title: Preimplantation genetic screening in women of advanced maternal age caused a decrease in clinical pregnancy rate: a randomized controlled trial.
abstract: BACKGROUND
  Advanced maternal age (AMA) is an important parameter that negatively influences the clinical pregnancy rate in IVF, in particular owing to the increased embryo aneuploidy rate. It has thus been suggested that only transferring euploid embryos in this patient group would improve the pregnancy rate. The purpose of this study was to test whether employing preimplantation genetic screening (PGS) in AMA patients would increase the clinical pregnancy rate.
  
  
  METHODS
  We conducted a two-center, randomized controlled trial (RCT) to analyze the outcome of embryo transfers in AMA patients (>or=38 years of age) after PGS using FISH analysis for chromosomes X, Y, 13, 16, 18, 21 and 22. The PGS group was compared with a control group. The primary outcome measure was clinical pregnancy rate after 6-7 weeks of gestation per randomized patient.
  
  
  RESULTS
  The study was terminated early as an interim analysis showed a very low conditional power of superiority for the primary outcome. Of the 320 patients calculated to be included in the study, 56 and 53 patients were randomized into the PGS and control groups, respectively. The clinical pregnancy rate in the PGS group was 8.9% (95% CI, 2.9-19.6%) compared with 24.5% (95% CI, 13.8-38.3%) in the control group, giving a difference of 15.6% (95% CI, 1.8-29.4%, P = 0.039).
  
  
  CONCLUSIONS
  Although the study was terminated early, this RCT study provides evidence against the use of PGS for AMA patients when performing IVF.
  
  
  BACKGROUND
  ISRCTN38014610.
authors.affiliation: Fertility Centre Scandinavia, Carlanderska Hospital, Göteborg, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Hardarson
authors.forename: C
authors.initials: C
authors.lastname: Hanson
authors.forename: K
authors.initials: K
authors.lastname: Lundin
authors.forename: T
authors.initials: T
authors.lastname: Hillensjö
authors.forename: L
authors.initials: L
authors.lastname: Nilsson
authors.forename: J
authors.initials: J
authors.lastname: Stevic
authors.forename: E
authors.initials: E
authors.lastname: Reismer
authors.forename: K
authors.initials: K
authors.lastname: Borg
authors.forename: M
authors.initials: M
authors.lastname: Wikland
authors.forename: C
authors.initials: C
authors.lastname: Bergh
mesh_terms: D000328:Adult; D000782:Aneuploidy; D025063:Chromosome Disorders / Q000209:etiology; D004624:Embryo Transfer / Q000009:adverse effects*; D005260:Female; D005820:Genetic Testing / Q000379:methods*; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008423:Maternal Age; D011247:Pregnancy; D018873:Pregnancy Rate; D019836:Preimplantation Diagnosis / Q000379:methods*; D013548:Sweden