Preimplantation genetic diagnosis for beta-thalassaemia: the Sardinian experience.
OBJECTIVE
To report the experiences on preimplantation genetic diagnosis (PGD) in couples at risk for beta-thalassaemia in Sardinia.


METHODS
23 couples at risk for beta-thalassaemia were included in the PGD programme with a total of 42 cycles performed. Among these, 11 couples were fertile, while the remaining 12 had associated fertility problems. In vitro Fertilization (IVF), PGD and prenatal genetic molecular confirmation protocols and results are reported.


RESULTS
All the patients followed the protocol of ovarian stimulation, oocyte retrieval, intracytoplasmic sperm injection (ICSI), embryo biopsy and genetic analysis. A total of 272 oocytes were fertilized in the regular way, and embryo biopsy was performed on 202 embryos. Out of these 202 embryos, 192 (95%) were successful. The genetic diagnosis was performed on 150 embryos (78.1%). Ninety-eight were identified as unaffected and 75 were transferred in 31 cycles. In the infertile patient group, two biochemical pregnancies (11.1% per transfer), in the fertile patient group, four clinical pregnancies, two twin and two singleton pregnancies (30.8% per transfer), were obtained. The genetic molecular results were confirmed in all pregnancies by first-trimester chorionic villus sampling (CVS).


CONCLUSIONS
Our study shows that PGD for beta-thalassaemia is an available procedure for couples who wish to avoid termination of pregnancy, except in cases where the IVF cycle efficiency is very poor.
Monni
Giovanni
G
Department of Obstetrics and Gynecology, Prenatal and Preimplantation Genetic Diagnosis, Fetal Therapy, Ospedale Microcitemico, Via Jenner s/n, 09121 Cagliari, Italy. prenatalmonni@tiscali.it
Cau
Giuseppina
G
Usai
Valeria
V
Perra
Graziella
G
Lai
Rosalba
R
Ibba
Giuseppe
G
Faà
Valeria
V
Incani
Federica
F
Rosatelli
Maria Cristina
MC
D001706:Biopsy; D015193:Chorionic Villi Sampling; D004252:DNA Mutational Analysis; D046149:Embryo Culture Techniques; D004624:Embryo Transfer; D004622:Embryo, Mammalian; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007558:Italy; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D019836:Preimplantation Diagnosis / Q000379:methods*; D020554:Sperm Injections, Intracytoplasmic; D017086:beta-Thalassemia / Q000175:diagnosis* / Q000235:genetics*