title: Diminished effect of maternal age on implantation after preimplantation genetic diagnosis with array comparative genomic hybridization.
abstract: OBJECTIVE
  To assess the relationship between maternal age, chromosome abnormality, implantation, and pregnancy loss.
  
  
  METHODS
  Multicenter retrospective study.
  
  
  METHODS
  IVF centers in the United States.
  
  
  METHODS
  IVF patients undergoing chromosome screening.
  
  
  METHODS
  Embryo biopsy on day 3 or day 5/6 with preimplantation genetic diagnosis (PGD) by array comparative genomic hybridization.
  
  
  METHODS
  Aneuploidy, implantation, pregnancy, and loss rates.
  
  
  RESULTS
  Aneuploidy rates increased with maternal age from 53% to 93% for day 3 biopsies and from 32% to 85% for blastocyst biopsies. Implantation rates for euploid embryos for ages <35-42 years did not decrease after PGD: ranges 44%-32% for day 3 and 51%-40% for blastocyst. Ongoing pregnancy rates per transfer did not decrease for maternal ages <42 years after PGD with day 3 biopsy (48.5%-38.1%) or blastocyst biopsy (64.4%-54.5%). Patients >42 years old had implantation rates of 23.3% (day 3), 27.7% (day 5/6), and the pregnancy rate with day 3 biopsy was 9.3% and with day 5 biopsy 10.3%.
  
  
  CONCLUSIONS
  Selective transfer of euploid embryos showed that implantation and pregnancy rates were not significantly different between reproductively younger and older patients up to age 42 years. Some patients who start an IVF cycle planning to have chromosome screening do not have euploid embryos available for transfer, a situation that increases with advancing maternal age. Mounting data suggests that the dramatic decline in IVF treatment success rates with female age is primarily caused by aneuploidy.
authors.affiliation: Bluegnome, La Jolla, California. Electronic address: gary.harton@cambridgebluegnome.com.
authors.forename: Gary L
authors.initials: GL
authors.lastname: Harton
authors.forename: Santiago
authors.initials: S
authors.lastname: Munné
authors.forename: Mark
authors.initials: M
authors.lastname: Surrey
authors.forename: Jamie
authors.initials: J
authors.lastname: Grifo
authors.forename: Brian
authors.initials: B
authors.lastname: Kaplan
authors.forename: David H
authors.initials: DH
authors.lastname: McCulloh
authors.forename: Darren K
authors.initials: DK
authors.lastname: Griffin
authors.forename: Dagan
authors.initials: D
authors.lastname: Wells
mesh_terms: D000293:Adolescent; D000328:Adult; D000782:Aneuploidy; D015897:Comorbidity; D055028:Comparative Genomic Hybridization / Q000706:statistics & numerical data*; D010064:Embryo Implantation / Q000235:genetics*; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data; D030342:Genetic Diseases, Inborn / Q000175:diagnosis / Q000235:genetics* / Q000401:mortality*; D020022:Genetic Predisposition to Disease / Q000453:epidemiology / Q000235:genetics; D005820:Genetic Testing / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008423:Maternal Age; D008875:Middle Aged; D011247:Pregnancy; D018873:Pregnancy Rate; D019836:Preimplantation Diagnosis / Q000706:statistics & numerical data*; D012307:Risk Factors; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Preimplantation genetic screening; aneuploidy; elective single-embryo transfer; embryo biopsy