is essential for selecting the best embryo for transfer during in vitro fertilization (IVF) to achieve a healthy pregnancy. Preimplantation genetic testing (PGT) is typically performed on preimplantation embryos to select a genetically normal embryo for transfer. A trophectoderm (TE) biopsy is necessary for PGT; this is an invasive procedure to the embryo that requires specialized equipment and highly trained embryologists, resulting in high costs associated with IVF treatment. Moreover, the biopsy procedure may increase the likelihood of developing pregnancy complications such as preeclampsia and hypertensive disorders. Therefore, there is a need for non-invasive embryo screening strategies. The presence of cell-free DNA (cfDNA) in the embryo culture medium presents an opportunity to screen for genetic abnormalities. cfDNA is released by embryos in the latter stages of preimplantation development, and its analysis has been proposed as a non-invasive approach for PGT. Here, we review studies reporting concordance rates between cfDNA and TE biopsies, or whole blastocysts (WB), in couples undergoing PGT. Non-invasive PGT results are promising for aneuploidy detection, with some early evidence of successful clinical application. Further research is required to explore its application for the detection of structural rearrangements and monogenic disorders.
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