Based on our current knowledge of the reproductive outcomes of fetal and placental mosaicism from prenatal diagnosis, the following can be used as a guide by the clinician (or a genetic counselor if available) when a mosaic embryo is being considered for transfer: |
1 |
Embryos showing mosaic euploid/monosomy or mosaic euploid/ monosomy are preferable to euploid/trisomy, given that monosomic embryos (excepting 45, X) are not viable |
2 |
If a decision is made to transfer mosaic embryos trisomic for a single chromosome, one can prioritize selection based on the level of mosaicism and the specific chromosome involved |
a. The preferable transfer category consists of mosaic embryos trisomic for chromosomes 1, 3, 4, 5, 6, 8, 9, 10, 11, 12, 17, 19, 20, 22, X, Y. None of these chromosomes involve the adverse characteristics enumerated below. |
b. Embryos mosaic for trisomies that are associated with potential for uniparental disomy [14, 15] are of lesser priority |
c. Embryos mosaic for trisomies that are associated with intrauterine growth retardation (chromosomes 2, 7, 16) are of lesser priority |
d. Embryos mosaic for trisomies capable of liveborn viability (chromosomes 13, 18, 21) are for obvious reasons of lowest priority |