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Journal of Medical Genetics logoLink to Journal of Medical Genetics
. 1999 Jan;36(1):45–50.

Preimplantation genetic diagnosis for couples at high risk of Down syndrome pregnancy owing to parental translocation or mosaicism

C Conn 1, J Cozzi 1, J Harper 1, R Winston 1, J Delhanty 1
PMCID: PMC1762940  PMID: 9950365

Abstract

The population risk for trisomy 21 is 1 in 700 births but some couples are at a much higher risk owing to parental translocation or mosaicism. We report on the first attempt to carry out preimplantation genetic diagnosis for two such couples using cleavage stage embryo biopsy and dual colour FISH analysis. Each couple underwent two treatment cycles. Couple 1 (suspected gonadal mosaicism for trisomy 21) had two embryos normal for chromosome 21 transferred, but no pregnancy resulted; 64% (7/11) unfertilised oocytes/embryos showed chromosome 21 aneuploidy. Couple 2 (46,XX,t(6;21)(q13;q22.3)) had a single embryo transferred resulting in a biochemical pregnancy; 91% (10/11) oocytes/embryos showed chromosome 21 imbalance, most resulting from 3:1 segregation of this translocation at gametogenesis. The opportunity to test embryos before implantation enables the outcome of female meiosis to be studied for the first time and the recurrence risk for a Down syndrome pregnancy to be assessed.


Keywords: preimplantation genetic diagnosis; Down syndrome; reciprocal translocation; gonadal mosaicism

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Selected References

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  1. Almeida P. A., Bolton V. N. The relationship between chromosomal abnormalities in the human oocyte and fertilization in vitro. Hum Reprod. 1994 Feb;9(2):343–346. doi: 10.1093/oxfordjournals.humrep.a138505. [DOI] [PubMed] [Google Scholar]
  2. Benkhalifa M., Janny L., Vye P., Malet P., Boucher D., Menezo Y. Assessment of polyploidy in human morulae and blastocysts using co-culture and fluorescent in-situ hybridization. Hum Reprod. 1993 Jun;8(6):895–902. doi: 10.1093/oxfordjournals.humrep.a138162. [DOI] [PubMed] [Google Scholar]
  3. Cassel M. J., Munné S., Fung J., Weier H. U. Carrier-specific breakpoint-spanning DNA probes: an approach to preimplantation genetic diagnosis in interphase cells. Hum Reprod. 1997 Sep;12(9):2019–2027. doi: 10.1093/humrep/12.9.2019. [DOI] [PubMed] [Google Scholar]
  4. Conn C. M., Harper J. C., Winston R. M., Delhanty J. D. Infertile couples with Robertsonian translocations: preimplantation genetic analysis of embryos reveals chaotic cleavage divisions. Hum Genet. 1998 Jan;102(1):117–123. doi: 10.1007/s004390050663. [DOI] [PubMed] [Google Scholar]
  5. Davies A. F., Barber L., Murer-Orlando M., Bobrow M., Adinolfi M. FISH detection of trisomy 21 in interphase by the simultaneous use of two differentially labelled cosmid contigs. J Med Genet. 1994 Sep;31(9):679–685. doi: 10.1136/jmg.31.9.679. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Delhanty J. D., Griffin D. K., Handyside A. H., Harper J., Atkinson G. H., Pieters M. H., Winston R. M. Detection of aneuploidy and chromosomal mosaicism in human embryos during preimplantation sex determination by fluorescent in situ hybridisation, (FISH). Hum Mol Genet. 1993 Aug;2(8):1183–1185. doi: 10.1093/hmg/2.8.1183. [DOI] [PubMed] [Google Scholar]
  7. Delhanty J. D., Harper J. C., Ao A., Handyside A. H., Winston R. M. Multicolour FISH detects frequent chromosomal mosaicism and chaotic division in normal preimplantation embryos from fertile patients. Hum Genet. 1997 Jun;99(6):755–760. doi: 10.1007/s004390050443. [DOI] [PubMed] [Google Scholar]
  8. Delhanty J. D., Wells D., Harper J. C. Genetic diagnosis before implantation. BMJ. 1997 Oct 4;315(7112):828–829. doi: 10.1136/bmj.315.7112.828. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Gnirke A., Barnes T. S., Patterson D., Schild D., Featherstone T., Olson M. V. Cloning and in vivo expression of the human GART gene using yeast artificial chromosomes. EMBO J. 1991 Jul;10(7):1629–1634. doi: 10.1002/j.1460-2075.1991.tb07685.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Griffin D. K., Handyside A. H., Harper J. C., Wilton L. J., Atkinson G., Soussis I., Wells D., Kontogianni E., Tarin J., Geber S. Clinical experience with preimplantation diagnosis of sex by dual fluorescent in situ hybridization. J Assist Reprod Genet. 1994 Mar;11(3):132–143. doi: 10.1007/BF02332090. [DOI] [PubMed] [Google Scholar]
  11. Harper J. C., Coonen E., Handyside A. H., Winston R. M., Hopman A. H., Delhanty J. D. Mosaicism of autosomes and sex chromosomes in morphologically normal, monospermic preimplantation human embryos. Prenat Diagn. 1995 Jan;15(1):41–49. doi: 10.1002/pd.1970150109. [DOI] [PubMed] [Google Scholar]
  12. Harper J. C., Coonen E., Ramaekers F. C., Delhanty J. D., Handyside A. H., Winston R. M., Hopman A. H. Identification of the sex of human preimplantation embryos in two hours using an improved spreading method and fluorescent in-situ hybridization (FISH) using directly labelled probes. Hum Reprod. 1994 Apr;9(4):721–724. doi: 10.1093/oxfordjournals.humrep.a138577. [DOI] [PubMed] [Google Scholar]
  13. Hillier S. G., Afnan A. M., Margara R. A., Winston R. M. Superovulation strategy before in vitro fertilization. Clin Obstet Gynaecol. 1985 Sep;12(3):687–723. [PubMed] [Google Scholar]
  14. Hopman A. H., Ramaekers F. C., Raap A. K., Beck J. L., Devilee P., van der Ploeg M., Vooijs G. P. In situ hybridization as a tool to study numerical chromosome aberrations in solid bladder tumors. Histochemistry. 1988;89(4):307–316. doi: 10.1007/BF00500631. [DOI] [PubMed] [Google Scholar]
  15. Jalbert P., Sele B., Jalbert H. Reciprocal translocations: a way to predict the mode of imbalanced segregation by pachytene-diagram drawing. Hum Genet. 1980;55(2):209–222. doi: 10.1007/BF00291769. [DOI] [PubMed] [Google Scholar]
  16. James R. M., Klerkx A. H., Keighren M., Flockhart J. H., West J. D. Restricted distribution of tetraploid cells in mouse tetraploid<==>diploid chimaeras. Dev Biol. 1995 Jan;167(1):213–226. doi: 10.1006/dbio.1995.1018. [DOI] [PubMed] [Google Scholar]
  17. Laverge H., De Sutter P., Verschraegen-Spae M. R., De Paepe A., Dhont M. Triple colour fluorescent in-situ hybridization for chromosomes X,Y and 1 on spare human embryos. Hum Reprod. 1997 Apr;12(4):809–814. doi: 10.1093/humrep/12.4.809. [DOI] [PubMed] [Google Scholar]
  18. Lengauer C., Green E. D., Cremer T. Fluorescence in situ hybridization of YAC clones after Alu-PCR amplification. Genomics. 1992 Jul;13(3):826–828. doi: 10.1016/0888-7543(92)90160-t. [DOI] [PubMed] [Google Scholar]
  19. Mikkelsen M., Stene J. Genetic counselling in Down's syndrome. Hum Hered. 1970;20(5):457–464. doi: 10.1159/000152346. [DOI] [PubMed] [Google Scholar]
  20. Munné S., Lee A., Rosenwaks Z., Grifo J., Cohen J. Diagnosis of major chromosome aneuploidies in human preimplantation embryos. Hum Reprod. 1993 Dec;8(12):2185–2191. doi: 10.1093/oxfordjournals.humrep.a138001. [DOI] [PubMed] [Google Scholar]
  21. Munné S., Weier H. U. Simultaneous enumeration of chromosomes 13, 18, 21, X, and Y in interphase cells for preimplantation genetic diagnosis of aneuploidy. Cytogenet Cell Genet. 1996;75(4):263–270. doi: 10.1159/000134497. [DOI] [PubMed] [Google Scholar]
  22. Pangalos C. G., Talbot C. C., Jr, Lewis J. G., Adelsberger P. A., Petersen M. B., Serre J. L., Rethoré M. O., de Blois M. C., Parent P., Schinzel A. A. DNA polymorphism analysis in families with recurrence of free trisomy 21. Am J Hum Genet. 1992 Nov;51(5):1015–1027. [PMC free article] [PubMed] [Google Scholar]
  23. Robinson W. P., Binkert F., Bernasconi F., Lorda-Sanchez I., Werder E. A., Schinzel A. A. Molecular studies of chromosomal mosaicism: relative frequency of chromosome gain or loss and possible role of cell selection. Am J Hum Genet. 1995 Feb;56(2):444–451. [PMC free article] [PubMed] [Google Scholar]
  24. Soloviev I. V., Yurov Y. B., Vorsanova S. G., Fayet F., Roizes G., Malet P. Prenatal diagnosis of trisomy 21 using interphase fluorescence in situ hybridization of post-replicated cells with site-specific cosmid and cosmid contig probes. Prenat Diagn. 1995 Mar;15(3):237–248. doi: 10.1002/pd.1970150307. [DOI] [PubMed] [Google Scholar]
  25. Van Hummelen P., Manchester D., Lowe X., Wyrobek A. J. Meiotic segregation, recombination, and gamete aneuploidy assessed in a t(1;10)(p22.1;q22.3) reciprocal translocation carrier by three- and four-probe multicolor FISH in sperm. Am J Hum Genet. 1997 Sep;61(3):651–659. doi: 10.1086/515516. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Van Steirteghem A. C., Nagy Z., Joris H., Liu J., Staessen C., Smitz J., Wisanto A., Devroey P. High fertilization and implantation rates after intracytoplasmic sperm injection. Hum Reprod. 1993 Jul;8(7):1061–1066. doi: 10.1093/oxfordjournals.humrep.a138192. [DOI] [PubMed] [Google Scholar]
  27. Verlinsky Y., Cieslak J., Freidine M., Ivakhnenko V., Wolf G., Kovalinskaya L., White M., Lifchez A., Kaplan B., Moise J. Polar body diagnosis of common aneuploidies by FISH. J Assist Reprod Genet. 1996 Feb;13(2):157–162. doi: 10.1007/BF02072538. [DOI] [PubMed] [Google Scholar]
  28. Zheng Y. L., Ferguson-Smith M. A., Warner J. P., Ferguson-Smith M. E., Sargent C. A., Carter N. P. Analysis of chromosome 21 copy number in uncultured amniocytes by fluorescence in situ hybridization using a cosmid contig. Prenat Diagn. 1992 Nov;12(11):931–943. doi: 10.1002/pd.1970121113. [DOI] [PubMed] [Google Scholar]

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