Secondary analyses in our trial found implantation rates of 11.7% in the preimplantation-genetic-screening group and 14.7% in the control group. The transfer of embryos that did not undergo biopsy or embryos without a FISH result (for which the implantation rate was 6.0%) contributed to a lower overall implantation rate associated with preimplantation genetic screening in our trial. Nonetheless, our policy of transferring such undetermined embryos, if no embryos with normal FISH results were available, led to additional ongoing pregnancies. The implantation rate in cycles in which two embryos with normal FISH results were transferred (16.8%) was similar to the rates previously reported with preimplantation genetic screening.
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Preimplantation Genetic Diagnosis International Society
The use of preimplantation genetic screening is increasingly common, in particular among women of advanced maternal age. It has even been suggested that preimplantation genetic screening will become a standard procedure for women undergoing IVF. Evidence supporting the use of preimplantation genetic screening, however, is limited. Observational studies comparing IVF with and without preimplantation genetic screening have shown that the use of preimplantation genetic screening is associated with higher implantation rates for transferred embryos but not with an increase in the rate of ongoing pregnancies per initiated cycle or per follicular aspiration. A recent Cochrane review of preimplantation genetic screening included only two trials (one available only in abstract form), and it reported no significant difference in ongoing-pregnancy rates between women undergoing IVF with and those undergoing IVF without preimplantation genetic screening. We conducted a multicenter, randomized, double-blind, controlled trial comparing ongoing-pregnancy rates after IVF with and without preimplantation genetic screening in women of advanced maternal age.
Preimplantation genetic diagnosis (DGP) | Barcelona IVF
Seventy-seven of the 206 women assigned to preimplantation genetic screening and 71 of the 202 control women did not complete three cycles of IVF nor did they achieve ongoing pregnancy within the study period. The reasons for not completing three cycles were similar between groups and were primarily due to poor ovarian response or the burden of treatment ().
Preimplantation Genetic Diagnosis (PGD)
Between May 2003 and November 2005, a total of 408 women were randomly assigned to undergo IVF with (206 women) or without (202 women) preimplantation genetic screening. One hundred ninety-five women in the preimplantation-genetic-screening group and 184 in the control group underwent the assigned intervention in all their cycles (); the primary reason for failure to consistently undergo the assigned intervention was withdrawal of consent, in most cases because of unwillingness to accept the blinding. These women were informed of their treatment assignment and received standard IVF with embryo transfer on day 3 of their remaining cycle or cycles. In the few cases in which preimplantation genetic screening could not be performed because of logistic problems or failure of the laser equipment, the women were not informed of their treatment assignment and were treated according to protocol in their remaining cycles.
Preimplantation Genetic Diagnosis Eugin Fertility Clinic
In the preimplantation-genetic-screening group, one woman underwent elective termination of a pregnancy that was spontaneously conceived after prenatal diagnosis showed a trisomy 18. There was one intrauterine death (due to abruptio placentae) and one premature delivery of twins at 24 weeks of gestation, resulting in the postpartum death of both children. In the control group, two women underwent elective termination of pregnancy because of prenatally detected fetal conditions, trisomy 18 in one case and a cleft lip and palate in the other. There was one intrauterine death of a fetus, which was delivered at 24 weeks of gestation.