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Table 1 PGDIS Recommendations for PGS laboratories [15]

From: A single trophectoderm biopsy at blastocyst stage is mathematically unable to determine embryo ploidy accurately enough for clinical use

1. For reliable detection of mosaicism, ideally 5 cells should be biopsied, with as little cell damage as possible. If the biopsy is facilitated using a laser, the identified contact points should be minimal and preferably at cell junctions. Overly aggressive use of the laser may result in cell damage and partial destruction of cellular DNA.

2. Only a validated Next Generation Sequencing (NGS) platform that can quantitatively measure copy numbers should be used for measurement of mosaicism in the biopsy sample. Ideally, a NGS methodology that can accurately and reproducibly measure 20% mosaicism in a known sample.

3. For reporting embryo results, the suggested cut-off point for definition of mosaicism is >20%, so lower levels should be treated as normal (euploid), > 80% abnormal (aneuploid), and the remaining ones between 20 and 80% mosaic (euploid-aneuploid mosaics).