Preimplantation genetic testing for aneuploidy (PGT-A) with trophectoderm (TE) biopsy is widely used in IVF for detection of aneuploidy embryos. However, the potential safety concern regarding biopsy and unknown long-term effects on embryos may restrict and limit this application. In recent years, a reliable, safe and effective non-invasive approach (niPGT-A) has been proposed that embryo cell free DNA (cfDNA) released by the embryo to the culture media can be collected and tested during the day 4-6 preimplantation development. The spent blastocyst media (SBM) was found to contain embryonic cfDNA and niPGT-A from the SBM were compared the concordance rates with the corresponding TE biopsies.

In this last PGT-A series webinar titled “Non-Invasive PGT-A”, we invite three outstanding speakers to share the updated information of this liquid biopsy in the following aspects:

  1. The methodology of niPGA-T.
  2. The concordance rates between niPGT-A vs. TE-biopsy and niPGT-A vs. ICM-biopsy.
  3. How to prevent maternal contaminations in SBM during this niPGT-A procedure.
  4. Comparison of diagnostic efficiency between SBM and blastocoele fluid (BF).
  5. The role of non-invasive chromosome screening (NICS) and its perspectives.
  6. Clinical application and transfer prioritization for niPGT-A.

This webinar is supported with an unrestricted education grant from Abbott.

We look forward to an exciting forum session and welcome you to join us.

Watch the lecture recordings below and take advantage of your opportunity to ask questions about this exciting area of reproductive medicine. Questions will be addressed at the live forum session taking place on Saturday, 21 November 2020 at 3pm GMT (+8).

Lecture 1: Non-Invasive PGT- Scientific Approach

Speaker: Dr. Antonio Capalbo (Rome, Italy) [click to view speaker’s bio]

In the last years there have been different attempts to overcome trophectoderm biopsy to diagnose the chromosomal content of the embryos. A non-invasive approach has been proposed that consist in the study of the embryo cell-free DNA (cfDNA) released by the embryo to the culture media during the latest stages of preimplantation development. After the first publications, several studies have compared the results of preimplantation genetic testing of aneuploidies (PGT-A) in trophectoderm (TE) biopsies with the results of the spent blastocyst media (SBM), to establish the concordance rates among both approaches. In these studies of non-invasive PGT-A (niPGT-A), the percentages of informative samples vary widely, likely as a consequence of the use of different methodologies and criteria used for result interpretation, urging the need for technical improvements before this new non-invasive technology can be clinically applied. In this presentation you will be provided with a critical appraisal of available scientific literature on niPGT, revisioning the strengths and limitations of the different scientific approaches employed to assess the performance of non-invasive preimplantation genetic testing.

Have questions pertaining to this lecture? Leave your questions in the comment box below or send them to secretariat@aspire-reproduction.org. Questions collected will be addressed at the live forum session happening on Saturday, 21 November 2020 at 3pm (GMT+8).

Lecture 2: Non-Invasive PGT-A: What Does it Offer the Patients?

Speaker: Professor Carlos Simón (Valencia, Spain) [click to view speaker’s bio]

In the last years there have been different attempts to overcome trophectoderm biopsy to diagnose the chromosomal content of the embryos. A non-invasive approach has been proposed that consist in the study of the embryo cell-free DNA (cfDNA) released by the embryo to the culture media during the latest stages of preimplantation development. After the first publications, several studies have compared the results of preimplantation genetic testing of aneuploidies (PGT-A) in trophectoderm (TE) biopsies with the results of the spent blastocyst media (SBM), to establish the concordance rates among both approaches. In these studies of non-invasive PGT-A (niPGT-A), the percentages of informative samples vary widely, likely reflecting the existence of mosaicism and/or presence of DNA from cumulus cells or polar bodies in the SBM, urging the need for technical improvements before this new non-invasive technology can be clinically applied.

More recently we have performed the interim analysis including 1,301 blastocysts obtained from 371 patients aged 20-44 years undergoing PGT-A and with TE biopsy and media collection on day 6. No previous assisted hatching or vitrification was allowed before media collection. Global concordance rates of the SBM with the corresponding TE biopsies were 78.2%. No significant differences were detected among centers ranging from 72.5% to 86.3%. A prioritization algorithm has been developed according to the concordance results observed and we suggest that an embryo prioritization system considering the euploidy rates in the SBM compared to the TE biopsy could offer a different perspective for patients and clinicians that do not want to undergo PGT-A, avoiding invasive embryo biopsy and decreased cost, potentially increasing accessibility for a wider patient population.

Have questions pertaining to this lecture? Leave your questions in the comment box below or send them to secretariat@aspire-reproduction.org. Questions collected will be addressed at the live forum session happening on Saturday, 21 November 2020 at 3pm (GMT+8).

Lecture 3: DNA Amplification in Non-Invasive PGT

Speaker: Dr. Sijia Lu (Shanghai, China) [click to view speaker’s bio]

Preimplantation genetic testing (PGT) has been widely used by IVF centers and clinics, for screening genetic abnormality before embryo transplantation. Blastomere or trophectoderm cells are the common sources of the genetic material of the embryo tested. Due to the invasiveness of the embryonic biopsy for the conventional PGT, there have been concerns about the technical safety and long-term effects on embryos having not yet been revealed.

A new generation non-invasive or mini-invasive PGT techniques have now been developed and applied in clinical studies and trials in the last five years. The blastocyst culture medium and blastocoele fluid were found to contain embryonic cfDNA and can be used as an alternative source for PGT. Owing the advancement of single-cell whole genome amplification methods and next generation sequencing, the ultra-low picrogram level of genomic DNA can be detected and sequenced for screening genetic abnormality at chromosomal and even single-base level.

Owing to Yikon’s patented whole genome amplification technology MALBAC, the non-invasive chromosome screening (NICS) for human embryo has been developed and the global first NICS baby was born 2016. The single-centre pilot clinical study of NICS obtained an ongoing pregnancy rate of 58% and reported 27 normal live births. With a continues development of NICS, it has now equipped with a machine learning-guided analysis system based on data collected from 345 paired blastocyst culture medium and whole blastocyst samples to predict euploidy in blastocyst IVF embryos. The new AI-based NICS validated in a blinded prospective observational study with 160 patients. We observed a significant increase in the ongoing pregnancy rate in A- versus Cgrade embryos and B- versus C-grade embryos, and a significant decrease in miscarriage rates compared to the morphological grading system. We hope IVF patients would benefit from the use of NICS technology with improved clinical outcomes.

Have questions pertaining to this lecture? Leave your questions in the comment box below or send them to secretariat@aspire-reproduction.org. Questions collected will be addressed at the live forum session happening on Saturday, 21 November 2020 at 3pm (GMT+8).

LIVE FORUM SESSION

Join us for an hour in a live interactive forum session where Prof. Tzeng, Dr. Capalbo, Prof. Simón and Dr. Lu will address and discuss the questions and cases received from this webinar.

Date: Saturday, 21 November 2020

Time: 3pm (GMT+8)

Live forum session for this webinar is open for registration. Register here