Prognostic factors for preimplantation genetic screening in repeated pregnancy loss

Abstract

The objective of this study was to identify specific subgroups of recurrent pregnancy loss (RPL) patients of unknown aetiology in whom the selection of chromosomally normal embryos for transfer improves reproductive outcome in preimplantation genetic screening (PGS). A total of 428 PGS cycles were included and chromosomes 13, 15, 16, 18, 21, 22, X and Y were evaluated. In RPL patients < or =37 years, a lower incidence of chromosomal abnormalities (P = 0.0004) and miscarriages (P = 0.0283) was observed, and there were significantly higher pregnancy (P < 0.0384) and implantation (P < 0.0434) rates than in patients >37 years. In the former subset, results showed: (i) significantly higher implantation rates (P = 0.0411) in couples that had experienced a previous aneuploid miscarriage; (ii) similar aneuploidy, pregnancy and implantation rates in couples suffering previous miscarriages during fertility treatments and in those with previous spontaneous pregnancies; (iii) no miscarriages after PGS in couples in whom a fluorescence in-situ hybridization assay showed the male partner's sperm to be abnormal; and (iv) lower implantation rates in couples with > or =5 previous miscarriages, associated with a lower percentage of chromosomally abnormal embryos. It is concluded that PGS is to be strongly recommended when RPL is associated with miscarriages during infertility treatments, chromosomopathy in a previous miscarriage, up to five previous miscarriages and a high incidence of chromosomal abnormalities in spermatozoa.

Genetic counseling for men with recurrent pregnancy loss or recurrent implantation failure due to abnormal sperm chromosomal aneuploidy

“…PGS utilizes either FISH or array-based analysis to detect chromosomal abnormalities or genetic defects in embryos undergoing IVF/ICSI [5]. PGS can also be used to identify embryos without aneuploidy or an unbalanced translocation for implantation in the female [22].…”

Spontaneous in vitro maturation and artificial activation of human germinal vesicle oocytes recovered from stimulated cycles

“…For chromosome determination, eggs were fixed using our technique (37,38) with some modifications. In short, the ZP and two PB were removed to avoid chromosome signal interferences.…”

Diminished effect of maternal age on implantation after preimplantation genetic diagnosis with array comparative genomic hybridization

“…This version of PGS can be called first-generation PGS. Initial studies with first-generation PGS suggested that implantation rates increased and loss rates decreased (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28). However, other studies, including several randomized controlled trials (RCTs), showed no benefit (29)(30)(31)(32)(33)(34)(35)(36) or, worse, a negative impact on implantation, pregnancy, or loss rates (37,38).…”