Positive outcome after preimplantation diagnosis of aneuploidy in human embryos *

TLDR

Chromosomal abnormalities cause embryo wastage, lowering implantation rates and raising miscarriage risk in older women. The study aimed to compare IVF outcomes between a control group and a test group that underwent embryo biopsy and PGD for aneuploidy. In a multi‑centre, matched retrospective design, only embryos classified as chromosomally normal by PGD were transferred, with patient groups matched for age, IVF history, stimulation duration, estradiol levels, and follicle count. PGD did not change fetal heart beat rates per embryo transferred but significantly reduced spontaneous abortions and increased ongoing pregnancies and live births.

Abstract

Chromosomal abnormalities are responsible for a great deal of embryo wastage, which is reflected, at least partially, in decreased implantation and increased miscarriage in older women. To address this problem the transfer of only chromosomally normal embryos previously selected by preimplantation genetic diagnosis (PGD) has been proposed. We designed a multi-centre in-vitro fertilization (IVF) study to compare controls and a test group that underwent embryo biopsy and PGD for aneuploidy. Patients were matched retrospectively, but blindly, for average maternal age, number of previous IVF cycles, duration of stimulation, oestradiol concentrations on day +1, and average mature follicles. All these parameters were similar in test and control groups. Only embryos classified as normal for those chromosomes were transferred after PGD. The results showed that the rates of fetal heart beat (FHB)/embryo transferred between the control and test groups were similar. However, spontaneous abortions, measured as FHB aborted/FHB detected, decreased after PGD (P < 0.05), and ongoing pregnancies and delivered babies increased (P < 0.05) in the PGD group of patients. Two conclusions were obtained: (i) PGD of aneuploidy reduced embryo loss after implantation; (ii) implantation rates were not significantly improved, but the proportion of ongoing and delivered babies was increased.