Preimplantation genetic diagnosis significantly reduces pregnancy loss in infertile couples: a multicenter study.
OBJECTIVE
The inicidence of miscarriage is correlated with maternal age. The majority of miscarriages are chromosomally abnormal. The purpose of this study was to determine in a large population of infertility patients (>2000 cycles) if preimplantation genetic diagnosis (PGD) reduced the rate of spontaneous abortions.


METHODS
Multicenter retrospective controlled study.


METHODS
One hundred IVF centers referring samples to a reference PGD laboratory.


METHODS
Infertile women.


METHODS
The spontaneous abortion rate after PGD was retrospectively compared to non-PGD cycles from the 2002 American Society for Reproductive Medicine-Society for Assisted Reproduction Technology report on IVF cycles.


METHODS
Spontaneous abortions and trisomic offspring rates.


RESULTS
The study included 2,279 cycles of PGD. The pregnancy rate per retrieval was 26.7% (average age 39.6). The mean pregnancy loss for the PGD group (0.167) was significantly lower than for the general IVF group (0.215) (P<.001). After PGD, the spontaneous abortion rate was 14.1% for ages 35-40, and 22.2% for women over 40, compared to 19.4% (P=.03) and 40.6% (P<.001), respectively, in controls. The clinical error rate of PGD (1.2%) was significantly lower than expected (4.7%) (P<.001).


CONCLUSIONS
The data suggests that PGD significantly reduces the risk of spontaneous abortions in women undergoing IVF and PGD, particularly in women over 40. In addition, PGD may also reduce the risk of trisomic offspring.
Munné
Santiago
S
Reprogenetics LLC, West Orange, New Jersey 07052, USA. munne@embryos.net
Fischer
Jill
J
Warner
Alison
A
Chen
Serena
S
Zouves
Christo
C
Cohen
Jacques
J
D000022:Abortion, Spontaneous / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005306:Fertilization; D005307:Fertilization in Vitro / Q000009:adverse effects*; D006801:Humans; D007246:Infertility / Q000628:therapy*; D008423:Maternal Age; D011247:Pregnancy; D018873:Pregnancy Rate; D019836:Preimplantation Diagnosis; D012189:Retrospective Studies; D012306:Risk; D014314:Trisomy