Blastomere transplantation in human embryos may be a treatment for single gene diseases☆

Abstract 

Objective

To determine whether human embryos accept blastomere transplants and integrate them normally into the architecture of the developing embryo.

Design

A human blastomere transplantation model, involving 44 cryopreserved embryos that were specifically donated to research.

Setting

Academically affiliated private infertility center.

Patient(s)

Forty-four human embryos.

Intervention(s)

In 21 experiments, one, two, or three blastomeres were transplanted, using standard microsurgical techniques that are widely used in preimplantation genetic diagnosis (PGD). Embryos were thawed and gender was determined, using established PGD techniques. Male (xy) blastomeres were then transplanted into female (xx) day 3 embryos, and the xy cells were tracked through blastocyst stage (days 5–6) and into the hatching period (day 6), using fluorescent in situ hybridization (FISH).

Main outcome measure(s)

Degree and location of xy cell integration into xx embryos.

Result(s)

High-quality recipient embryos (with 4 to 10 cells) developed uniformly into normal blastocyst stage embryos in 12 of 12 experiments (100%) and integrated donor blastomeres into their architecture, with apparently even distribution of daughter cells; this integration was documented in inner cell mass as well as in trophoectoderm. The intensity of this distribution appeared to correlate with the number of blastomeres transferred. Among nine abnormally developing embryos, only three (33%) demonstrated a normal distribution of offspring donor cells.

Conclusion(s)

High-quality embryos appear to have the ability to integrate donor blastomeres. Because the treatment of single gene diseases does not require successful treatment of all cells, blastomere transplantation could be explored as a treatment option, which also would greatly enhance efficiency and utilization of preimplantation genetic diagnosis.

Keywords:  Blastomere transplantation, preimplantation genetic diagnosis, preimplantation genetic treatment, in vitro fertilization, micromanipulation