Preimplantation genetic screening for all 24 chromosomes by microarray comparative genomic hybridization significantly increases implantation rates and clinical pregnancy rates in patients undergoing in vitro fertilization with poor prognosis

Abstract

CONTEXT:A majority of human embryos produced in vitro are aneuploid, especially in couples undergoing in vitro fertilization (IVF) with poor prognosis. Preimplantation genetic screening (PGS) for all 24 chromosomes has the potential to select the most euploid embryos for transfer in such cases.AIM:To study the efficacy of PGS for all 24 chromosomes by microarray comparative genomic hybridization (array CGH) in Indian couples undergoing IVF cycles with poor prognosis.SETTINGS AND DESIGN:A retrospective, case–control study was undertaken in an institution-based tertiary care IVF center to compare the clinical outcomes of twenty patients, who underwent 21 PGS cycles with poor prognosis, with 128 non-PGS patients in the control group, with the same inclusion criterion as for the PGS group.MATERIALS AND METHODS:Single cells were obtained by laser-assisted embryo biopsy from day 3 embryos and subsequently analyzed by array CGH for all 24 chromosomes. Once the array CGH results were available on the morning of day 5, only chromosomally normal embryos that had progressed to blastocyst stage were transferred.RESULTS:The implantation rate and clinical pregnancy rate (PR) per transfer were found to be significantly higher in the PGS group than in the control group (63.2% vs. 26.2%, P = 0.001 and 73.3% vs. 36.7%, P = 0.006, respectively), while the multiple PRs sharply declined from 31.9% to 9.1% in the PGS group.CONCLUSIONS:In this pilot study, we have shown that PGS by array CGH can improve the clinical outcome in patients undergoing IVF with poor prognosis.

Comparison of neonatal outcomes of very low birth weight infants by mode of conception: in vitro fertilization versus natural pregnancy

“…During the process of IVF, morphological evaluations of embryos and preimplantation genetic screening are conducted for best embryo selection. Recently, as more precise and less invasive genetic screening methods have been developed (23,24), pregnancy outcomes have improved (24,25). The introduction of more-advanced genetic screening to IVF clinics may have contributed to a comparable or even lower incidence of congenital anomalies in VLBW infants born after IVF in our study.…”

Erratum: Relationship between morphology, euploidy and implantation potential of cleavage and blastocyst stage embryos

“…Controlled ovarian stimulation, oocyte retrieval and intracytoplasmic sperm injection (ICSI) were performed as previously reported. [ 25 ] Fertilization was checked at 16–18 h post ICSI. Embryo culture was undertaken in sequential culture media (Vitrolife, Sweden) to blastocyst stage, wherein 2pn embryos were cultured in groups of up to 6–8 embryos in 0.7 ml of G1P under oil (Vitrolife, Sweden) from day 1 to day 3 and G2P under oil (Vitrolife, Sweden) from day 3 to day 5.…”

“…[ 8 9 10 11 12 ] Contrastingly, the advent of PGS in the form of comprehensive chromosomal screening (CCS) for all 24 chromosomes using newly validated platforms[ 13 14 15 16 17 18 ] is proving to be a promising approach for improving clinical outcomes in IVF, as evidenced by recent studies that showed that biopsy at the cleavage stage or the blastocyst stage followed by CCS resulted in improved embryo selection as compared to traditional morphology-based selection alone. [ 19 20 21 22 23 24 25 ] Furthermore, the combination of trophectoderm (TE) biopsy followed by blastocyst vitrification and CCS has not only resulted in an improvement in clinical outcomes, but is also allowing infertile women, even of advanced maternal age (AMA),[ 24 ] to adopt single-embryo transfers (SETs) as a viable option without lowering success rates.…”

High concordance between next generation sequencing and single-nucleotide polymorphism array in preimplantation genetic testing for aneuploid

“…Preimplantation genetic testing for aneuploid (PGT-A) and preimplantation genetic testing for chromosomal structural rearrangement (PGT-SR) were widely used to screen embryos' genetic condition prior to transfer for advanced maternal age couples, recurrent implantation failure, recurrent miscarriage patients and chromosome structure abnormality carrier patients [12]. It has been found that transfer of PGT-screened normal blastocysts could signi cantly increase implantation and reduce pregnancy loss [13][14][15]. Hence, these techniques were widely used in chromosomal and genetic disease diagnosis.…”