Do patients who undergo Preimplantation Genetic Diagnosis have higher pregnancy rates and should fewer embryos be transferred?

Abstract

ObjectiveThe purpose of this study is to evaluate the pregnancy rate of patients who undergo PGD (Preimplantation Genetic Diagnosis) and to compare it to patients who have IVF (In Vitro Fertilization) without PGD.DesignRetrospective.Materials and methods912 patients that had IVF with or without PGD from 1/4/03 to 3/31/04 at our clinic were included in the study. Of these, 296 patients had PGD and 616 women had IVF without PGD. These patients had ovarian stimulation with gonadotropins and most received either GnRH agonists or antagonists as part of their stimulation protocol. Ovulation was induced with HCG when at least two follicles were mature, and oocyte retrieval was performed 36 hours after HCG. In the women that desired PGD, PGD was performed 3 days after retrieval and embryo transfer was performed day 3–6. Pregnancy rates were then determined by HCG level and were compared among the 2 groups. Statistical analysis was performed using the Fisher’s exact test.ResultsThe patient characteristics are seen in table 1. The average age for the 296 PGD patients was 38.76 and the average age for the 616 non PGD patients was 38.56. Of these, 52 patients in the PGD group had no embryos transferred, usually secondary to the fact that all embryos were diagnosed as abnormal. Among the IVF patients, 110 had no embryo transferred due to multiple reasons such as desire for cryopreservation, poor embryos or risk for ovarian hyperstimulation syndrome. When comparing the pregnancy rate in the patients that had embryo transfers, the pregnancy rate among the PGD and non-PGD patients did not vary significantly (45.08% vs. 38.54% respectively). Table 1 Patient CharacteristicsTable 2 Pregnancy rates in Embryo Transfer GroupsConclusionView Large Image Figure ViewerDownload Hi-res image Download (PPT) ObjectiveThe purpose of this study is to evaluate the pregnancy rate of patients who undergo PGD (Preimplantation Genetic Diagnosis) and to compare it to patients who have IVF (In Vitro Fertilization) without PGD. The purpose of this study is to evaluate the pregnancy rate of patients who undergo PGD (Preimplantation Genetic Diagnosis) and to compare it to patients who have IVF (In Vitro Fertilization) without PGD. DesignRetrospective. Retrospective. Materials and methods912 patients that had IVF with or without PGD from 1/4/03 to 3/31/04 at our clinic were included in the study. Of these, 296 patients had PGD and 616 women had IVF without PGD. These patients had ovarian stimulation with gonadotropins and most received either GnRH agonists or antagonists as part of their stimulation protocol. Ovulation was induced with HCG when at least two follicles were mature, and oocyte retrieval was performed 36 hours after HCG. In the women that desired PGD, PGD was performed 3 days after retrieval and embryo transfer was performed day 3–6. Pregnancy rates were then determined by HCG level and were compared among the 2 groups. Statistical analysis was performed using the Fisher’s exact test. 912 patients that had IVF with or without PGD from 1/4/03 to 3/31/04 at our clinic were included in the study. Of these, 296 patients had PGD and 616 women had IVF without PGD. These patients had ovarian stimulation with gonadotropins and most received either GnRH agonists or antagonists as part of their stimulation protocol. Ovulation was induced with HCG when at least two follicles were mature, and oocyte retrieval was performed 36 hours after HCG. In the women that desired PGD, PGD was performed 3 days after retrieval and embryo transfer was performed day 3–6. Pregnancy rates were then determined by HCG level and were compared among the 2 groups. Statistical analysis was performed using the Fisher’s exact test. ResultsThe patient characteristics are seen in table 1. The average age for the 296 PGD patients was 38.76 and the average age for the 616 non PGD patients was 38.56. Of these, 52 patients in the PGD group had no embryos transferred, usually secondary to the fact that all embryos were diagnosed as abnormal. Among the IVF patients, 110 had no embryo transferred due to multiple reasons such as desire for cryopreservation, poor embryos or risk for ovarian hyperstimulation syndrome. When comparing the pregnancy rate in the patients that had embryo transfers, the pregnancy rate among the PGD and non-PGD patients did not vary significantly (45.08% vs. 38.54% respectively). Table 1 Patient CharacteristicsTable 2 Pregnancy rates in Embryo Transfer Groups The patient characteristics are seen in table 1. The average age for the 296 PGD patients was 38.76 and the average age for the 616 non PGD patients was 38.56. Of these, 52 patients in the PGD group had no embryos transferred, usually secondary to the fact that all embryos were diagnosed as abnormal. Among the IVF patients, 110 had no embryo transferred due to multiple reasons such as desire for cryopreservation, poor embryos or risk for ovarian hyperstimulation syndrome. When comparing the pregnancy rate in the patients that had embryo transfers, the pregnancy rate among the PGD and non-PGD patients did not vary significantly (45.08% vs. 38.54% respectively). Table 1 Patient Characteristics Table 2 Pregnancy rates in Embryo Transfer Groups Conclusion