title: In vitro fertilization with preimplantation genetic screening improves implantation and live birth in women age 40 through 43.
abstract: OBJECTIVE
  In Vitro Fertilization is an effective treatment for infertility; however, it has relatively low success in women of advanced maternal age (>37) who have a high risk of producing aneuploid embryos, resulting in implantation failure, a higher rate of miscarriage or birth of a child with chromosome abnormalities. The purpose of this study was to compare the implantation, miscarriage and live birth rates with and without preimplantation genetic screening (PGS) of embryos from patients aged 40 through 43 years.
  
  
  METHODS
  This is a retrospective cohort study, comparing embryos screened for ploidy using trophectoderm biopsy and array comparative genomic hybridization to embryos that were not screened. We compared pregnancy outcomes for traditional fresh IVF cycles with day 5 embryo transfers, Frozen Embryo Transfer (FET) cycles without PGS and PGS-FET (FET of only euploid embryos) cycles of patients with maternal ages ranging from 40 to 43 years, undergoing oocyte retrievals during the period between 1/1/2011 and 12/31/2012.
  
  
  RESULTS
  The implantation rate of euploid embryos transferred in FET cycles (50.9%) was significantly greater than for unscreened embryos transferred in either fresh (23.8%) or FET (25.4%) cycles. The incidence of live birth per transferred embryo for PGS-FET (45.5%) was significantly greater than for No PGS fresh (15.8%) or No PGS FET (19.0 %) cycles. The incidences of live birth per implanted sac for PGS FET cycles (89.3%), No PGS fresh cycles (66.7%) and No PGS FET cycles (75.0%) were not significantly different.
  
  
  CONCLUSIONS
  The present data provides evidence of the benefits of PGS with regard to improved implantation and live birth rate per embryo transferred.
authors.affiliation: New York University Langone Medical Center, NYU Fertility Center, 660 First Avenue, New York, NY, 10016, USA, Hsiao-Ling.Lee@nyumc.org.
authors.forename: Hsiao-Ling
authors.initials: HL
authors.lastname: Lee
authors.forename: David H
authors.initials: DH
authors.lastname: McCulloh
authors.forename: Brooke
authors.initials: B
authors.lastname: Hodes-Wertz
authors.forename: Alexis
authors.initials: A
authors.lastname: Adler
authors.forename: Caroline
authors.initials: C
authors.lastname: McCaffrey
authors.forename: James A
authors.initials: JA
authors.lastname: Grifo
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology / Q000235:genetics; D000328:Adult; D001723:Birth Rate; D002869:Chromosome Aberrations; D055028:Comparative Genomic Hybridization; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D005820:Genetic Testing; D006801:Humans; D050498:Live Birth / Q000453:epidemiology / Q000235:genetics*; D008423:Maternal Age; D011247:Pregnancy; D019836:Preimplantation Diagnosis