Impact of preimplantation genetic diagnosis for chromosomal disorders on reproductive outcome.
Despite recent controversy, existing experience suggests that aneuploidy testing has had a significant impact on the reproductive outcome of poor prognosis IVF patients, which is based on the experience of over 20,000 cases of PGD for chromosomal disorders. The clinical impact was demonstrated in the improved implantation and pregnancy rates, reduction of spontaneous abortions and improved take-home baby rate in patients of advanced reproductive age, those with repeated IVF failures and recurrent spontaneous abortions. The lack of positive effect of aneuploidy testing in a few smaller series may be due to potential detrimental effect of two blastomere removal, reducing the implantation potential of the biopsied embryos, or exclusion from testing a few key chromosomes and poor outcome of aneuploidy testing, affecting the appropriate pre-selection of embryos for transfer. Despite the need for randomized controlled studies to quantify in more detail the clinical impact of the pre-selection of aneuploidy-free zygotes, the positive impact of PGD is particularly obvious from the comparison of reproductive outcome in the same patients with and without PGD, revealing the actual benefits of PGD.
Kuliev
Anver
A
Reproductive Genetics Institute, 2825 N Halsted, Chicago, IL 60657, USA. anverkuliev@hotmail.com
Verlinsky
Yury
Y
D000022:Abortion, Spontaneous / Q000517:prevention & control; D000782:Aneuploidy; D001706:Biopsy; D001755:Blastocyst / Q000473:pathology; D025063:Chromosome Disorders / Q000175:diagnosis* / Q000235:genetics*; D004624:Embryo Transfer / Q000379:methods; D005260:Female; D005820:Genetic Testing / Q000379:methods; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000235:genetics*; D019836:Preimplantation Diagnosis; D011379:Prognosis