Comprehensive carrier genetic test using next generation deoxyribonucleic acid sequencing in infertile couples wishing to conceive through assisted reproductive technology

The comprehensive carrier genetic screening test developed here offers a powerful tool to detect alleles for hundreds of Mendelian diseases in patients.

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Authors

Julio Martin, Ph.D., Asan, Ph.D., Yuting Yi, M.S., Trinidad Alberola, Ph.D., Beatriz Rodríguez-Iglesias, Ph.D., Jorge Jiménez-Almazán, Ph.D., Qin Li, B.S., Huiqian Du, M.S., Pilar Alama, M.D., Amparo Ruiz, M.D., Ernesto Bosch, M.D., Nicolas Garrido, Ph.D., Carlos Simon, M.D.

Volume 104, Issue 5, Pages 1286-1293

Abstract

Objective:

To develop an expanded pan-ethnic preconception carrier genetic screening test for use in assisted reproductive technology (ART) patients and donors.

Design:

Retrospective analysis of results obtained from 2,570 analyses.

Setting:

Reproductive genetic laboratory.

Patient(s):

The 2,570 samples comprised 1,170 individuals from the gamete donor programs; 1,124 individuals corresponding to the partner of the patient receiving the donated gamete; and 276 individuals from 138 couples seeking ART using their own gametes.

Intervention(s):

None.

Main Outcome Measure(s):

Next-generation sequencing of 549 recessive and X-linked genes involved in severe childhood phenotypes reinforced with five complementary tests covering high prevalent mutations not detected by next-generation sequencing.

Result(s):

Preclinical validation included 48 DNA samples carrying known mutations for 27 genes, resulting in a sensitivity of 99%. In the clinical dataset, 2,161 samples (84%) tested positive, with an average carrier burden of 2.3 per sample. Five percent of the couples using their own gametes were found to have pathogenic variants conferring high risk for six different diseases. These high-risk couples and patients received genetic counseling and recommendations for preimplantation genetic diagnosis. For patients receiving gamete donation, we applied a genetic testing and blinded matching system to avoid high-risk combinations regardless of their carrier burden. For female donors, 1.94% were positive for X-linked conditions; they received genetic counselling and were discarded.

Conclusion(s):

We have developed a comprehensive carrier genetic screening test that, combined with our matching system and genetic counseling, constitutes a powerful tool to avoid more than 600 Mendelian diseases in the offspring of patients undergoing ART.

Read the full text at: http://www.fertstert.org/article/S0015-0282(15)01713-6/fulltext


Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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