The birth of a healthy baby after transfer of a mosaic embryo in the in vitro fertilization program: clinical and ethical aspects


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Abstract

Background. The low effectiveness of assisted reproductive technology (ART) programs in older reproductive-aged patients is associated with a finite pool of high-quality oocytes and with a high risk for aneuploid embryos. According to the results of preimplantation genetic testing for aneuploidy (PGT-A), the pattern of embryonic chromosomal disorders differs on days 3 and 5 after fertilization, which may be due to a high degree of mosaicism in the embryo on day 3 of development and to its ability to compensate for these disorders by day 5. Case report. A 49-year-old patient came to the unit with a 5-year history of infertility with repeated failed ART attempts. The patient underwent an IVF/ICSI and PGT-A program with subsequent transfer of a mosaic embryo into the uterine cavity. She had a physiological pregnancy that ended in premature operative delivery. At the time of writing this paper, the baby is somatically healthy, developing according to age. Conclusion. Mosaic embryos may be the only available ones to be transferred to the uterine cavity in ART programs. Despite the fact that the clinical significance of mosaicism remains to be unestablished, it is known that mosaic embryos with a high proportion of euploid cells can lead to the birth of a healthy baby. The analysis of literature sources indicates that the outcomes of ART programs during the transfer of a mosaic embryo depend on the degree of mosaicism and the type of aneuploidy. Mosaicism can be physiological in nature and it is necessary to be very balanced in the analysis of PGT-A results.

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About the authors

Elena V. Kulakova

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: e_kulakova@oparina4.ru
Ph.D., Senior Researcher at the B.V. Leonov Department of Assisted Technologies for the Treatment of Infertility

Yulia S. Drapkina

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: julia.drapkina@gmail.com
Ph.D., Obstetrition-Gynecologist at the B.V. Leonov Department of Assisted Technologies for the Treatment of Infertility

Kamila U. Alieva

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: kaya79@mail.ru
Ph.D., Researcher at the B.V. Leonov Department of Assisted Technologies for the Treatment of Infertility

Nadezhda V. Zaretskaya

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: n_zaretskaya@oparina4.ru
Ph.D., Head of Clinical Work, Department of Clinical Genetics

Alexey N. Ekimov

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: a_ekimov@oparina4.ru
Clinical Geneticist at the Molecular Genetics Laboratory

Natalia P. Makarova

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: np_makarova@oparina4.ru
Dr. Biol. Sci., Senior Researcher at the B.V. Leonov Department of Assisted Technologies for the Treatment of Infertility

Anastasia P. Sysoeva

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: a_sysoeva@oparina4.ru
embryologist at the Department of Assisted Reproductive Technologies in the Treatment of Infertility

Elena A. Kalinina

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: e_kalinina@oparina4.ru
Dr. Med. Sci., Professor, Head of the Department of Assisted Technologies for the Treatment of Infertility, Scientific Secretary of the Dissertation Council

References

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