What to expect from an in vitro fertilization/ preimplantation genetic diagnosis and gender selection program for family balancing?

Abstract

Objective: We report our experience of 351 intracytoplasmic sperm injection (ICSI) cycles with preimplantation genetic diagnosis (PGD) and gender selection for family balancing. Design: A cohort study. Setting: Istishari Fertility Center, Amman, Jordan. Patient(s): Fertile couples undergoing 351 ICSI/PGD cycles for family balancing. Intervention(s): Controlled ovarian hyperstimulation, oocyte collection, and ICSI followed by embryo biopsy and fluorescence in situ hybridization (FISH) with X/Y probes on day-3 embryos. Main Outcomes and Measure(s): FISH results, pregnancy rate (PR) and clinical PR per cycle started and per embryo transfer (ET), and implantation rate. Results: Of the 351 cycles started, 343 (97.7%) proceeded to egg collection and 317 (90.3%) to PGD. Per cycle reaching PGD, the average number of day-3 embryos suitable for biopsy was 5.3, and the chance of finding embryos of the selected gender (whether male or female) was 77.8%. The average number of embryos transferred was 1.8. The PR per cycle started and PR per ET were 39.9% and 50.2%, and the corresponding clinical PR was 37.6% and 47.3%. The implantation rate was 26%. Conclusions: Couples requesting PGD for family balancing should be counseled that one in ten cycles will not reach the stage of PGD and eight out of ten will have embryos of the selected gender. The PR is 40% per started cycle.