Cell-based non-invasive prenatal testing for monogenic disorders: confirmation of unaffected fetuses following preimplantation genetic testing

Christian Liebst Frisk Toft*, Hans Jakob Ingerslev, Ulrik Schiøler Kesmodel, Lotte Hatt, Ripudaman Singh, Katarina Ravn, Bolette Hestbek Nicolaisen, Inga Baasch Christensen, Mathias Kølvraa, Line Dahl Jeppesen, Palle Schelde, Ida Vogel, Niels Uldbjerg, Richard Farlie, Steffen Sommer, Marianne Louise Vang Østergård, Ann Nygaard Jensen, Helle Mogensen, Kristín Rós Kjartansdóttir, Birte DegnHenrik Okkels, Anja Ernst, Inge Søkilde Pedersen

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Purpose: Proof of concept of the use of cell-based non-invasive prenatal testing (cbNIPT) as an alternative to chorionic villus sampling (CVS) following preimplantation genetic testing for monogenic disorders (PGT-M). Method: PGT-M was performed by combined testing of short tandem repeat (STR) markers and direct mutation detection, followed by transfer of an unaffected embryo. Patients who opted for follow-up of PGT-M by CVS had blood sampled, from which potential fetal extravillous throphoblast cells were isolated. The cell origin and mutational status were determined by combined testing of STR markers and direct mutation detection using the same setup as during PGT. The cbNIPT results with respect to the mutational status were compared to those of genetic testing of the CVS. Results: Eight patients had blood collected between gestational weeks 10 and 13, from which 33 potential fetal cell samples were isolated. Twenty-seven out of 33 isolated cell samples were successfully tested (82%), of which 24 were of fetal origin (89%). This corresponds to a median of 2.5 successfully tested fetal cell samples per case (range 1–6). All fetal cell samples had a genetic profile identical to that of the transferred embryo confirming a pregnancy with an unaffected fetus, in accordance with the CVS results. Conclusion: These findings show that although measures are needed to enhance the test success rate and the number of cells identified, cbNIPT is a promising alternative to CVS. Trial registration number: N-20180001

OriginalsprogEngelsk
TidsskriftJournal of Assisted Reproduction and Genetics
Vol/bind38
Udgave nummer8
Sider (fra-til)1959-1970
ISSN1058-0468
DOI
StatusUdgivet - aug. 2021

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Publisher Copyright:
© 2021, The Author(s).

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

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