title: In vitro fertilization with preimplantation genetic screening.
abstract: BACKGROUND
  Pregnancy rates in women of advanced maternal age undergoing in vitro fertilization (IVF) are disappointingly low. It has been suggested that the use of preimplantation genetic screening of cleavage-stage embryos for aneuploidies may improve the effectiveness of IVF in these women.
  
  
  METHODS
  We conducted a multicenter, randomized, double-blind, controlled trial comparing three cycles of IVF with and without preimplantation genetic screening in women 35 through 41 years of age. The primary outcome measure was ongoing pregnancy at 12 weeks of gestation. The secondary outcome measures were biochemical pregnancy, clinical pregnancy, miscarriage, and live birth.
  
  
  RESULTS
  Four hundred eight women (206 assigned to preimplantation genetic screening and 202 assigned to the control group) underwent 836 cycles of IVF (434 cycles with and 402 cycles without preimplantation genetic screening). The ongoing-pregnancy rate was significantly lower in the women assigned to preimplantation genetic screening (52 of 206 women [25%]) than in those not assigned to preimplantation genetic screening (74 of 202 women [37%]; rate ratio, 0.69; 95% confidence interval [CI], 0.51 to 0.93). The women assigned to preimplantation genetic screening also had a significantly lower live-birth rate (49 of 206 women [24%] vs. 71 of 202 women [35%]; rate ratio, 0.68; 95% CI, 0.50 to 0.92).
  
  
  CONCLUSIONS
  Preimplantation genetic screening did not increase but instead significantly reduced the rates of ongoing pregnancies and live births after IVF in women of advanced maternal age. (Current Controlled Trials number, ISRCTN76355836 [controlled-trials.com].).
authors.affiliation: Center for Reproductive Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: Mastenbroek
authors.forename: Moniek
authors.initials: M
authors.lastname: Twisk
authors.forename: Jannie
authors.initials: J
authors.lastname: van Echten-Arends
authors.forename: Birgit
authors.initials: B
authors.lastname: Sikkema-Raddatz
authors.forename: Johanna C
authors.initials: JC
authors.lastname: Korevaar
authors.forename: Harold R
authors.initials: HR
authors.lastname: Verhoeve
authors.forename: Niels E A
authors.initials: NE
authors.lastname: Vogel
authors.forename: Eus G J M
authors.initials: EG
authors.lastname: Arts
authors.forename: Jan W A
authors.initials: JW
authors.lastname: de Vries
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Bossuyt
authors.forename: Charles H C M
authors.initials: CH
authors.lastname: Buys
authors.forename: Maas Jan
authors.initials: MJ
authors.lastname: Heineman
authors.forename: Sjoerd
authors.initials: S
authors.lastname: Repping
authors.forename: Fulco
authors.initials: F
authors.lastname: van der Veen
mesh_terms: D000328:Adult; D000782:Aneuploidy; D001723:Birth Rate; D025063:Chromosome Disorders / Q000175:diagnosis*; D004311:Double-Blind Method; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D005500:Follow-Up Studies; D005820:Genetic Testing / Q000379:methods; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008423:Maternal Age; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D019836:Preimplantation Diagnosis / Q000009:adverse effects; D020554:Sperm Injections, Intracytoplasmic