Preimplantation genetic diagnosis (PGD) results with respect to number of mii oocyte

Unal, S.; Yelke, H.; Altin, G.; Candan, Zafer Nihat; Kumtepe, Yakup; Kahraman, Semra

doi:10.1016/j.fertnstert.2009.07.1451

Cited by 3 publications

(3 citation statements)

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“…However, several studies from leading centers in the United States 88 and Europe 80,89,90 could not demonstrate a significant association between COH and aneuploidy rates. They retrospectively analyzed a combined sum of >14,000 oocytes/embryos and failed to find any significant effect of the type of medication used (pure FSH versus preparations with luteinizing hormone activity), the use of GnRH agonist versus antagonist, or the numbers of oocytes retrieved on aneuploidy rate.…”

Section: Ovarian Stimulation and Aneuploidymentioning

confidence: 96%

“…When comparing the group that decided to cancel the PGS to the group that continued with it, the author demonstrated that the implantation and delivery rates were significantly higher in the group that continued with the PGS, even though fewer embryos were available for transfers. Unal et al 80 analyzed results of PGS cycles when one blastomere was biopsied from a total of 6098 day 3 embryos with at least seven blastomeres. Although ET and pregnancy were less frequent when fewer than six oocytes were aspirated, there were no significant difference in terms of implantation rates and clinical pregnancy once a patient had 6 to 10, 10 to 20, or >20 oocytes retrieved.…”

Section: Is There a Minimal Number Of Oocytes To Start Pgd?mentioning

confidence: 99%

“…Kahraman's group have summarized aneuploidy rates from a total of 6098 day 3 embryos and found similar aneuploidy rate irrespective of the number of oocytes retrieves. 80 A recent retrospective study from an experienced center in Brussels 89 specifically looked at the possible effect on aneuploidy rate of long GnRH agonist use versus antagonist protocol. The study involved 694 consecutive PGS cycle for women <37 years of age.…”

Section: Ovarian Stimulation and Aneuploidymentioning

confidence: 99%

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Clinical Management of in Vitro Fertilization with Preimplantation Genetic Diagnosis

Tur-Kaspa

2012

Semin Reprod Med

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Patients who undergo in vitro fertilization (IVF) because of preimplantation genetic diagnosis (PGD) require different clinical management than those who come in because of infertility alone. PGD adds a "fourth dimension" to the emotional aspect of a patients' assisted reproductive technology treatment. It significantly decreases the number of embryos available for transfer by 25 to 81%, and therefore ovarian stimulation for IVF with PGD should be tailored individually, taking into account patients' safety and estimated ovarian reserve. Recent studies showed that with increased number of oocytes retrieved, the higher the chance to have an embryo transfer and normal cryopreserved blastocysts. With adequate ovarian stimulation, there is no cutoff for the numbers of oocytes/embryos needed to start PGD with, especially for younger patients. Patient-friendly protocols, such as those based on gonadotropin-releasing hormone antagonist and vaginal progesterone support may be used. Elective single embryo transfer and blastocysts cryopreservation to avoid multiple pregnancies may be offered with PGD. The benefit of adding preimplantation genetic screening to IVF treatment is still controversial, and evidence-based data on 24-chromosome testing of polar bodies or trophectoderm is needed before it may be implemented into routine patient care.This review discusses the clinical management of IVF with PGD based on the best available data and my personal clinical experience as a reproductive specialist with >1000 IVF/intracytoplasmic sperm injection-PGD cycles. The information provided here will assist reproductive specialists, nurses, geneticists, genetic counselors, and embryologists to better counsel and treat couples who wish to conceive with a healthy child through IVF with PGD. It is time for PGD to be viewed as a modern modality of preventive medicine. As such, it should be incorporated into national health-care systems and be covered by medical insurance.

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Section: Ovarian Stimulation and Aneuploidymentioning

confidence: 96%

Section: Is There a Minimal Number Of Oocytes To Start Pgd?mentioning

confidence: 99%

Section: Ovarian Stimulation and Aneuploidymentioning

confidence: 99%

See 1 more Smart Citation

Clinical Management of in Vitro Fertilization with Preimplantation Genetic Diagnosis

Tur-Kaspa

2012

Semin Reprod Med

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The ovarian stimulation regimen does not affect aneuploidy or blastocyst rate

Cozzolino,

Mossetti,

Mariani

et al. 2024

Reproductive BioMedicine Online

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No effect of ovarian stimulation and oocyte yield on euploidy and live birth rates: an analysis of 12 298 trophectoderm biopsies

et al. 2020

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STUDY QUESTION Does ovarian stimulation affect embryo euploidy rates or live birth rates (LBRs) after transfer of euploid embryos? SUMMARY ANSWER Euploidy rates and LBRs after transfer of euploid embryos are not significantly influenced by gonadotropin dosage, duration of ovarian stimulation, estradiol level, follicle size at ovulation trigger or number of oocytes retrieved, regardless of a woman’s age. WHAT IS KNOWN ALREADY Aneuploidy rates increase steadily with age, reaching >80% in women >42 years old. The goal of ovarian stimulation is to overcome this high aneuploidy rate through the recruitment of several follicles, which increases the likelihood of obtaining a euploid embryo that results in a healthy conceptus. However, several studies have suggested that a high response to stimulation might be embryotoxic and/or increase aneuploidy rates by enhancing abnormal segregation of chromosomes during meiosis. Furthermore, a recent study demonstrated a remarkable difference in euploidy rates, ranging from 39.5 to 82.5%, among young oocyte donors in 42 fertility centres, potentially suggesting an iatrogenic etiology resulting from different stimulation methods. STUDY DESIGN, SIZE, DURATION This is a retrospective cohort study that included 2230 in vitro fertilisation (IVF) with preimplantation genetic testing for aneuploidy (PGT-A) cycles and 930 frozen-thawed single euploid embryo transfer (FET) cycles, performed in our centre between 2013 and 2017. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 12 298 embryos were analysed for ploidy status. Women were divided into five age groups (<35, 35–37, 38–40, 41–42 and >42 years old). Outcomes were compared between different durations of stimulation (<10, 10–12 and ≥13 days), total gonadotropin dosages (<4000, 4000–6000 and >6000 IU), numbers of oocytes retrieved (<10, 10–19 and ≥20 oocytes), peak estradiol levels (<2000, 2000–3000 and >3000 pg/mL), and sizes of the largest follicle on the day of trigger (<20 and ≥20 mm). MAIN RESULTS AND THE ROLE OF CHANCE Within the same age group, both euploidy rates and LBRs were comparable between cycles regardless of their differences in total gonadotropin dosage, duration of stimulation, number of oocytes harvested, size of the largest follicles or peak estradiol levels. In the youngest group, (<35 years, n = 3469 embryos), euploidy rates were comparable between cycles with various total gonadotropin dosages (55.6% for <4000 IU, 52.9% for 4000–6000 IU and 62.3% for >6000 IU; P = 0.3), durations of stimulation (54.4% for <10 days, 55.2% for 10–12 days and 60.9% for >12 days; P = 0.2), number of oocytes harvested (59.4% for <10 oocytes, 55.2% for 10–19 oocytes and 53.4% for ≥20 oocytes; P = 0.2), peak estradiol levels (55.7% for E2 < 2000 pg/mL, 55.4% for E2 2000–3000 pg/mL and 54.8% for E2 > 3000 pg/mL; P = 0.9) and sizes of the largest follicle (55.6% for follicles <20 mm and 55.1% for follicles ≥20 mm; P = 0.8). Similarly, in the oldest group (>42 years, n = 1157 embryos), euploidy rates ranged from 8.7% for gonadotropins <4000 IU to 5.1% for gonadotropins >6000 IU (P = 0.3), from 10.8% for <10 days of stimulation to 8.5% for >12 days of stimulation (P = 0.3), from 7.3% for <10 oocytes to 7.4% for ≥20 oocytes (P = 0.4), from 8.8% for E2 < 2000 pg/mL to 7.5% for E2 > 3000 pg/mL (P = 0.8) and from 8.2% for the largest follicle <20 mm to 8.9% for ≥20 mm (P = 0.7). LBRs after single FET were also comparable between these groups. LIMITATIONS, REASONS FOR CAUTION Although this large study (2230 IVF/PGT-A cycles, 12 298 embryos and 930 single FET cycles) demonstrates the safety of ovarian stimulation in terms of aneuploidy and implantation potential of euploid embryos, a multi-centre study may help to prove the generalisability of our single-centre data. WIDER IMPLICATIONS OF THE FINDINGS These findings reassure providers and patients that gonadotropin dosage, duration of ovarian stimulation, estradiol level, follicle size at ovulation trigger and number of oocytes retrieved, within certain ranges, do not appear to significantly influence euploidy rates or LBRs, regardless of the woman’s age. STUDY FUNDING/COMPETING INTEREST(S) No external funding was received and there are no competing interests to declare. TRIAL REGISTRATION NUMBER N/A

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Preimplantation genetic diagnosis (PGD) results with respect to number of mii oocyte

Cited by 3 publications

References 0 publications

Clinical Management of in Vitro Fertilization with Preimplantation Genetic Diagnosis

Clinical Management of in Vitro Fertilization with Preimplantation Genetic Diagnosis

The ovarian stimulation regimen does not affect aneuploidy or blastocyst rate

No effect of ovarian stimulation and oocyte yield on euploidy and live birth rates: an analysis of 12 298 trophectoderm biopsies

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