Outcomes of Preimplantation Genetic Diagnosis Cycles by Fluorescent In situ Hybridization of Infertile Males with Nonmosaic 47,XYY Syndrome

Background： The 47,XYY syndrome could result in fertility problems. However, seldom studies reported comprehensive researches on the embryonic development and pregnancy outcomes of these patients. This study aimed to evaluate the clinical outcomes of nonmosaic 47,XYY patients performed with fluorescent in situ hybridization （FISH） and preimplantation genetic diagnosis （PGD） treatment. Methods： This was a retrospective study. Between January 2012 and May 2017, 51 infertile males with nonmosaic 47,XYY syndrome underwent FISH-PGD were included in the study. According to sex chromosomal FISH results, embryos were classified as normal signal, no nuclei fixed, no signal in fixed nuclei, suspensive signal, and abnormal signal groups, respectively. The incidence of each group, the fixation rate, and hybridization rate were calculated. Embryonic development and pregnancy outcomes were also analyzed. The measurement data were analyzed with Student＇s t-test. The comparison of categorical data was analyzed with the Chi-square test and Fisher＇s exact test when expected cell count was 〈5. Results： The 53 PGD cycles with 433 embryos were analyzed. The fixation rate was 89.6%, while the hybridization rate was 96.4%. There were 283 embryos with two sex chromosomal signals with clear diagnosis （65.4%）. The numbers of no nuclei fixed, no signal in fixed nuclei, suspensive signal, and abnormal signal groups were 45 （10.4%）, 14 （3.2%）, 24 （5.5%）, and 67 （15.5%）, respectively. Embryos with abnormal signals were abandoned. The number of good-quality embryos was 210 （57.4%）, including implanted embryos on day 4/day 5 a.ld cryopreserved. The rates of good-quality embryos in the no nuclei fixed （22.2%）, no signal in fixed nuclei （28.6%）, and suspensive signal groups （33.3%） were comparable （P 〉 0.05）, and were significantly lower than the normal signal group （66.4%, P 〈 0.001 ）. The clinical pregnancy rates of fresh and frozen embryos transferred cycles were 70.6% and 85.7%, respectively. Conclusions： Among embryos with a clear diagnosis of sex chromosome, about one-fifth showed abnormal signals. Embryos with two sex chromosomal signals are more likely to develop into good-quality ones. The application of the PGD by FISH may help to improve the clinical outcomes.

47，XYY综合征患者精子染色体的FISH研究

目的分析47，XYY综合征患者的精子染色体组成，评估其子代染色体异常的风险。方法采用多色荧光原位杂交（FISH）技术，利用CSPX、Y、18及GLP13、21探针和精子核杂交，杂交信号归类计数，与对照进行统计学分析。结果经χ2检验和Fisher精确概率检验，47，XYY患者的精子常染色体异常数明显高于正常对照（P〈0．05），性染色体异常数与正常对照相比差异无统计学意义（P〉0．05）。结论47，XYY患者不增加其子代性染色体异常的风险，而常染色体发生次级不分离的风险却远高于对照。因此。通过应用FISH技术分析该类患者的精子染色体，可为评估其子代染色体异常风险提供客观的实验数据。

47,XYY/47,XY,＋mar超雄综合征患儿额外小标记染色的形态及来源

目的 探讨47,XYY/47,XY,＋mar嵌合型超雄综合征患儿额外小标记染色体的形态和来源.方法 在传统G显带染色体核型分析的基础上,进一步应用双色荧光原位杂交技术分析21例染色体核型为47,XYY/47,XY,＋mar嵌合型超雄综合征患儿额外小标记染色体的形态和来源.结果 21例患儿的额外小标记染色体中,18例来源于Y染色体,3例来源于常染色体.来源于Y染色体的额外小标记染色体则均以带有着丝粒的染色体小片段形式存在;来源于常染色体的额外小标记染色体则均以带有着丝粒的染色体环状形态存在.结论 47,XYY/47,XY,＋mar嵌合型超雄综合征患儿的额外小标记染色体多数来源于性染色体,少数来源于常染色体.这些额外小标记染色体主要以环状、带有着丝粒的染色体小片段状的形式存在.对于47,XYY/47,XY,＋mar嵌合型超雄综合征患儿,应进一步明确其分子细胞遗传学特征,以指导遗传咨询、产前诊断和确定治疗方案.

克氏征嵌合型患者的诊断及遗传风险评估

目的分析克氏征嵌合体患者的淋巴细胞和精子的染色体组成,为其快速诊断提供新方法,并为评估其子代遗传风险提供依据。方法应用三色荧光原位杂交技术(FISH)分析三例克氏征嵌合体患者的淋巴细胞、经优选处理前后精子的X、Y、18号染色体的组成。结果与淋巴细胞G显带核型分析相比,FISH结果所发现的嵌合体比例无显著性差异(P>0.05);与对照组相比,三例患者的精子性染色体异常率增高、XY精子比例增高,患者2、3差异有显著性(P<0.05);处理前及分别经两种优选方法处理后,精子染色体异常率无显著性差异(P>0.05)。结论 FISH技术是诊断克氏征嵌合体的快速有效方法;对该类患者精子的FISH分析结果,有助于评估其子代的遗传风险,为优生遗传咨询提供可靠的依据。