Preimplantation genetic screening for aneuploidy of embryos after in vitro fertilization in women aged at least 35 years: a prospective randomized trial

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.

Key Words: Preimplantation genetic screening, in vitro fertilization, advanced maternal age, RCT, embryo quality