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Hum. Reprod. Advance Access published online on June 14, 2006
Human Reproduction, doi:10.1093/humrep/del186
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received January 27, 2005
Revised April 19, 2006
Accepted April 21, 2006

Article

The analysis of one or two blastomeres for PGD using fluorescence in-situ hybridization

An Michiels 1 *, Elvire Van Assche 1, Inge Liebaers 1, André Van Steirteghem 2, and Catherine Staessen 1

1 Centre for Medical Genetics, Research Centre Reproduction and Genetics, Laarbeeklaan, Brussels, Belgium
2 Research Centre Reproduction and Genetics and Centre for Reproductive Medicine, Academisch Ziekenhuis, Vrije Universiteit Brussel, Laarbeeklaan, Brussels, Belgium

* To whom correspondence should be addressed.
An Michiels, E-mail: an.michiels{at}az.vub.ac.be


  Abstract

BACKGROUND: The analysis of one or two blastomeres for PGD using fluorescence in-situ hybridization (FISH) is debated. The proportion of analysable embryos, false negatives, false positives, sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and efficiency were evaluated when one or two blastomeres were analysed. METHODS: Embryos of patients having PGD for aneuploidy screening were assigned non-randomly to two groups: group I (n = 413), more slow cleaving embryos with one nucleus for analysis, and group II (n = 1366), regularly cleaving embryos with two nuclei for analysis. A two-round FISH procedure was performed investigating seven chromosomes; 486 embryos were reanalysed. RESULTS: The proportion of analysable embryos was significantly higher in group II (98.2 versus 95.9%) (P = 0.04). Despite the apparently increased false-positive rate (group I: 25.6% and group II: 13.6%) and the decreased PPV (group I: 91.9% and group II: 96.7%), specificity (group I: 74.4% and group II: 86.4%) and efficiency (group I: 93.5% and group II: 97.3%) in group I, no significance was reached (P = 0.11, P = 0.053, P = 0.11 and P = 0.06, respectively). CONCLUSIONS: Although the analysis of one blas-tomere generates statistically significantly fewer embryos with a diagnosis than does the analysis of two blastomeres, the 2% difference may not be clinically relevant. The diagnostic accuracy is not significantly different between the two groups, hence not favouring the analysis of one or two blastomeres.

Keywords: aneuploidy screening/diagnostic accuracy/FISH/one blastomere biopsy/PGD.
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