Preimplantation genetic diagnosis for Tay-Sachs disease: successful pregnancy after pre-embryo biopsy and gene amplification by polymerase chain reaction.
OBJECTIVE
To determine the ability to apply preimplantation genetic diagnostic techniques to screen for and prevent Tay-Sachs disease (TSD).


METHODS
A couple, both carriers for the 4 base pair (bp) insertion in exon 11 of the beta-hexosaminidase A gene, which results in TSD, underwent IVF, pre-embryo biopsy, polymerase chain reaction (PCR) DNA amplification of the biopsied blastomeres, and pre-embryo transfer. One to two blastomeres were aspirated using a biopsy pipette that was inserted through an opening in the zona formed with acidified phosphate buffer. Polymerase chain reaction was performed on the individual blastomeres for 20 cycles followed by an additional 30 cycles using nested primers. This yielded amplified DNA products of 272 and 276 bp for the normal and mutant gene, respectively. Heteroduplex formation was used for identification of normal, homozygous affected, and heterozygous pre-embryos.


RESULTS
Seven of 13 oocytes fertilized normally and were biopsied at the four- to eight-cell stages. Deoxyribonucleic acid amplification occurred in four of seven pre-embryos (one homozygous affected and three homozygous normal pre-embryos). The three normal pre-embryos that continued to cleave after biopsy were transferred on the evening of day 3 after retrieval. Subsequently, a single gestational sac was observed and the genetic diagnosis was confirmed at amniocentesis.


CONCLUSIONS
A successful pregnancy and birth were accomplished after preimplantation genetic diagnostic screening for the prevention of TSD.
Gibbons
W E
WE
Department of Obstetrics and Gynecology, Jones Institute of Reproductive Medicine, Eastern Virginia Medical School, Norfolk.
Gitlin
S A
SA
Lanzendorf
S E
SE
Kaufmann
R A
RA
Slotnick
R N
RN
Hodgen
G D
GD
D001483:Base Sequence; D001706:Biopsy; D001755:Blastocyst / Q000473:pathology*; D001757:Blastomeres / Q000473:pathology; D005260:Female; D005307:Fertilization in Vitro; D005821:Genetic Techniques; D006579:Heterozygote; D006801:Humans; D008297:Male; D008969:Molecular Sequence Data; D015345:Oligonucleotide Probes / Q000235:genetics; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D013661:Tay-Sachs Disease / Q000175:diagnosis* / Q000235:genetics*
D015345:Oligonucleotide Probes