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대한생식의학회지 제31권 제1호 2010년
형광직접보합법을 이용한 착상전 유전진단 기법의 최적화와 경험 축적에 의한 임신율의 향상
삼성제일병원 생식생물학 및 불임연구실, 유전학연구실, 산부인과
임천규, 민동미,이형송,변혜경,박소연,류현미
Improvement of Pregnancy Rate in Preimplantation Genetic Diagnosis with FISH Procedure by the Laboratory Optimization and Experiences
Chun Kyu Lim, Dong Mi Min, Hyoung Song Lee, Hye Kyung Byun, So Yeon Park, Hyun Mee Ryu, Jin Young Kim, Mi Kyoung Koong, Inn Soo Kang, Jin Hyun Jun
Laboratory of Reproductive Biology & Infertility, Laboratory of Medical Genetics, Department of Obsterics and Gynecology, Samsung Cheil Hospital and Women's Healthcare Center, Sungkyunkwan University School of Medicine
Objectives: This study was performed to evaluate the laboratory system for successful PGD using fluorescence in situ hybridization (FISH) and the clinical outcome of PGD cycles in five years experiences. Methods: A total of 181 PGD-FISH cycles of 106 couples were performed, and diagnosed chromosome normality in the preimplantation embryos. The laboratory and clinical data were classified by the following optimization steps, and statistically analyzed. Phase I: Blastomere biopsy with two kinds of pipettes, removal of cytoplasmic proteins without treatment of pepsin and culture of biopsied embryos with single medium; Phase II: Blatomere biopsy with single pipette, removal of cytoplasmic proteins with pepsin and culture of biopsied embryos with single medium; Phase III: Blastomere biopsy with single pipette, removal of cytoplasmic proteins with pepsin and culture of biopsied embryos with sequential media. Results: A total of 3,209 oocytes were collected, and 83.8% (2,212/2,640) of fertilization rate was obtained by ICSI procedure. The successful blastomere biopsies were accomplished in 98.6% (2,043/2,071) of embryos, and the successful diagnosis rate of FISH was 94.7% (1,935/ 2,043) of blastomeres from overall data. Embryo transfers with normal embryos were conducted in 93.9% (170/181) of started cycles. There was no difference in the successful rate of biopsy and diagnosis among Phase I, II and III. However, the pregnancy rate per embryo transfer of Phase III (38.8%, 26/67) was significantly (p<0.05) higher than those of Phase I (13.9%, 5/36) and Phase II (14.9%, 10/67). Conclusions: The laboratory optimization and experience for the PGD with FISH procedure can increase the pregnancy rate to 38.8% in the human IVF-ET program. Our facility of PGD with FISH provides the great possibility to get a normal pregnancy for the concerned couples by chromosomal aberrations.
키워드 : Preimplantation genetic diagnosis (PGD), Fluorescence in-situ hybridization (FISH), Chromosome, Pregnancy rate
교신저자 : junjh55@hanmail.net
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