“…Advantages of FISH methods include the following: (1) FISH is in use in most clinical cytogenetic laboratories, (2) commercial FISH probes are available for common microdeletion=duplication syndromes, (3) FISH may identify mosaicism, which other methods have limited ability to resolve, and (4) FISH can provide information about chromosomal location and help clarify the mechanism for a deletion or duplication as long as the region is large enough for detection with FISH probes and metaphase chromosomes are available. Limitations of FISH methods include (1) limited availability of ready-to-use labeled FISH probes for genomic imbalances that are rare or private (Koolen et al, 2008), (2) the expense and challenge of setup and training of personnel to make and process home-brew FISH probes, (3) the expense of custom-designed FISH probes from commercial companies, (4) Bacterial artificial chromosome (BAC) clones purchased from public sources that are not specific or are annotated incorrectly (Perry et al, 2006;Redon et al, 2006), and (5) FISH probes, usually 100-150 kb, that are too large for the detection of small microdeletions or microduplications, for example, tandem duplications (Lee et al, 2007).…”