Intent to treat analysis of preimplantation genetic screening (PGS) and in vitro fertilization (IVF) versus expectant management (EM) in patients with recurrent pregnancy loss (RPL)

Murugappan, Gayathree; Shahine, Lora K.; Perfetto, C.O.; Hickok, Lee R.; Lathi, Ruth B.

doi:10.1016/j.fertnstert.2014.07.323

Cited by 14 publications

(20 citation statements)

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“…Indeed, several RCTs showed that PGT‐A improved the live birth rate and reduced miscarriage in a limited number of infertile patients with a favorable prognosis . However, in one study, PGT‐A did not improve the live birth rate or reduce the miscarriage rate in RPL patients . Semi‐structured telephone interviews conducted in the USA showed that all patients who were offered PGT‐A expressed the need to become parents .…”

Section: Discussionmentioning

confidence: 99%

Attitudes toward preimplantation genetic testing for aneuploidy among patients with recurrent pregnancy loss in Japan

Takeda

Sugiura‐Ogasawara

Ebara

et al. 2020

J of Obstet and Gynaecol

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Aim To examine attitudes toward preimplantation genetic testing for aneuploidy (PGT‐A) in patients with recurrent pregnancy loss (RPL) because it has been performed worldwide in spite of little evidence regarding whether it can improve the live birth rate and prevent miscarriage. There has been no study to examine attitudes toward PGT‐A in patients with RPL. Methods We conducted a cross‐sectional study that used a questionnaire to examine attitudes toward PGT‐A, the desire for PGT‐A and the factors associated with this desire in 386 patients with RPL between November 2014 and January 2019. Results Overall, 25.1% of patients desired PGT‐A and 35.2% answered that they knew about it. Regarding the reasons for wanting PGT‐A, 42.3% thought that it would insure a live birth and with complete case analysis, showed that the patients' wish for PGT‐A as a means of giving live birth was affected by their IVF‐ET history (adjusted odds ratio 2.7, 95% CI 1.2–7.2) and whether they had any knowledge of PGT‐A (2.4, 1.1–5.3). Those with a higher total family income (3.5, 1.2–10.1) and a previous IVF‐ET (4.6, 2.0–10.3) tended to want PGT‐A as a means of avoiding miscarriage. Conclusion The majority had no opinion or a poor knowledge of PGT‐A. More patients who self‐assessed as knowing about PGT‐A or who had undergone IVF‐ET had the above type of misunderstanding. Accurate and up‐to‐date information from facilities different from those in which PGT‐A is performed is necessary before reaching a decision on PGT‐A.

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Section: Discussionmentioning

confidence: 99%

Attitudes toward preimplantation genetic testing for aneuploidy among patients with recurrent pregnancy loss in Japan

Takeda

Sugiura‐Ogasawara

Ebara

et al. 2020

J of Obstet and Gynaecol

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“…The clinical pregnancy, live-birth, and clinical miscarriage rates did not statistically significantly differ between the outcomes published in the Hodes-Wertz study (P¼ .89, P¼ .66, P¼ .61, respectively). We reported that 62% of IVF cycles had at least one surplus embryo (12).…”

Section: Figurementioning

confidence: 94%

“…Of these seven miscarriages, 57% (n ¼ 4) occurred after detection of fetal cardiac activity (10). Information on the percentage of cycles with surplus embryos was not provided in the Hodes-Wertz study, so we drew from their database of 240 RPL patients with 118 attempts at IVF and PGS (12). The clinical pregnancy, live-birth, and clinical miscarriage rates did not statistically significantly differ between the outcomes published in the Hodes-Wertz study (P¼ .89, P¼ .66, P¼ .61, respectively).…”

Section: Figurementioning

confidence: 99%

Cost-effectiveness analysis of preimplantation genetic screening and in vitro fertilization versus expectant management in patients with unexplained recurrent pregnancy loss

Murugappan

Ohno

Lathi

2015

Fertility and Sterility

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“…However, at present there are a lack of randomised controlled trials (RCTs) investigating whether PGT for aneuploidy screening (PGT‐A) is superior to expectant management in RM patients. Recent retrospective data suggest that PGT‐A does not increase live birth rates or shorten times to pregnancy in this population . The recently published ESTEEM trial (ESHRE Study into the Evaluation of oocyte Euploidy by Microarray analysis) that evaluated polar body PGT‐A for advanced maternal age excluded RM patients but found a reduction in miscarriage rates in the PGT‐A arm .…”

Section: Female Age and Embryonic Aneuploidymentioning

confidence: 99%

Modern management of recurrent miscarriage

Homer

2018

Aust NZ J Obst Gynaeco

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Recurrent miscarriage (RM), also known as recurrent pregnancy loss, is a distressing condition affecting around 1% of couples trying to conceive It can be very frustrating for both clinicians and patients as, despite intensive workup, no clear underlying pathology is forthcoming in at least 50% of couples. This leads to despair for patients and leaves clinicians at a loss for how to help. Desperation in both camps can promote the uptake of investigations and interventions of unproven benefit. The pathophysiology underpinning RM is incredibly diverse, involving areas such as haematology, endocrinology, immunology and genetics. During the seven to eight years since the UK Royal College of Obstetricians andGynaecologists published guidelines on this topic in 2011, new evidence and guidance from expert authorities have emerged. Here, these important advances in this challenging field of clinical practice will be reviewed. K E Y W O R D Santiphopholipid syndrome, chromosomal translocation, progesterone, recurrent miscarriage, uterine septum

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Intent to treat analysis of preimplantation genetic screening (PGS) and in vitro fertilization (IVF) versus expectant management (EM) in patients with recurrent pregnancy loss (RPL)

Cited by 14 publications

References 0 publications

Attitudes toward preimplantation genetic testing for aneuploidy among patients with recurrent pregnancy loss in Japan

Attitudes toward preimplantation genetic testing for aneuploidy among patients with recurrent pregnancy loss in Japan

Cost-effectiveness analysis of preimplantation genetic screening and in vitro fertilization versus expectant management in patients with unexplained recurrent pregnancy loss

Modern management of recurrent miscarriage

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