Analysis of PGT‐M and PGT‐SR outcomes at a Canadian fertility clinic

Butler, Rachel; Nakhuda, Gary S.; Guimond, Colleen; Chen, Jing; Lee, Nora; Hitkari, Jason; Tallon, Niamh; Taylor, Beth; Yuzpe, A. Albert

doi:10.1002/pd.5496

Cited by 18 publications

(5 citation statements)

References 6 publications

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“…The lowest number of embryos suitable for transfer (16%) and associated outcome (clinical pregnancy rate of 32% per transfer or 16 % per started cycle) are observed in our subset of cycles with HLA matching (De Rycke et al 2020). Our results are in line with those of a Canadian PGT centre reporting ongoing pregnancies rates of 49% for PGT-M and 43% for PGT-SR (Butler et al 2019). It is obviously difficult to compare clinical outcomes between individual centres because of varying factors such as maternal age, indication type or differences in genetic testing and IVF procedures.…”

Section: Clinical Outcomesupporting

confidence: 86%

PREIMPLANTATION GENETIC TESTING: Clinical experience of preimplantation genetic testing

et al. 2020

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Thirty years of rapid technological advances in the field of genetic testing and assisted reproduction have reshaped the procedure of preimplantation genetic testing (PGT). The development of whole genome amplification and genome-wide testing tools together with the implementation of optimal hormonal stimulation protocols and more efficient cryopreservation methods have led to more accurate diagnoses and improved clinical outcomes. In addition, the shift towards embryo biopsy at day 5/6 has changed the timeline of a typical PGT clinical procedure. The Brussels' PGT centre started more than 25 years ago, offering PGT within a healthcare system funded by the government. In this paper, we have summarized our experience with PGT, presenting an up-to-date overview of the different steps in PGT from patient referral to baby follow-up.

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Section: Clinical Outcomesupporting

confidence: 86%

PREIMPLANTATION GENETIC TESTING: Clinical experience of preimplantation genetic testing

et al. 2020

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“…26 MB and above can be recognized reliably. 27 With this method, the time to have a healthy baby is shorter and it provides great benefits to both the family and the society.…”

Section: Resultsmentioning

confidence: 99%

The Role of Chromosome Analysis in Patients with Recurrent Pregnancy Loss

Balta¹,

Erdoğan²,

Kiraz³

et al. 2020

Ahi Evran Medical Journal

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İki ya da daha fazla klinik olarak tanımlanmış gebeliğin kaybına tekrarlayan gebelik kaybı (TGK) denir. TGK nedenleri arasında kromozom anomalileri; endokrinolojik hastalıklar; otoimmun problemler; uterin anomaliler, trombofilik faktörler yer alır. Bu çalışmada Orta Anadolu'da TGK yaşamış çiftlerin kromozom analizi sonuçları ve bunların TGK ile ilişkisini tartışmayı amaçladık.Araçlar ve Yöntem: İki ve üzerinde düşük yapmış 721 kadın ve 699 eşi erkek toplam 1420 kişi çalışmaya dahil edildi. Kromozom analizi periferal kan lenfositleri kullanılarak standart sitogenetik Giemsa-Tripsin-Giemsa bantlama tekniği kullanılarak yapıldı. Hastaların tüm kromozomları sayısal ve yapısal kromozom anomalileri açısından incelendi.Bulgular: 698 kişide 46,XX, 680 kişide 46,XY olmak üzere toplam 1378 kişide normal kromozom kuruluşu tespit edildi (%97). En sık olarak 4 hastada 46,XX,9qh+(%0.28) ve 3 hastada 46,XY,9qh+(%0.21) olmak üzere toplam 15 hastada normal kromozom varyantları tespit edildi. Bunun yanında 12 hastada dengeli resiprokal translokasyon (%0.8), 4 hastada 45,XX,rob(13;14)(q10;q10) ve 2 hastada 45,XY,rob(13;14)(q10;q10) olmak üzere 6 hastada ise robertsoniyan translokasyon tespit edildi (%0.4).Sonuç: Bu çalışmada TGK' nın ebeveynlerin kromozom analizinden kaynaklanan en önemli sebebi kromozomal translokasyonlardı 18 (%1.2). TGK yaşayan bireylerin yaklaşık %2'sinde resiprokal ya da robertsoniyan translokasyonlar, inversiyonlar, cinsiyet kromozom anomalileri gibi sayısal ve yapısal kromozom anomalileri görülmektedir. Bu hastaların sağlıklı bebek sahibi olmaları için preimplantasyon genetik tanı testleri üreme tıbbı ile uğraşan kadın doğum uzmanı, tıbbı genetik uzmanları ve klinik embriyologlar tarafından hastalara önerilmelidir.

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“…Different small studies have investigated the outcome of PGT-M and have shown a CLBR ranging from 28.6% to 48.9% (Butler et al, 2019;Zanetti et al, 2019). The latest ESHRE consortium mentioned a CLBR of 24% for PGT-M (Coonen et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Parameters of poor prognosis in preimplantation genetic testing for monogenic disorders

et al. 2021

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STUDY QUESTION What is the likelihood of success of a single cycle of preimplantation genetic testing for monogenic disorders (PGT-M), measured as the cumulative live birth rate (CLBR) and based on various patient demographics? SUMMARY ANSWER For all women aged ≤40 years, the CLBR was at least 10% when the number of oocytes was ≥7 (range 10–30%) or was at least 5% when the number of oocytes was ≥3 (range 5–17%). WHAT IS KNOWN ALREADY The number of oocytes is significantly associated with the number of embryos for genetic testing and the clinical outcome in PGT-M. Embryos diagnosed as affected or embryos that remain without diagnosis cannot be used for embryo transfer. The size of the group of embryos non-suitable for transfer varies between 25% and 81%, depending on the indication. Thus, PGT-M is more likely to be more severely impacted by suboptimal ovarian response, poor fertilization and suboptimal embryo development than conventional IVF/ICSI schemes without PGT. STUDY DESIGN, SIZE, DURATION This was a single-centre retrospective comparative cohort study, of cycles between January 2011 and December 2015. A total number of 2265 PGT-M cycles were compared to 2833 conventional ICSI cycles. The principal aim of our study was the identification of the parameters of poor CLBR in couples undergoing PGT-M using multiplex short tandem repeat (STR) markers on blastomere biopsy DNA. The secondary aim was to compare the parameters of poor CLBR of the PGT-M population to those of couples undergoing ICSI without PGT. PARTICIPANTS/MATERIALS, SETTING, METHODS The baseline characteristics of the PGT-M group were compared to the conventional ICSI group. A multiple regression analysis was applied to account for the following potential confounding factors: female age, number of previous ART cycles, number of oocytes/suitable embryos for transfer and dosage of gonadotrophins used for ovarian stimulation. MAIN RESULTS AND THE ROLE OF CHANCE The PGT-M group was younger (female age 32.0 vs 34.5 years), had a higher number of previous ART cycles (1.1 vs 0.9 cycles) and used more gonadotrophins (2367 vs 1984 IU). Per cycle, the PGT-M group had more retrieved oocytes (11.8 vs 8.3 oocytes), fewer suitable embryos for transfer (1.7 vs 2.8 embryos) and a lower CLBR (29.4% vs 35.0%). Multiple regression analysis showed that the CLBR in the PGT-M group was significantly influenced by female age, the number of previous ART cycles, the number of oocytes and the dose of ovarian stimulation. In both groups, the predicted CLBR increased with increasing numbers of oocytes and suitable embryos. At least two retrieved oocytes or one embryo per single PGT-M cycle could confer an estimated CLBR above 10%. By assessing female age and the number of retrieved oocytes together, it was shown that for all women aged ≤40 years, the predicted CLBR per single PGT-M cycle was ≥10% when the number of oocytes was ≥7 or was ≥5% when the number of oocytes was ≥3. LIMITATIONS, REASONS FOR CAUTION Despite the large sample size, the findings are confined by limited confounder adjustment and the lack of specific PGT-M comparators. WIDER IMPLICATIONS OF THE FINDINGS This study aimed to describe the likelihood of success of PGT-M treatment, measured as CLBR, based on various patient demographics. In a PGT-M program, couples need to be informed of the prognosis more specifically when it is futile. The table of predicted CLBRs presented in this study is a useful tool in counselling PGT-M couples for making reproductive choices. STUDY FUNDING/COMPETING INTEREST(S) No funding was required and there are no competing interests. TRIAL REGISTRATION NUMBER N/A.

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Analysis of PGT‐M and PGT‐SR outcomes at a Canadian fertility clinic

Cited by 18 publications

References 6 publications

PREIMPLANTATION GENETIC TESTING: Clinical experience of preimplantation genetic testing

PREIMPLANTATION GENETIC TESTING: Clinical experience of preimplantation genetic testing

The Role of Chromosome Analysis in Patients with Recurrent Pregnancy Loss

Parameters of poor prognosis in preimplantation genetic testing for monogenic disorders

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