Abstract
Preimplantation Genetic Diagnosis and Screening (PGD/PGS) for monogenic diseases and/or numerical/structural chromosomal abnormalities is a tool for embryo testing aimed at identifying nonaffected and/or euploid embryos in a cohort produced during an IVF cycle. A critical aspect of this technology is the potential detrimental effect that the biopsy itself can have upon the embryo. Different embryo biopsy strategies have been proposed. Cleavage stage blastomere biopsy still represents the most commonly used method in Europe nowadays, although this approach has been shown to have a negative impact on embryo viability and implantation potential. Polar body biopsy has been proposed as an alternative to embryo biopsy especially for aneuploidy testing. However, to date no sufficiently powered study has clarified the impact of this procedure on embryo reproductive competence. Blastocyst stage biopsy represents nowadays the safest approach not to impact embryo implantation potential. For this reason, as well as for the evidences of a higher consistency of the molecular analysis when performed on trophectoderm cells, blastocyst biopsy implementation is gradually increasing worldwide. The aim of this review is to present the evidences published to date on the impact of the biopsy at different stages of preimplantation development upon human embryos reproductive potential.
Highlights
Preimplantation Genetic Diagnosis and Screening (PGD/ PGS) is a tool whose application in Assisted Reproduction Techniques (ART) has significantly grown in the last decades [1]
Preimplantation Genetic Diagnosis and Screening (PGD/PGS) for monogenic diseases and/or numerical/structural chromosomal abnormalities is a tool for embryo testing aimed at identifying nonaffected and/or euploid embryos in a cohort produced during an IVF cycle
The aim of this review is to present the evidences published to date on the impact of the biopsy at different stages of preimplantation development upon human embryos reproductive potential
Summary
Preimplantation Genetic Diagnosis and Screening (PGD/ PGS) is a tool whose application in Assisted Reproduction Techniques (ART) has significantly grown in the last decades [1]. The same data referring to years 2012-2013 [3] instead showed an impressive countertendency since the rate of PB biopsy and cleavage stage biopsy procedures decreased to approximately 2% and 75%, respectively. Blastocyst stage biopsy implementation instead is gradually increasing in ART. The reason for this dramatic change is a review and meta-analysis published by Mastenbroek and colleagues in 2011 clearly showing that PGS as it was conducted, namely, cleavage stage biopsy analyzed by 9chromosome FISH, is a harmful procedure [4]. The use of PB biopsy did not spread due to its intrinsic logistic, clinical, and technical drawbacks that compromise its accuracy, especially when compared to TE biopsy strategy
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