Effects of maternal age on euploidy rates in a large cohort of embryos analyzed with 24-chromosome single-nucleotide polymorphism–based preimplantation genetic screening

Demko, Zachary; Simon, Alexander L.; McCoy, Rajiv C.; Petrov, Dmitri A.; Rabinowitz, Matthew

doi:10.1016/j.fertnstert.2016.01.025

Cited by 147 publications

(106 citation statements)

References 37 publications

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“…Notably, all 4 of the degenerated blastocysts were aneuploid. These results are consistent with the known linear relationship between advanced maternal age and aneuploidy of embryos [5,12].…”

Section: Discussionsupporting

confidence: 92%

“…While the linear relationship between aneuploidy and maternal age is not novel, the universal use of PGS in women in their late thirties is controversial. PGS has limitations that thwart its applicability to all IVF protocols including: infrequent misdiagnosis resulting from mosaicism, sampling of limited cells, financial constraints, and lack of standard laboratory protocols for PGS [12,13]. However, PGS can shorten time to live births, minimize multiple gestations, and decrease miscarriage rates through the reduction of embryo aneuploidy [12,14,15].…”

Section: Discussionmentioning

confidence: 99%

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Utility of Preimplantation Genetic Screening in Women of Advanced Maternal Age with Poor Embryo Survival: A Case Report

Stephens¹,

Kanter²,

Gavrilova-Jordan³

2018

Gynecol Reprod Health

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A crucial component of In-Vitro Fertilization (IVF) success is selection of excellent quality embryos for uterine transfer. The ability to correlate excellent quality embryos with successful implantation is diminished in women of advanced maternal age (AMA). In recent years, controversy has surrounded the universal use of preimplantation genetic screening (PGS) in women undergoing IVF. A 39-year-old Caucasian nulligravida with age related infertility underwent an unsuccessful fresh IVF cycle that was followed by the unusually poor survival of morphologically good quality frozen blastocysts. Subsequently, she underwent a second IVF cycle with PGS of fresh blastocysts as well as blastocysts from the first IVF cycle. A successful transfer of euploid embryos resulted in a live birth. This case, although not conclusive, delineates the additional benefit of using PGS in women of advanced maternal age with poor survival of morphologically good quality embryos.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Utility of Preimplantation Genetic Screening in Women of Advanced Maternal Age with Poor Embryo Survival: A Case Report

Stephens¹,

Kanter²,

Gavrilova-Jordan³

2018

Gynecol Reprod Health

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“…However, when FEB is achieved, the pregnancy rates were similar, irrespective of maternal age (Shapiro et al, 2002). This finding can be explained by the higher proportion of euploidy found in FEB compared with cleavage stage embryos (Demko et al, 2016). Another potential explanation for this finding is the narrow maternal age (40-43 years) that was included in this study.…”

Section: Discussionmentioning

confidence: 69%

Cumulative live birth rate following elective single blastocyst transfer compared with double blastocyst transfer in women aged 40 years and over

Tannus

Cohen

Son

et al. 2017

Reproductive BioMedicine Online

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This retrospective cohort study aimed to identify predictive factors for live birth following blastocyst transfer in women aged 40-43, and to compare the cumulative live birth rate (LBR) following elective single blastocyst (eSBT) and double blastocyst (DBT) transfer. The study included 411 women who had fresh blastocyst transfers on day 5. In stepwise logistic regression, independent predictive factors for live birth were: transferring fully expanded blastocysts (Gardner stage ≥3) (odds ratio [OR] 3.5, 95% confidence interval [CI] 1.59-9.71) and transferring two blastocysts compared with a single blastocyst (OR 1.7, 95% CI 1.08-2.9). Maternal age was not found to be significant (OR 0.78, 95% CI 0.62-1.1). When comparing eSBT (n = 150) with DBT (n = 151), the DBT group achieved higher LBRs (26.5 versus 19.3%, P = 0.017) and higher multiple births (0 versus 17.5%, P = 0.02). However, the cumulative LBR was similar (28.0 versus 31.1%), with significantly lower multiple births in the eSBT group (0 versus 14.9%, P = 0.03). These results indicate that in women aged 40-43, when fully expanded blastocysts are achieved, maternal age is not a predictor for live birth, and eSBT can be performed without compromising cumulative LBRs.

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“…This complicates embryo selection approaches based on PGS. The decision whether to transfer a mosaic blastocyst is particularly relevant when no euploid embryo is available for transfer, as is the case for many patients of advanced maternal age [95]. These questions will only grow as more sensitive screening methods are implemented and more cases of potentially viable low-level mosaicism are detected.…”

Section: Discussionmentioning

confidence: 99%

Mosaicism in Preimplantation Human Embryos: When Chromosomal Abnormalities Are the Norm

2017

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Along with errors in meiosis, mitotic errors during post-zygotic cell division contribute to pervasive aneuploidy in human embryos. Relatively little is known, however, about the genesis of these errors or their fitness consequences. Rapid technological advances are helping close this gap, revealing diverse molecular mechanisms contributing to mitotic error. These include altered cell cycle checkpoints, aberrations of the centrosome, and failed chromatid cohesion, mirroring findings from cancer biology. Recent studies are challenging the idea that mitotic error is abnormal, emphasizing that the fitness impacts of mosaicism depend on its scope and severity. In light of these findings, technical and philosophical limitations of various screening approaches are discussed, along with avenues for future research.

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Effects of maternal age on euploidy rates in a large cohort of embryos analyzed with 24-chromosome single-nucleotide polymorphism–based preimplantation genetic screening

Abstract: Our results confirm the known inverse relationship between advanced maternal age (>35 years) and embryo euploidy, demonstrating that equal numbers of euploid embryos are available at day 3 and day 5.

Cited by 147 publications

References 37 publications

Utility of Preimplantation Genetic Screening in Women of Advanced Maternal Age with Poor Embryo Survival: A Case Report

Utility of Preimplantation Genetic Screening in Women of Advanced Maternal Age with Poor Embryo Survival: A Case Report

Cumulative live birth rate following elective single blastocyst transfer compared with double blastocyst transfer in women aged 40 years and over

Mosaicism in Preimplantation Human Embryos: When Chromosomal Abnormalities Are the Norm

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