Preimplantation aneuploidy testing for infertile patients of advanced maternal age: a randomized prospective trial

Objective

To assess the potential benefit of preimplantation aneuploidy testing on the outcome of in vitro fertilization (IVF) for women of advanced maternal age (AMA).

Design

Prospective randomized clinical trial.

Setting

Private IVF clinic.

Patient(s)

Sixty-two infertile AMA couples undergoing fertility treatment.

Intervention(s)

Fluorescent in situ hybridization (FISH) for chromosomes X, Y, 13, 15, 16, 17, 18, 21, and 22.

Main Outcome Measure(s)

Preimplantation aneuploidy testing of biopsied blastomeres on day 3 of development.

Result(s)

Fertilization and blastocyst developmental rates were similar for the test and control groups: 80% versus 77.4% and 49% versus 48.2%, respectively. The average number of embryos transferred was comparable at 2.2 for the test group and 2.7 for the control group. Implantation rates were also equivalent across the two groups: 37.3% in the control group versus 36.5% in the test group. Nevertheless, the spontaneous abortion rate was observed to be lower for the test group: 25.9% versus 32.26% in the control group. This resulted in an observed increase in delivery rates for the test group: 78% versus 67.74% in the control group.

Conclusion(s)

Preimplantation aneuploidy testing does not appear to statistically significantly improve outcome parameters in infertile AMA patients; however, a trend toward a decrease in the spontaneous abortion rate with a subsequent higher delivery rate was observed.

Key Words: Preimplantation aneuploidy testing, chromosomal aneuploidy, AMA