Use Of Preimplantation Genetic Screening Research Articles

Originating ovarian follicle size is not correlated with PREGNANCY FOLLOWING transferred single thawed blastocysts regardless of the use of pre-implantation genetic screening

The effect of ovarian follicle size on oocyte maturity is a recurrent topic in the literature, while studies of the effect of follicle size on embryo implantation have been much less common. Only four prior studies have attempted to correlate the size of the ovarian follicle from which the oocyte originated with the subsequent embryo’s transfer outcome, and the findings of those studies have been mixed. No prior study included thawed embryos to preclude potential interaction effects between large follicles and endometrial receptivity, nor has any prior study included any pre-implantation genetic testing (PGT) in order to consider potential effects of aneuploidy.

Recent advances in in vitro fertilization.

The field of assisted reproductive technology is rapidly progressing with many new advances in the last decade. The present review discusses methods to improve oocyte quality in older women and new stimulation protocols that may improve the number of mature oocytes retrieved during an in vitro fertilization cycle. We will discuss the present use of pre-implantation genetic screening (PGS) and finally focus on some new methods to determine endometrial receptivity. The focus of this review is to point out areas of technology that may be controversial or are new enough to require proper controlled studies for validation.

Differences in outcome when PGS is performed for family balancing compared with recurrent miscarriage

The use of preimplantation genetic screening (PGS) in IVF is rising, especially amongst patients requesting gender specific embryos, or “family balancing”. One study in 2012 investigated this population and found that the use of PGS in IVF increased implantation rates (1). To our knowledge, however, no study thus far has directly compared outcomes between patients undergoing PGS for family balancing with those with other diagnoses.

Is knowledge power? does use of preimplantation genetic screening in autologous in vitro fertilization cycles change disposition time to donor egg?

Is knowledge power? does use of preimplantation genetic screening in autologous in vitro fertilization cycles change disposition time to donor egg?

Use of preimplantation genetic screening in donor oocyte cycles results in a greater than seven-fold lower multiple gestation rate without compromising pregnancy rate

Use of preimplantation genetic screening in donor oocyte cycles results in a greater than seven-fold lower multiple gestation rate without compromising pregnancy rate

Selection against Disability: Abortion, ART, and Access.

This essay re-examines the disability critique of prenatal and pre-implantation screening in light of evidence about the larger context in which fertility and reproductive healthcare is rendered in the U.S. It argues that efforts to identify acceptable criteria for trait-based selection or otherwise impose reasons-based limitations on reproductive choice should be avoided because such limitations tend to perpetuate the discrimination encountered by adults with disabilities seeking fertility and reproductive health services.

Comparative Genomic Hybridization Selection of Blastocysts for Repeated Implantation Failure Treatment: A Pilot Study

The aim of this study is to determine if the use of preimplantation genetic screening (PGS) by array comparative genomic hybridization (array CGH) and transfer of a single euploid blastocyst in patients with repeated implantation failure (RIF) can improve clinical results. Three patient groups are compared: 43 couples with RIF for whom embryos were selected by array CGH (group RIF-PGS), 33 couples with the same history for whom array CGH was not performed (group RIF NO PGS), and 45 good prognosis infertile couples with array CGH selected embryos (group NO RIF PGS). A single euploid blastocyst was transferred in groups RIF-PGS and NO RIF PGS. Array CGH was not performed in group RIF NO PGS in which 1-2 blastocysts were transferred. One monoembryonic sac with heartbeat was found in 28 patients of group RIF PGS and 31 patients of group NO RIF PGS showing similar clinical pregnancy and implantation rates (68.3% and 70.5%, resp.). In contrast, an embryonic sac with heartbeat was only detected in 7 (21.2%) patients of group RIF NO PGS. In conclusion, PGS by array CGH with single euploid blastocyst transfer appears to be a successful strategy for patients with multiple failed IVF attempts.

Epigenetic Regulation in Reproductive Medicine and Gynecologic Cancers

Epigenetic Regulation in Reproductive Medicine and Gynecologic Cancers

RETIRED: Preimplantation Genetic Testing

To review the techniques and indications of preimplantation genetic testing, including preimplantation genetic diagnosis and screening. Limited to an introductory discussion about the genetic aspects of preimplantation reproductive techniques. This update does not discuss in detail the adverse outcomes that have been recorded in association with assisted reproductive technologies. The Cochrane Library and Medline were searched for articles relating to preimplantation testing that were published from 1990 to February 2008, using the following terms: preimplantation genetic diagnosis, preimplantation genetic screening, and in vitro fertilization. Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. Additional publications were identified from the bibliographies of these articles. Randomized controlled trials were considered evidence of the highest quality, followed by cohort studies. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and from national and international medical specialty societies. This update is a consensus of the Genetics Committee of the Society of Obstetricians and Gynaecologists of Canada. The recommendations were made according to guidelines developed by the Canadian Task Force on Preventive Health Care. This update educates readers about new genetic concepts, directions, and technology. The major harms and costs identified are those of assisted reproductive technologies. The Society of Obstetricians and Gynaecologists of Canada. Preimplantation genetic diagnosis is an alternative to prenatal diagnosis for the detection of genetic disorders in couples at risk of transmitting a genetic condition to their offspring. Preimplantation genetic screening has been proposed to improve the effectiveness of in vitro fertilization in women of advanced maternal age or in couples with recurrent miscarriage or implantation failure, but the benefits of this approach are debated. The recommendations were made according to guidelines developed by the Canadian Task Force on Preventive Health Care. 1. Before preimplantation genetic diagnosis is performed, genetic counselling must be provided to ensure that patients fully understand the risk of having an affected child, the impact of the disease on an affected child, and the benefits and limitations of all available options for preimplantation and prenatal diagnosis. (III-A) 2. Couples should be informed that preimplantation genetic diagnosis can reduce the risk of conceiving a child with a genetic abnormality carried by one or both parents if that abnormality can be identified with tests performed on a single cell. (II-2B) 3. Invasive prenatal testing to confirm the results of preimplantation genetic diagnosis is encouraged because the methods used for preimplantation genetic diagnosis have technical limitations that include the possibility of a false negative result. (II-2B) 4. Before preimplantation genetic screening is performed, thorough education and counselling must be provided to ensure that patients fully understand the limitations of the technique, the risk of error, and the lack of evidence that preimplantation genetic screening improves live-birth rates. (III-A) 5. Available evidence does not support the use of preimplantation genetic screening as currently performed to improve live-birth rates in patients with advanced maternal age, recurrent implantation failure, or recurrent pregnancy loss. (I-D).

IVF/ICSI with or without preimplantation genetic screening for aneuploidy in couples without genetic disorders: a systematic review and meta-analysis

To assess the efficacy of preimplantation genetic screening to increase ongoing pregnancy rates in couples without known genetic disorders. Systematic review and meta-analysis of randomized controlled trials. Two reviewers independently determined study eligibility and extracted data. Ten randomized trials (1,512 women) were included. The quality of evidence was moderate. Meta-analyses using a random-effects model suggest that PGS has a lower rate of ongoing pregnancies (risk ratio=0.73, 95% confidence interval 0.62-0.87) and a lower rate of live births (risk ratio=0.76, 95% confidence interval 0.64-0.91) than standard in vitro fertilization/intracytoplasmic sperm injection. In women with poor prognosis or in general in vitro fertilization program, in vitro fertilization/intracytoplasmic sperm injection with preimplantation genetic screening for aneuploidy does not increase but instead was associated with lower rates of ongoing pregnancies and live births. The use of preimplantation genetic screening in daily practice does not appear to be justified.

Preimplantation genetic screening in a case of recurrent trisomy 21 offspring

To describe a unique case of recurrent aneuploidy and the use of preimplantation genetic screening (PGS). Case report. Midwest academic medical center. A 36-year-old woman with two trisomy 21 offspring. Preimplantation genetic screening. Karyotype of embryos, liveborn eukaryotic infant. Preimplantation genetic screening was performed on three cryopreserved embryos, followed by a two-embryo transfer yielding a eukaryotic infant. Preimplantation genetic screening may prove to be useful as a diagnostic tool to help ensure a euploid pregnancy when termination is not a viable option for a couple.

A prospective randomized controlled trial of preimplantation genetic screening in the “good prognosis” patient

To determine whether the routine use of preimplantation genetic screening (PGS) in "good prognosis" women improves in vitro fertilization (IVF) cycle outcome. Randomized, controlled, prospective clinical study. Private infertility clinic. Infertile women predicted to have a good prognosis as defined by: age <39 years, normal ovarian reserve, body mass index <30 kg/m(2), presence of ejaculated sperm, normal uterus, <or=2 previous failed IVF cycles. Patients were randomized to the PGS group or the control group on day 3 after oocyte retrieval; 23 women underwent blastomere biopsy on day 3 after fertilization (PGS group), and 24 women underwent routine IVF (control group). All embryos were transferred on day 5 or 6 after fertilization. Pregnancy, implantation, multiple gestation, and live birth rates. No statistically significant differences were found between the PGS and control groups with respect to clinical pregnancy rate (52.4% versus 72.7%). However, the embryo implantation rate was statistically significantly lower for the PGS group (31.7% versus 62.3%) as were the live birth rate (28.6% versus 68.2%) and the multiple birth rate (9.1% versus 46.7%). In a "good prognosis" population of women, PGS does not appear to improve pregnancy, implantation, or live birth rates.

Comprehensive aneuploidy screening of oocytes: scientific data and clinical application

OBJECTIVE: Most meiotic chromosome errors occur during oogenesis and their frequency increases markedly with advancing age. Embryos derived from aneuploid oocytes may arrest during development, not implant, or spontaneously abort. For this reason some fertility clinics have advocated the use of preimplantation genetic screening (PGS) to identify and transfer euploid embryos. Routine PGS strategies involve blastomere examination via fluorescent in situ hybridization (FISH). However, this approach only permits a limited cytogenetic analysis.

Preimplantation genetic screening: a survey of in vitro fertilization clinics

PurposeThe purpose of this study was to determine which US in vitro fertilization clinics provide preimplantation genetic screening for aneuploidy in treating infertility, and to explore clinic directors' attitudes toward this technique. MethodsOnline survey included 415 US assisted reproductive technology clinics. The survey had a valid response rate of 45% or 186 clinics. ResultsNearly 68% of US in vitro fertilization clinics responding to the survey provided preimplantation genetic screening in an effort to increase success rates of fertility treatment. More than half of these in vitro fertilization clinics (56%) provided preimplantation genetic screening for advanced maternal age and the same percentage provided preimplantation genetic screening to treat repeated in vitro fertilization failure, whereas 66% provided preimplantation genetic screening to treat women with repeated miscarriage. Opinions of the effectiveness of preimplantation genetic screening for these indications varied widely, even among those providing it. Most directors (85%) of clinics providing preimplantation genetic screening believed that more data are needed to determine whether and to whom it should be offered. ConclusionsDespite the lack of data supporting the use of preimplantation genetic screening for recurrent pregnancy loss, in vitro fertilization failure, and advanced maternal age, a majority of in vitro fertilization clinics in the United States offer preimplantation genetic screening for these purposes. There is significant support among clinic directors for more research into the effectiveness of preimplantation genetic screening and for professional guidelines in this area.

The role of aneuploidy in repeated implantation failure: implications for patient counseling and preimplantation genetic screening

OBJECTIVE: It has been suggested that the use of preimplantation genetic screening (PGS) to assist in the identification and preferential transfer of chromosomally normal embryos, may lead to improved IVF outcomes for certain groups of patients. Current PGS strategies, employ FISH analysis of 9-12 chromosomes, and have been shown to increase implantation and pregnancy rates for women of advanced age and women with recurrent spontaneous abortion. However, patients with repeated implantation failure (RIF) have been harder to target. We employed comparative genomic hybridization (CGH) clinically, to examine the entire chromosome complement of oocytes and embryos derived from RIF couples. DESIGN: Investigation of all chromosomes in zygotes and blastocysts using CGH. MATERIALS AND METHODS: First and second polar bodies (PBs) were biopsied from 194 zygotes from 27 women (average age: 40 years) and analyzed by CGH. Additionally, 79 blastocysts from 13 women (average age: 37 years) were also biopsied and examined. All patients had a history of failed IVF attempts (mean 3.9 failed cycles). Zygotes and blastocysts were cryopreserved while CGH analysis took place. Normal embryos were transferred in subsequent cycles. RESULTS: The oocyte and blastocyst aneuploidy rates were 68% and 43% respectively. 27% of aneuploid zygotes were classified as highly abnormal (3 or more chromosome errors), versus 16% of blastocysts. PGS using FISH would have failed to detect 42% of oocyte and 38% of blastocyst aneuploidies. Thus far, 12 women have had an embryo transfer (ET) after PB CGH, leading to one ongoing pregnancy. 6 women have had an ET after blastocyst analysis, resulting in 4 ongoing pregnancies. Further ET's are underway. CONCLUSIONS: Comprehensive screening of oocytes and blastocysts revealed that errors may affect any chromosome in material from RIF patients, including unusual types of abnormality not seen during later gestational stages. Screening of oocytes from RIF patients seems to have little if any impact on pregnancy rates, although such analyses may reveal prognostic information (some patients had multiple abnormalities affecting all oocytes and are unlikely to be able to conceive using their own gametes). Unlike oocyte screening, blastocyst analysis was associated with high pregnancy rates. Hence, the application of comprehensive chromosome screening is likely to assist a subset of RIF patients (those capable of producing blastocysts) in achieving pregnancies.

In Vitro Fertilization with Preimplantation Genetic Screening

Pregnancy rates in women of advanced maternal age undergoing in vitro fertilization (IVF) are disappointingly low. It has been suggested that the use of preimplantation genetic screening of cleavage-stage embryos for aneuploidies may improve the effectiveness of IVF in these women. We conducted a multicenter, randomized, double-blind, controlled trial comparing three cycles of IVF with and without preimplantation genetic screening in women 35 through 41 years of age. The primary outcome measure was ongoing pregnancy at 12 weeks of gestation. The secondary outcome measures were biochemical pregnancy, clinical pregnancy, miscarriage, and live birth. Four hundred eight women (206 assigned to preimplantation genetic screening and 202 assigned to the control group) underwent 836 cycles of IVF (434 cycles with and 402 cycles without preimplantation genetic screening). The ongoing-pregnancy rate was significantly lower in the women assigned to preimplantation genetic screening (52 of 206 women [25%]) than in those not assigned to preimplantation genetic screening (74 of 202 women [37%]; rate ratio, 0.69; 95% confidence interval [CI], 0.51 to 0.93). The women assigned to preimplantation genetic screening also had a significantly lower live-birth rate (49 of 206 women [24%] vs. 71 of 202 women [35%]; rate ratio, 0.68; 95% CI, 0.50 to 0.92). Preimplantation genetic screening did not increase but instead significantly reduced the rates of ongoing pregnancies and live births after IVF in women of advanced maternal age. (Current Controlled Trials number, ISRCTN76355836 [controlled-trials.com].).