A multicenter, prospective, blinded, nonselection study evaluating the predictive value of an aneuploid diagnosis using a targeted next-generation sequencing–based preimplantation genetic testing for aneuploidy assay and impact of biopsy

Tiegs, Ashley W.; Tao, Xin; Zhan, Yiping; Whitehead, Christine V.; Kim, Julia; Hanson, Brent M.; Osman, Emily K.; Kim, Thomas J.; Patounakis, George; Gutmann, Jacqueline N.; Castelbaum, Arthur J.; Seli, Emre; Jalas, Chaim; Scott, Richard T.

doi:10.1016/j.fertnstert.2020.07.052

Cited by 161 publications

(97 citation statements)

References 22 publications

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“…21,22 To date, only two 'nonselection' studies to investigate the clinical predictive value of PGT-A have been published. 2,23 This involves performing PGT-A without using the information to select embryos for transfer, followed by unblinding PGT-A results once actual clinical outcomes have been determined. Similar studies involving the transfer of embryos classified as mosaic or segmental aneuploid are currently underway.…”

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confidence: 99%

Preimplantation genetic testing for aneuploidy: A review of published blastocyst reanalysis concordance data

Marín

Treff

2020

Prenatal Diagnosis

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Preimplantation genetic testing for aneuploidy (PGT-A) reduces miscarriage risk, increases the success of IVF, shortens time to pregnancy, and reduces multiple gestation rates without compromising outcomes. The progression of PGT-A has included common application of next-generation sequencing (NGS) from single nucleotide polymorphism microarray, quantitative real-time PCR, and array comparative hybridization platforms of analysis. Additional putative advances in PGT-A capability include classifying embryos as mosaic and predicting the presence of segmental imbalance. A critical component in the process of technical validation of these advancements involves evaluation of concordance between reanalysis results and initial testing results. While many independent studies have investigated the concordance of results obtained from the remaining embryo with the original PGT-A diagnosis, compilation and systematic analysis of published data has not been performed. Here, we review results from 26 primary research articles describing concordance in 1271 human blastocysts from 2260 pairwise comparisons. Results illustrate significantly higher discordance from PGT-A methods which utilize NGS and include prediction of mosaicism or segmental imbalance. These results suggest caution when considering new iterations PGT-A.

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confidence: 99%

Preimplantation genetic testing for aneuploidy: A review of published blastocyst reanalysis concordance data

Marín

Treff

2020

Prenatal Diagnosis

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“…The mean age of the treated patients in this cohort (35.8 years) may contribute to high miscarriage rate in the present cohort (29.7%), together with ovarian insufficiency [34], which was diagnosed in many infertile patients in this cohort (table 1). Two prospective randomised clinical trials have demonstrated that preimplantation genetic testing of the chromosome complement (PGT-A) of the trophectoderm of blastocyst embryos has the potential to identify embryos with a higher implantation potential and to avoid miscarriages caused by aneuploidy [35,36]. These findings, however, have not been confirmed by all [37].…”

Section: Original Articlementioning

confidence: 99%

Single embryo transfer in all infertile couples treated with assisted reproduction produces excellent results and avoids multiple births

Geyter¹

2021

Swiss Med Wkly

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Assisted reproductive technology (ART) is an efficacious and frequently used treatment of infertility. Multiple births resulting from the widespread practice of transfer of more than one embryo per treatment trial have reached epidemic proportions. Since the revision of the Swiss law on ART in September 2017, up to 12 embryos per couple may now be developed in vitro and cryopreserved in Switzerland. This potentially allows for the selection and transfer of only one embryo to avoid multiple birth with ART. We decided to offer transfer of one embryo to all infertile patients undergoing ART in our institution. In this retrospective cohort study the cumulative pregnancy and live-birth rates after universal transfer of one embryo from January 2018 to December 2019 were analysed. The cumulative pregnancy rate per oocyte collection and up to five transfer cycles was as high as 48.9%, whereas the cumulative live-birth rate reached 33.4% and none were multiple births. These results were age-dependent, with best outcome in patients aged 37 years or younger. When still remaining cryopreserved embryos were taken into account, the cumulative birth-rates could exceed 60% per oocyte collection in all age groups. The consequent adoption of a single embryo transfer significantly reduced the incidence of multiple births in the department of obstetrics and the number of prematurely born infants resulting from multiple pregnancies in the department of neonatology. Universal elective single embryo transfer is feasible in Switzerland, benefits infertile couples treated with ART and reduces the number of multiple births in obstetrics and of newborn children hospitalised into neonatal care.

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“…Although it remains an ongoing discussion, mounting evidence suggests identification of a euploid embryo for transfer significantly increases implantation, clinical pregnancy and live birth rates for patients with a range of indications, including advanced maternal age and recurrent miscarriage, as well as good-prognosis patients using single-embryo transfer (Rubio et al, 2019). Preimplantation genetic testing for aneuploidy (PGT-A) using blastocyst biopsy and next-generation sequencing (NGS) has now clearly been shown to have high predictive potential for forecasting failure to deliver for preimplantation embryos diagnosed with aneuploidy (Tiegs et al, 2020). Removal of a single blastomere for PGT-A at the cleavage-stage may decrease the conceptus' implantation potential (Scott et al, 2013;Mastenbroek and Repping, 2014); however, the implications of blastocyst biopsy are far less substantial (Cimadomo et al, 2016;Tiegs et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

“…Preimplantation genetic testing for aneuploidy (PGT-A) using blastocyst biopsy and next-generation sequencing (NGS) has now clearly been shown to have high predictive potential for forecasting failure to deliver for preimplantation embryos diagnosed with aneuploidy (Tiegs et al, 2020). Removal of a single blastomere for PGT-A at the cleavage-stage may decrease the conceptus' implantation potential (Scott et al, 2013;Mastenbroek and Repping, 2014); however, the implications of blastocyst biopsy are far less substantial (Cimadomo et al, 2016;Tiegs et al, 2020). Regardless, this assessment may still be confounded by the prevalence of genetic mosaicism leading to false euploid diagnoses (Baart et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Extracellular vesicles, microRNA and the preimplantation embryo: non-invasive clues of embryo well-being

Hawke

Watson

Betts

2021

Reproductive BioMedicine Online

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• Extracellular vesicles and microRNA comprise the blastocyst secretome • Vesicles are elevated for blastocysts with diminished developmental competence • Vesicles may be rapidly detected by nanoparticle tracking analysis and flow cytometry • Ailing blastocysts release greater variety and amounts of microRNA • Studies have yet to show clear correlation between microRNA and embryo competence RBMO VOLUME 00 ISSUE 0 2020

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A multicenter, prospective, blinded, nonselection study evaluating the predictive value of an aneuploid diagnosis using a targeted next-generation sequencing–based preimplantation genetic testing for aneuploidy assay and impact of biopsy

Cited by 161 publications

References 22 publications

Preimplantation genetic testing for aneuploidy: A review of published blastocyst reanalysis concordance data

Preimplantation genetic testing for aneuploidy: A review of published blastocyst reanalysis concordance data

Single embryo transfer in all infertile couples treated with assisted reproduction produces excellent results and avoids multiple births

Extracellular vesicles, microRNA and the preimplantation embryo: non-invasive clues of embryo well-being

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