To PGD or not to PGD: is there a magic number of oocytes to start with?

Tur-Kaspa, Ilan; Bernal, A.; Tkachenko, Natalia N.; Pawlovska, J.; Rechitsky, Svetlana; Verlinsky, Yuri

doi:10.1016/j.fertnstert.2007.07.790

Cited by 6 publications

(9 citation statements)

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“…43,44 However, comparing their results to those of some centers in the United States demonstrate this is not necessarily the case. [45][46][47] During a 4-year period (November 2002 to November 2006), the author performed 166 consecutive oocyte retrievals for IVF for PGD for 51 different monogenic disorders (women 42 years of age) at IHR/RGI in Chicago. 46,47 The outcome of these cycles was compared with the outcome of the 520 oocyte retrievals from 45 centers reported by the PGD ESHRE consortium for 2004.…”

Section: Is Pgd Safe? Embryo Development Pregnancy Rates and Childrmentioning

confidence: 99%

“…The additional high cost and the technical complexities associated with PGD should also be considered when deciding on the number of embryos to be transferred after PGD. 46,48,65,66 Infertility Diagnosis May Affect IVF-PGD Results PGD was originally offered to fertile couples who delivered a child with a genetic disorder. 15,16 A recent study of the cumulative reproductive outcome of 1498 couples who underwent PGD found that fertility status and parity had no significant effect on PGD outcome.…”

Section: How To Maximize Ivf-pgd Outcomementioning

confidence: 99%

“…Evaluation of the ovarian reserve should be performed by using age, antral follicle count and/or anti-Müllerian hormone, and day 3 folliclestimulating hormone (FSH) levels to allow individual tailoring of the ovarian stimulation protocol. 46,47,65,[69][70][71] An investigation of the uterine cavity should also be done to check for polyps, submucosal fibroids, or intrauterine adhesions. Unsuspected uterine cavity abnormalities may be found in 11 to 22% of patients.…”

Section: How To Maximize Ivf-pgd Outcomementioning

confidence: 99%

“…To better counsel patients on IVF-PGD outcome, Tur-Kaspa et al 46,65,69 investigated PGD's efficiency to produce embryos suitable for ET and pregnancy, with low and high number of oocytes at different age groups. During a 4-year period (November 2002 to November 2006), 560 consecutive IVF-PGD cycles were performed at IHR/RGI in Chicago.…”

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

confidence: 99%

“…Therefore, Tur-Kaspa et al concluded that the practice of canceling of cycles when low number of oocytes/embryo are anticipated should be reconsidered. 46,65,69 Verpoest et al, 49 from the same center as Vandervorst et al, 79 reevaluated the 1998 findings and summarized in 2009 the cumulative reproductive outcome of 1498 couples who underwent PGD. They reached a similar conclusion to the one recommended by Tur-Kaspa.…”

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

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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