Preimplantation genetic screening for aneuploidy of embryos after in vitro fertilization in women aged at least 35 years: a prospective randomized trial
Presented in part at the 63rd Annual Meeting of the American Society for Reproductive Medicine, Washington, DC, October 15–17, 2007.
Received 23 May 2008; received in revised form 30 October 2008; accepted 30 October 2008. published online 26 February 2009.
Objective
To test the hypothesis that patients with advanced maternal age (AMA) have a higher implantation rate (IR) after embryo transfer of embryos with a normal chromosomal pattern for the chromosomes studied with preimplantation genetic screening (PGS) compared with patients who had an embryo transfer without PGS.
Design
Prospective randomized controlled trial (RCT).
Setting
Academic tertiary setting.
Patient(s)
Patients with AMA (≥35 years).
Intervention(s)
In an RCT, the clinical IR per embryo transferred was compared after embryo transfer on day 5 or 6 between the PGS group (analysis of chromosomes 13, 16, 18, 21, 22, X, and Y) and the Control group without PGS.
Main Outcome Measure(s)
No differences were observed between the PGS group and the Control group for the clinical IR (15.1%; 14.9%; rate ratio 1.01; exact confidence interval [CI], 0.25–5.27), the ongoing IR (at 12 weeks) (9.4%; 14.9%), and the live born rate per embryo transferred (9.4%; 14.9%; rate ratio 0.63; exact CI, 0.08–3.37). Fewer embryos were transferred in the PGS group (1.6 ± 0.6) than in the Control group (2.0 ± 0.6). A normal diploid status was observed in 30.3% of the embryos screened by PGS.
Conclusion(s)
In this RCT, the results did not confirm the hypothesis that PGS results in improved reproductive outcome in patients with AMA.
Reprint requests: Thomas M. D'Hooghe, M.D., Ph.D., Center for Human Genetics, UZ Leuven, Herestraat 49, B-3000 Leuven, Belgium (FAX: 32-16-344368).
SD. has nothing to disclose. C.M. has nothing to disclose. C.S. has nothing to disclose. K.P. has nothing to disclose. E.V. has nothing to disclose. L.M. has nothing to disclose. C.M. has nothing to disclose. J.-.P.F. has nothing to disclose. J.R.V. has nothing to disclose. T.M.D. has nothing to disclose.
Supported by a grant from the Fund for Scientific Research (FWO).
ABSTRACT