アイジェノミクスのアジア支社（日本・台湾・中国・韓国）共催のオンラインシンポジウムを開催いたします！各国からERA検査やEMMA・ALICE検査のさまざまな実施事例をご紹介する他、台湾より、最新の非侵襲胚発生能検査「Embrace (niPGT-A)」の 実施事例もご紹介できる予定です。スペイン本社からは、ナーサー・アル・アズマー博士がゲスト参加し、POCの最新研究成果を発表致します。
第二回 Igenomix APAC シンポジウム
14:30 ～ 17:40
2:35 – 3:05 PM
Efficacy of Endometrial Receptivity Analysis (ERA)
Dr. Kyoung-yong Moon, MD
IORA Fertility Clinic (Korea)
Endometrial receptivity issues represent a potential source of implantation failure. The aim of this clinical study was to evaluate our experience with the endometrial receptivity array (ERA) among patients with a history of repetitive implantation failure.
In recent years, an efficacy of the ERA in Korea has been discussed and debated among physicians. So, we investigated whether the contribution of the endometrial factor could be identified with the ERA test and if actionable results can lead to improved outcomes such pregnancy rate increase.
Today, through a care review, we would like to discuss the efficacy of ERA.
Representative M.D. Director, IORA Fertility Clinic
Physician M.D., Maria Fertility Hospital at Seoul, Busan
Department of Obstetrics / Gynecology, College of Medicine, Seoul National University
Medical education course
School of Medicine, Seoul National University
- The Best Poster Presentation Award at the 10th Pacific Rim Society for Reproductive medicine
- The Best Oral Presentation Award at the 68th Annual Meeting of the Korean Society for Reproductive Medicine
- Nomogram to predict the number of oocytes retrieved in controlled ovarian stimulation
- Impact of presence of antiphospholipid antivbodies on in vitro fertilization
- Comparison of Histologic Results from Hysteroscopic Biopsy and Blinded Biopsy by Currettage in Women with Tamoxifen Therapy after Breast Cancer
- and many others
Q. Any PGS patients?
No, I don’t usually perform PGS (PGT-A) for RIF patients. Instead, I perform PGT-SR or PGT-A for recurrent pregnancy loss patients.
Q. What will you do next if you have a failed pregnancy after ERA and euploid embryo transferred?
ERA is the last test for RIF due to cost. I screen other conditions such as immunologic problem, thrombophilia, anatomical problem or chronic endometritis, and try to improve other problems. (Again, I don’t screen euploid embryo by PGT-A)
3:05 – 3:35 PM
ni-PGT-A, time for clinical application?
Dr. Chun-Kai Chen, MD MMSc
Hope Fertility and PGT center (Taiwan)
For the last thirty years, a variety of methods were developed to assess the chromosomal status of the embryos, initially FISH, followed by aCGH, then NGS. As to the method to get genetic material , cleavage stage biopsy was used before and nowadays blastocyst biopsy. However, the benefits of PGT-A were frequently questioned. The invasive biopsy procedure was suspected to decrease the implantation potential and the embryo mosaicism influence the reliability of PGT-A report. Both were to blame for the ineffectiveness of PGT-A on pregnancy rate.
Spent culture medium has been proposed as an alternative source of embryonic genetic material to retrieve. Different test methods for the non-invasive PGT-A (niPGT-A) were evaluated in the past few years. With continuous improvement of the procedure, the concordance rate ranged from 80-100% for the recent reports. The maternal contamination rate decreased a lot and false negative rate is improving. Accordingly, the concordance rate increasing. We introduce the test in our center recently will present the preliminary experience.
It seems the niPGT-A provides a priority of embryo selection for euploidy rather than diagnosis at the moment. Although there are still many aspects to refine, the niPGT is on its bright and promising way.
- 1980-1987; Bachelor of Medicine; National Taiwan University
- 1989-1994; Resident and Chief Resident; Department of Obstetrics and Gynecology, National Taiwan University Hospital
- 1995-1998; Visiting Staff; Department of Obstetrics and Gynecology, National Taiwan University Hospital
- 1996-1998; Clinical Lecture; Department of Obstetrics and Gynecology, National Taiwan University Hospital
- 1996-1997; Master of Medical Science degree in Assisted Reproduction Technology; Department of Obstetrics and Gynecology, University of Nottingham; UK
- 1997 April-Sept; Research Fellow; Human Genetics and Embryology group, Department of Obstetrics and Gynecology, University College London
- 1998 Aug-1999; Visiting Staff; Department of Obstetrics and Gynecology, Chang-Gung Memorial Hospital, Lin-Kou Medical Center
- 1999-2013; Lecturer; Department of Obstetrics and Gynecology, Chang-Gung Medical College & University
- 1999-2013; Assistant Professor; Department of Obstetrics and Gynecology, Chang-Gung Memorial Hospital, Lin-Kou Medical Center
- 2013 till now; Chief Director; Hope Fertility and PGT Center, Taipei
- Chen CK, Yu HT, Soong YK, Lee CL. New perspectives of pre-implantation genetic diagnosis and pre-implantation genetic screening. Taiwan J Obstet Gynecol. 2014 Jun;53(2):146-50.
- Chen CK, Yu HT, Wu D, Lin CY, Wang ML, Yeh HY, Huang HY, Wang HS, Soong YK, Lee CL. Pre-implantation genetic diagnosis for reciprocal and translocations with fluorescence in situ hybridization. Taiwan J Obstet Gynecol. 2014 Mar;53(1):48-52.
- Wang CW, Horng SG, Chen CK, Wang HS, Huang HY, Lee CL, Soong YK. Ovulation induction with tamoxifen and alternate-day gonadotrophin in patients with thin endometrium. Reprod Biomed Online 2008 Jul;17(1):20-6.
- Chen CK, Wu HM and Soong YK. Clinical application of ultrasound in infertility: from two-dimensional to three dimensional. J Med Ultrasound. 2007 15(2):126-133.
- Wang CN, Chen CK., Wang HS, Chiueh HY and Soong YK. Successful management heterotopic cesarean scar pregnancy combined with intrauterine pregnancy after in vitro fertilization-embryo transfer. Fertil Steril 2007 88(3):706-710.
- Wang TH, Chang CL, Wu HM, Chiu YM, Chen CK, Wang HS. Insulin-like growth factor-II (IGF-II), IGF-binding protein-3 (IGFBP-3), and IGFBP-4 in follicular fluid are associated with oocyte maturation and embryo development. Fertil Steril. 2006 Nov;86(5):1392-401.
- Chen CK, Wang CW, Tsai WJ, Hsieh LL, Wang HS and Soong YK. Evaluation of meiotic spindles in thawed oocytes after vitrification using polarized light microscopy. Fertil Steril 2004 82(3):666-72.
- Chen CK, Wu YC, Shen GY, Lin CY, Wang ML, Lee MW, Huang HY, Wang HS and Soong YK. Pre-implantation genetic diagnosis: preliminary report of two-year experience. Chang Gung Medical Journal 2004 27:726-33.
- Wu YC, Chen CK, Chou CJ, Huang HY and Soong YK. Successful pregnancy after preimplantation genetic diagnosis in a female carrier of Robertsonian translocation: a case report. Journal of the Formosan Medical Association 2004 103 (8):637-9.
- Liu JM, Chen CK and Chang SD. Diagnosis of chromosomal anomalies due to adjacent-1 malsegregation resulting from translocation heterzygotes. Journal of the Formosan Medical Association 2004 103 (12):952-6.
- Wang CW, Yao DS, Horng SG, Chiu HC, Chen CK, Lee CL, Huang HY, Wang HS, Soong YK, Pao CC. Feasibility of human telomerase reverse transcriptase mRNA expression in individual blastomeres as an indicator of early embryo development. J Assist Reprod Genet. 2004 May;21(5):163-8.
- Chen CK, Shen GY, Horng SG, Wang CW, Huang HY, Wang HS and Soong YK. The relationship of pronuclear stage morphology and chromosome status at cleavage stage. J Assist Reprod Genet 2003 20(10):413-20.
- Chen CK, Chang SD, Chen YJ, Hsueh DW and Soong YK. Comparative genomic hybridization-assisted prenatal diagnosis of a de novo inverted duplication of chromosome 10q. J Reprod Med 2003 48(5):391-4.
- Horng SG, Chang CL, Wu HM, Wang CW, Chen CK, Huang HY, Wang HS and Soong YK. Laser–assisted hatching of embryos in women of advanced age after in vitro fertilization: a preliminary report. Chang Gung Medical Journal 2002 25:531-7.
- Wang CW, Lai YM, Chan PR, Horng SG, Chang CL, Chen CK, Wu HM, Huang HY, Wang HS and Soong YK. Resumption of meiosis-I tissue to enucleated preovulatory oocytes: a preliminary report. J Assist Reprod Genet 2002 19(10):493-9.
- Moore GE, Ruangvutilert P, Chatzimeletiou K, Bell G, Chen CK, Johnson P, Harper JC. Examination of trisomy 13, 18 and 21 foetal tissues at different gestational ages using FISH. Eur J Hum Genet 2000 Mar;8(3):223-8.
- Ho HN, Chao KH, Chen CK, Yang YS, Huang SC. Activation status of T and NK cells in the endometrium throughout menstrual cycle and normal and abnormal early pregnancy. Human Immunology. 1996; 49:130-6.
- Chen CK, Huang SC, Chen CL, Yen MR, Hsu HC, Ho HN. Increased expression of CD69 and HLA-DR but not of CD25 or CD71 on endometrial T lymphocytes of nonpregnant women. Human Immunology. 1995; 42(3):227-32.
Q. From your slide, the modified protocol from D4 to D6 culture to D3 to D5 culture showed a low concordance level. Just a curiosity, does it mean the embryos only ‘pushes’ or gives out more their DNA material starting on D4 ? what do you think is the reason of low concordance in spent media D3 to D5?
I suspect D3 washing could not get clear of cumulus cells (DNA) as D4 washing. So that MCC happened more in D3-D5 SCM. However, we need more data and evidence to resolve the question.
Q. IRB approval?
So far, we still use PGT report as decision for ET criteria. The spent culture medium was collected under patients consent and sent to Igenomix to get the niPGT report. The report was compared with the TE biopsy.
Q. Is the results effected by the volume of the medium taken?
The medium volume acceptable for analysis is 5 to 10ul per sample. The maximum acceptable volume is 15 ul. More than 15ul could not perform the following experiments. (Answered by Grace)
Q. Do you think niPGT-A can parform in conventional IVF with washing of COC to avoid contamination?
At present, D4 washing and D4-D6 SCM collection seemed proper to achieve the acceptable concordance rate. We are still seeking whether it could be performed in D3 washing with similar concordance rate.
3:35 – 4:05 PM
Impact of ERA, EMMA/ALICE on Euploid Embryo Transfer
Dr. Shinnosuke Komiya, MD
HORAC IVF Grand Front (Japan)
In Japan, PGT-A can only be used to a limited extent. Euploid embryos can theoretically reduce the miscarriage rate, and, in fact, we have experienced pregnancies in RIF cases after PGT-A embryo transfers. But there are still cases of repeated implantation failure even after embryo selection. In this study, we retrospectively analyzed the impact of ERA and EMMA/ALICE tests on euploid embryo transfers performed in our clinic.
2010.07 – 2012.06
Hospital of National Defense Medical Collage, junior resident
2012.07 – 2014.03
104th Field Hospital Unit, Itami Garrison, Japan Ground Self Defense Force, medical officer
2014.04 – 2016.03
Kaizuka City Hospital / Rinku General Medical Center, senior resident
2016.04 – 2018.11
IVF Osaka Clinic, assistant director
2018.12 – Now
HORAC Grand Front Osaka Clinic, assistant director
2019.04 – Now
Kansai Medical University, Graduate School of Medicine, Department of Obstetrics and Gynecology, graduate student
- S. Komiya, Y. Naito, H. Okada, Y. Matsuo, K. Hirota, T. Takagi, K. Mizushima, R. Inoue, A. Abe, Y. Morimoto, Characterizing the gut microbiota in females with infertility and preliminary results of a water-soluble dietary fiber intervention study, Journal of Clinical Biochemistry and Nutrition, 2020; 67(1), DOI: 10.3164/jcbn.20-53
- Y. Matsuo, S. Komiya, Y. Yasumizu, Y. Yasuoka, K. Mizushima, T. Takagi, K. Kryukov, F. Aisaku, Y. Morimoto, Y. Naito, H. Okada, H. Bono, S. Nakagawa, K. Hirota, Full-length 16S rRNA gene amplicon analysis of human gut microbiota using MinION™ nanopore sequencing confers species-level resolution, BMC Microbiology, 2021; 21(1):35, DOI: 10.1186/s12866-021-02094-5
- S. Komiya, Y. Matsuo, S. Nakagawa, Y. Morimoto, K. Kryukov, T. Imanishi, H. Okada, K. Hirota, MinION™, a portable long-read sequencer, enables rapid vaginal microbiota analysis in a clinical setting, bioRxiv, 2021; DOI: 10.1101/2021.01.07.425663
Q. Do you have any outcome of Bifidobacterium positive patients?
Bifidobacterium is one of the most important intestinal bacteria, and although many studies have shown that it contributes to health, the associated mechanism has not been yet completely elucidated.
(DOI: 10.1002 / jsfa.6356), of course, there is no research that mentions about embryo implantation.
However, as vaginal Bifidobacterium and intestinal Bifidobacterium are almost the same cluster (DOI: 10.1371 / journal.pone.0196290), the group in which we found Bifidobacterium in the uterus and vagina is probably the same group in which we found the intestinal Bifidobacterium.
The intestinal flora affects the mind and body in various aspects such as metabolism and health, so I think that this is a mechanism that can contribute to pregnancy.
1 – Intestinal Bifidobacterium is rich (patient body general condition is very good)
2 – Bifidobacterium propagates in the vagina due to excretory behavior, etc.
3 – Bifidobacterium is detected by intrauterine bacterial flora test (including possible contamination)
So, I think it is okay to exclude it from the treatment.
However, as it is only a hypothesis, an intestinal flora test would be required to confirm it.
4:05 – 4:35 PM
Mosaic embryo transfer strategy, an update
Dr. Jason Yen-Ping Ho, MD
Taipei Fertility Center (Taiwan)
Advances in NSG-based Preimplantation Genetic Testing for Aneuploidy (PGT-A) have led to practice changes in ART; however, overwhelmed details also raised the controversy of management of chromosomal mosaicism especially when no euploid embryos are available. Chromosomal mosaicism majorly develops during mitosis of embryos after fertilization. Although there is no direct evidence to support that mosaic blastocyst has the capacity to develop normally after implantation, increasing studies have showed that transfer of putative mosaic blastocysts may result in healthy live births with marked lower ongoing pregnancy rate in comparison with the transfer of euploid blastocysts. We reviewed the latest reports on mosaic embryo transfer and try to made a strategic recommendation.
-Vice President, TAIPEI Fertility CENTER
-Director, Center for Reproductive Medicine, China Medical University Hospital, Taiwan
-Assistant Professor, Department of Obstetrics and Gynecology, China Medical University, Taiwan
-Research Fellow, Stanford University, USA
-Assistant Professor, National Yang-Ming University, Taiwan
-Resident, Taichung Veterans General Hospital, Taiwan
- Ho JY (何彥秉), Chen MJ, YiYC , Guu HF, Ho ES. (2003/09) The effect of preincubation period of oocytes on nuclear maturity, fertilization rate, embryo quality, and pregnancy outcome in IVF and ICSI. J Assist Reprod Genet 2003;20:357-363. (SCI)
- Ho JY (何彥秉), Hwang JL, Chen MJ, Guu HF, Ho ES. (2004/02) What is the LH ceiling level for follicular growth arrest in late follicular phase? Hum Reprod. 2004;19:463-464. (SCI)
- Ho JY (何彥秉), Guu HF, Yi YC, Chen MJ, Ho ES. (2005/04) The serum follicle-stimulting hormone-to-luteinizing hormone ratio at the start of stimulation with gonadotropins after pituitary down-regulation is inversely correlated with a mature oocyte yield and can predict “low responders”. Fertil Steril. 2005;83:883-888. (SCI)
- Ho JY (何彥秉), Chen MJ, Sheu WH, Yi YC, Tsai AC, Guu HF, Ho ES. (2006/10) Differential effects of oral conjugated equine estrogen and transdermal estrogen on atherosclerotic vascular disease risk markers and endothelial function in healthy postmenopausal women. Hum Reprod. 2006;21:2715-2720. (SCI)
- Yi YC, Chen MJ, Ho JY (何彥秉), Guu HF, Ho ES. (2007/10) Mitochondria transfer can enhance the murine embryo development. J Assist Reprod Genet 2007;24:455-459. (SCI)
- Tseng JJ, Ho JY (何彥秉), Chen WH, Chou MM. (2008/06) Prenatal diagnosis of isolated fetal hydrocolpos secondary to congenital imperforate hymen. J Chin Med Assoc 2008; 71:325-328. (SCI)
- Man WC, Ho JY (何彥秉), Wen Y, Sokol ER, Polan ML, Chen B. (2009/12) Is lysyl oxidase-like protein-1, alpha-1 antitrypsin, and neutrophil elastase site specific in pelvic organ prolapse? Int Urogynecol J Pelvic Floor Dysfunct. 2009 Dec;20(12):1423-9. (SCI)
- Ho JY (何彥秉), Man WC, Wen Y, Polan ML, Ho ES (何師竹), Chen B. (2010/08) Transforming growth interacting factor expression in leiomyoma compared with myometrium. Fertil Steril. 2010 Aug;94(3):1078-83. (SCI)
- Tseng JJ (曾振志), Ho JY (何彥秉), Wen MC, Hwang JI. Uterine necrosis associated with acute suppurative myometritis after angiographic selective embolization for refractory postpartum hemorrhage. Am J Obstet Gynecol. 2011 Jun;204(6):e4-6. (SCI)
- Wen Y, Ho JY (何彥秉), Polan ML, Chen B. Expression of apoptotic factors in vaginal tissues from women with urogenital prolapse. Neurourol Urodyn. 2011 Nov;30(8):1627-32. (SCI)
- Kung HF, Chen MJ, Guu HF, Chen YF, Yi YC, Ho JY (何彥秉), Min-Min Chou. Luteal phase support with decapeptyl improves pregnancy outcomes in intracytoplasmic sperm injection with higher basal follicle-stimulating hormone or lower mature oocytes. J Chin Med Assoc 2014; 77:524-530. (SCI)
- Huang PC, Chen MJ, Guu HF, Yi YC, Ho JY (何彥秉), Chen YF, Chen LY, Min-Min Chou. Effect of premature serum progesterone rise on embryo transfer outcomes and the role of blastocyst culture and transfer in assisted reproductive technology cycles with premature progesterone rise. Taiwanese J Obstet Gynecol 2015; 54:641-646. (SCI)
- Chang WC, Huang SF, Lee YM, Lai HC, Cheng BH, Cheng WC, Ho JY (何彥秉), Jeng LB, Ma WL. Cholesterol import and steroidogenesis are biosignatures for gastric cancer patient survival. Oncotarget. 2017;8:692-704. (SCI)
- Chen L, Bao BY, Chang WC, Ho JY (何彥秉), Cheng BH, Wang CL, Tang Q, Cheng WC, Chang HW, Hung YC, Ma WL. Short androgen receptor poly-glutamine-promoted endometrial cancer is associated with benzo[a]pyrene-mediated aryl hydrocarbon receptor activation. J Cell Mol Med. 2018;22:46-56. (SCI)
- Chung WM, Ho YP (何彥秉), Chang WC, Dai YC, Chen L, Hung YC, Ma WL. Increase paclitaxel sensitivity to better suppress serous epithelial ovarian cancer via ablating androgen receptor/ aryl hydrocarbon receptor-ABCG2 axis. Cancers. 2019;11:463. (SCI)
4:35 – 5:05 PM
Application of ERA combined with endometrial immune assessment in RIF patients
Dr. Yan Jia, MD
Chengdu Xinan Gynecology Hospital (China)
1. The experience of appling ERA to patients with immune dysregulation and RIF patients.
2. ERA data of Chengdu Xinan Gynecology Hospital:implantation rate，pregnancy rate and so on.
Be proficient in: infertility and IVF technology, recurrent miscarriage and recurrent embryo implantation failure，gynecology endocrine diseases. Dr. Jia has extensive experience in IVF technology and is a backbone youth physician of Chengdu Xinan Gynecology Hospital with many clinical and research achievements.
Recently, she has devoted herself to basic and clinical research of recurrent abortion and RIF. Dr. Jia has carried out touring learning and training of recurrent abortion diagnosis in many domestic IVF centers, and has attended many international reproductive immunization conferences and shared her experiences in America,Portugal,Spain,the Netherlands and so on. She conducted in-depth research on recurrent miscarriage and recurrent implantation failure.Equipped with robust professional foundation and scientific research background，she also has been the researcher for numerous projects sponsored by the National Natural Science Foundation of China and provincial Science Foundation.What’s more,she is responsible for 3 reproductive endocrinology municipal projects.She has published many articles on Core Journals and 3 of them are collected into SCI.
- 2021：Zubiao Gao,Xiaofeng Ye,Anne Bordeaux,Stanka Hettic,Siyao Lin,Fang Han,Yan Jia(Correspondence author), MiR-26b regulates cell proliferation and apoptosis of CD117+CD44+ ovarian cancer stem cells by targeting PTEN, European Journal of Histochemistry.
- 2020：Hong-xia Ye，Lan Li，Ya-jun Dong，Peng-hao Li, Qin Su, Yan-hua Guo, Yan-rong Lu, Ying Zhong，Yan Ji(Correspondence author),a，Jing-qiu Cheng，miR-146a-5p improves the decidual cytokine microenvironment by regulating the toll-like receptor signaling pathway in unexplained spontaneous abortion.International Immunopharmacology 89(2020)101066.
Q. Is oral dexamethasone comparable to intrauterine dexamethasone?
We have not compared about them, we just choose different treatment according to different situations. For the patients with endometrial local immune abnormalities, for example, the first patient has a high level of T56 cells, so we performed intrauterine perfusion of dexamethasone, but not oral. And if patients experienced a high level of basal endogenous progesterone, we will use oral dexamethasone for prevention.
Q. 1)Do you use PRPT? Platelet rich plasma treatment? Any experience with this? 2) Also do you use oral dexamethasone or just the intrauterine?
1) We have no experiences about it.
2) We will use intrauterine perfusion of dexamethasone treatment instead oral way for the patients with endometrial local immune abnormalities. And it’s time to use 0.75 mg oral dexamethasone everyday to control the patient’s endogenous progesterone for the patients with high level of basal endogenous progesterone. And this way is mainly proper for frozen-thawed embryo transfer cylce or ERA cycle.
Q. What is your protocol with intrauterine dexa infusion? Dose and timing during cycle please
We will start intrauterine perfusion of dexamethasone when the woman period ends and repeat it with a break of 1 day or 2 days, 5mg each time, until luteal transformation starts. 3-4 times in total.
5:05 – 5:35 PM
Molecular analysis of Products of Conception (POC) provides comprehensive understanding of the chromosomal causes of clinical miscarriage
Dr. Nasser Al-Asmar Piñar, PhD
Igenomix (Spain – HQ)
The incidence of spontaneous clinical abortion in the general population is 15%. Most of them (~80%) occur before the 12th week of gestation, which could be considered as a biological barrier. Aneuploidies are alterations in the number of chromosomes that can cause spontaneous abortions and chromosomal abnormalities in newborns. More than 50% of miscarriages in the first trimester, whether spontaneous or following assisted reproduction treatments (ART), are the result of chromosomal abnormalities. To analyze de POC is important to give an explanation to the patient why the pregnancy loss has occurred if it is abnormal. If it is normal, we will have to focus on another possible cause that is not chromosomal: endometrial, endocrine, immunological, thrombophilic… To provide best reproductive advice for a future cycle, whether it is trying to get pregnant naturally at home or going thru ART. Molecular techniques (NGS), combined with the use of STRs, make it possible to increase the efficiency of the analysis of chromosomal abnormalities of POCs compared to conventional cytogenetic techniques, improving the percentage of samples with informative results, and reducing the rate of false negatives caused by contamination with maternal DNA.
Nasser Al-Asmar received his Bachelor’s degree in Pharmacy, a Master’s degree in Biotechnology of Human Assisted Reproduction and his PhD in Biomedicine and Biotechnology at Valencia University, Valencia, Spain. He was Laboratory Manager at Igenomix USA (Miami, FL) from its opening in 2012 until January 2016, when he became Scientific Advisor first in the USA and now for Spain and Latam. He is a member of the permanent board of the Genetics Interest Group of ASEBIR (Association for the Study of the Biology of Reproduction) and Professor at the Master of Biology and Technology of Mammal Reproduction at the University of Murcia (UMU), Spain. Nasser Al-Asmar has over 15 years of clinical and research laboratory experience. In the clinical setting, he has extensive experience in the study of chromosomal abnormalities in embryos (PGT-A) and spermatozoa using array CGH technology, fluorescence “in situ” hybridization (FISH) and Next Generation Sequencing, analyzing Products of Conception as well. In 2019 Nasser Al-Asmar had lectures in International Conferences in several countries such as Argentina, India, Nigeria, Kuwait, Japan, Hong Kong, Spain… about all different topics in Reproductive Genetics. In 2020 he had the same experience but virtually, giving lectures in different Conferences for Austria, Ukraine, Perú, Brazil, Taiwan, India, Dubai, KSA, Spain…
- Rodrigo L, Rubio C, Peinado V, Villamón R, Al-Asmar N, Remohí J, Pellicer A, Simón C, Gil-Salom M. Testicular sperm from patients with obstructive and non-obstructive azoospermia: aneuploidy risk and reproductive prognosis using testicular sperm from fertile donors as control samples. Fertil Steril. 2011 Mar 1;95(3):1005-12. Epub 2010 Nov 11.
- Nasser Al-Asmar, Vanessa Peinado, María Vera, Jose Remohí, Antonio Pellicer, Carlos Simón Terry Hassold, and Carmen Rubio. Chromosomal abnormalities in embryos from couples with a previous aneuploid miscarriage. Fertility and Sterility Vol. 98, No. 1, July 2012 0015-0282 doi:10.1016/j.fertnstert.2012.03.035
- Carmen Rubio, Lorena Rodrigo, Pere Mir, Emilia Mateu, Vanessa Peinado, Miguel Milán, Nasser Al-Asmar, Inmaculada Campos-Galindo, Sandra Garcia, Carlos Simón. Use of array comparative genomic hybridization (array-CGH) for embryo assessment: clinical results. Fertility and Sterility. 02/2013
- Rodrigo L, Mateu E, Mercader A, Cobo AC, Peinado V, Milán M, Al-Asmar N, Campos-Galindo I, García-Herrero S, Mir P, Simón C, Rubio C. New tools for embryo selection: comprehensive chromosome screening by array comparative genomic hybridization. Biomed Res Int. 2014; 2014:517125. doi: 10.1155/2014/517125.
- Diez-Juan A, Rubio C, Marin C, Martinez S, Al-Asmar N, Riboldi M, Díaz-Gimeno P, Valbuena D, Simón C. Mitochondrial DNA content as a viability score in human euploid embryos: less is better. Fertil Steril. 2015 Sep;104(3):534-41.e1. doi: 10.1016/j.fertnstert.2015.05.022. Epub 2015 Jun 11.
- Gruhn JR, Al-Asmar N, Fasnacht R, Maylor-Hagen H, Peinado V, Rubio C, Broman KW, Hunt PA, Hassold T. Correlations between Synaptic Initiation and Meiotic Recombination: A Study of Humans and Mice. Am J Hum Genet. 2016 Jan 7;98(1):102-15. doi: 10.1016/j.ajhg.2015.11.019. Epub 2015 Dec 31.
- Vera-Rodríguez M, Michel CE, Mercader A, Bladon AJ, Rodrigo L, Kokocinski F, Mateu E, Al-Asmar N, Blesa D, Simón C, Rubio C. Distribution patterns of segmental aneuploidies in human blastocysts identified by next-generation sequencing. Fertil Steril. 2016 Apr;105(4):1047-1055.e2. doi: 10.1016/j.fertnstert.2015.12.022. Epub 2016 Jan 8.
- Carrasquillo RJ, Kohn TP, Cinnioglu C, Rubio C, Simon C, Ramasamy R, Al-Asmar N. Advanced paternal age does not affect embryo aneuploidy following blastocyst biopsy in egg donor cycles. J Assist Reprod Genet. 2019 Aug 5. doi: 10.1007/s10815-019-01549-z. [Epub ahead of print] PMID: 31385121.
- Dviri M, Madjunkova S, Koziarz A, Madjunkov M, Mashiach J, Nekolaichuk E, Trivodaliev K, Al-Asmar N, Moskovtsev SI, Librach C. Is there an association between paternal age and aneuploidy? Evidence from young donor oocyte-derived embryos: a systematic review and individual patient data meta-analysis. Fertil Steril. 2016 Apr;105(4):1047-1055.e2. doi: 10.1016/j.fertnstert.2015.12.022. Epub 2016 Jan 8. PMID: 26776911.
Q. Dear Dr. Asmar, Have you experienced with POCs from patient transferred euploid blastocyst but still miscarriage?
Yes. The percentage of miscarriages after transferred a euploid blastocyst is less than 10%. In the vast majority of the cases the result of the POC is concordant with the embryo that we transferred (euploid XX or XY). So we have to look for other causes, such us Chronic endometritis, anatomical factor, thrombophilias, immunological factor… . Also, a limitation of the NGS for PGT-A is that you might missed a polyploidy on the embryo, so this could lead into a miscarriage. In my personal experience, I had once a euploid embryo transferred analyzed by aCGH (this happened 5-6 years ago) and the result of the POC, that was analyzed by NGS, was mosaic with trisomy at the chromosome 10.
Q. Do you have information in POCs from ART population?
Yes. See paper attached. As a summary, it was observed that from the around 50% of chromosomal abnormalities in the first trimester miscarriages, 42.6% of miscarriages are due to aneuploides after natural conception and up to 63% of the miscarriages happens because chromosomal abnormalities after ART. Also, in the ART couples with a regular IVF with own oocytes, the chromosomal abnormalities was higher in couples with severe oligozoospermic males (<5 mill/mL) than in couples in which the male has more than 5 mill/mL of spermatozoa (72.7% vs 53.6% respectively).
Andy Chang, PhD, MBA
Igenomix Regional Senior Director, APAC