Preimplantation genetic diagnosis significantly reduces pregnancy loss in infertile couples: a multicenter study

Munné, Santiago; Fischer, J.; Warner, A.; Chen, Serena; Zouves, Christo; Cohen, Jacques

doi:10.1016/j.fertnstert.2005.10.014

Cited by 140 publications

(90 citation statements)

References 36 publications

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“…Chromosomal aberrations in embryos contribute not only to spontaneous abortions, but also recurrent failed implantation among women with unexplained infertility, regardless of maternal age [1,2]. Aneuploidy is the leading cause of spontaneous abortions and mental retardation among women of advancing age [3,4]. What remains unclear is the recurrence of aneuploidy with repeated attempts and the predictive value of subsequent reproductive outcome.…”

Section: Introductionmentioning

confidence: 99%

Predictive value of preimplantation genetic diagnosis for aneuploidy screening in repeated IVF-ET cycles among women with recurrent implantation failure

Pagidas

Ying

Keefe

2008

J Assist Reprod Genet

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Objective To determine the predictive value of euploid embryos in women with recurrent implantation failure undergoing repeated IVF-ET cycles with PGD (PGD). Design Cohort of IVF-PGD cycles in a tertiary care ART facility. Materials and method(s) Fifty-five consecutive patients with repeated implantation failure (more than three failed IVF-ET cycles) underwent two or more PGD cycles for aneuploidy testing. Mean maternal age was 37.6±5.3 years. Biopsies were performed on day 3. One blastomere was removed from each pre-embryo, fixed and analyzed by multicolor and multi-probe FISH for chromosomes X and Y, 13, 15, 16, 17, 18, 21, and 22. Result(s) Forty-three of 55 patients (78%) undergoing PGD had at least one euploid embryo for transfer. Of these 31 patients (72%) also had at least one euploid embryo available for transfer with the second cycle. Of the 12 (28%) patients with no euploid embryos available for transfer with the second IVF/PGD cycle, five had a third cycle of PGD and two of these had euploid embryos available for transfer. Seventeen of the 31 patients (55%) who had euploid embryos on the second PGD cycle conceived. The ongoing pregnancy and implantation rates in patients with at least one euploid embryo were 40% and 18%, respectively. Twelve of the 55 patients (22%) had no euploid embryos available for transfer on the first PGD cycle, but on the second PGD cycle, six (50%) of these had euploid embryos for transfer. Only two pregnancies were achieved among this group of women, yielding a pregnancy rate of 17%, but both conceptions resulted in miscarriage. Of the six patients with no euploid embryos available after the second PGD cycle, four patients had a third IVF/PGD cycle, but none had euploid embryos available for transfer. Also, among women with euploid embryos available only in either the first or second PGD cycle, but not both, no ongoing pregnancy was achieved. No woman who had a PGD cycle productive of no euploid embryos had an ongoing pregnancy. Significant differences were found in terms of ongoing pregnancy (40%, P<0.05) and implantation rates (18%, P<0.05) in women with euploid embryos available for transfer with the first and second IVF/PGD cycles, compared to women with no euploid embryos available for transfer with either the first or second cycle. The positive predictive value of the first euploid cycle predicting a second euploid cycle was 72%, 95% CI 0.66-0.78. The negative predictive value of an aneuploid cycle was 50%, 95% CI 0.27-0.72. The sensitivity and specificity of the first PGD cycle predicting the second was 84%, 95% CI 0.77-0.91 and 33%, 95% CI 0.18-0.48, respectively. Conclusion(s) Even with a history of recurrent implantation failure, the availability of euploid embryos, especially on two, consecutive PGD cycles is associated with high ongoing pregnancy and implantation rates. Conversely, the absence of euploid embryos for transfer predicts poor reproductive outcome, even if subsequent cycles do yield euploid embryos.

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Section: Introductionmentioning

confidence: 99%

Predictive value of preimplantation genetic diagnosis for aneuploidy screening in repeated IVF-ET cycles among women with recurrent implantation failure

Pagidas

Ying

Keefe

2008

J Assist Reprod Genet

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“…This is how preimplantation genetic screening (PGS) started, and today, we have evolved from the early FISH years to the use of array CGH and next-generation sequencing (NGS). The commonest indications for PGS in IVF include the following: patients of advanced maternal age (AMA), repeated implantation failure (RIF), recurrent pregnancy loss (RPL), and, to a lesser extent, patients with partners with male factor infertility [45,46] and egg donors [47]. From a technical point of view, genetic screening has evolved from biopsies of the oocyte's first and second polar bodies [48,49] to biopsies of cleavage-stage embryos.…”

Section: Freeze-all-why?mentioning

confidence: 99%

The state of “freeze-for-all” in human ARTs

Basile

Garcia-Velasco

2016

J Assist Reprod Genet

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The recent development of vitrification technologies and the good outcomes obtained in assisted reproduction technologies have supported new indications for freezing and segmentation of treatment. Beyond OHSS prevention and avoidance of embryo transfers in the setting of an adverse endocrinological profile or endometrial cavity, we have witnessed a trend to shift fresh embryo transfers to frozen embryo transfers in many programs. We critically review the available evidence and suggest that freeze-all is not Bfor all,b ut should be individualized.

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“…There is a large amount of evidence to indicate that PGS improves implantation and reduces miscarriage ( [53][54][55][56][57]. However, these studies were retrospective and non-randomised.…”

Section: Controversies Over Pgsmentioning

confidence: 99%

Errors in Chromosome Segregation During Oogenesis and Early Embryogenesis

Hultén

Smith

Delhanty

2010

Reproductive Endocrinology and Infertility

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Errors in chromosome segregation occurring during human oogenesis and early embryogenesis are very common. Meiotic chromosome development during oogenesis is subdivided into three distinct phases. The crucial events including meiotic chromosome pairing and recombination takes place from around 11 weeks until birth. Oogenesis is then arrested until ovulation, when the first meiotic division takes place with the second meiotic division not completed until after fertilization. It is generally accepted that most aneuploid fetal conditions, such as for example trisomy 21 Down syndrome, is due to maternal chromosome segregation errors. The underlying reasons are not yet fully understood. It is also clear that superimposed on the maternal meiotic chromosome segregation errors there is a large amount of mitotic errors taking place post-zygotically during the first few cell divisions in the embryo. In this chapter we summarize current knowledge of errors in chromosome segregation during oogenesis and early embryogenesis, with special reference to the clinical implications for successful assisted reproduction.

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Preimplantation genetic diagnosis significantly reduces pregnancy loss in infertile couples: a multicenter study

Cited by 140 publications

References 36 publications

Predictive value of preimplantation genetic diagnosis for aneuploidy screening in repeated IVF-ET cycles among women with recurrent implantation failure

Predictive value of preimplantation genetic diagnosis for aneuploidy screening in repeated IVF-ET cycles among women with recurrent implantation failure

The state of “freeze-for-all” in human ARTs

Errors in Chromosome Segregation During Oogenesis and Early Embryogenesis

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