title: Impact of blastocyst biopsy and comprehensive chromosome screening technology on preimplantation genetic screening: a systematic review of randomized controlled trials.
abstract: Embryonic aneuploidy is highly prevalent in IVF cycles and contributes to decreased implantation rates, IVF cycle failure and early pregnancy loss. Preimplantation genetic screening (PGS) selects the most competent (euploid) embryos for transfer, and has been proposed to improve IVF outcomes. Use of PGS with fluorescence-in-situ hybridization technology after day 3 embryo biopsy (PGS-v1) significantly lowers live birth rates and is not recommended for use. Comprehensive chromosome screening technology, which assesses the whole chromosome complement, can be achieved using different genetic platforms. Whether PGS using comprehensive chromosome screening after blastocyst biopsy (PGS-v2) improves IVF outcomes remains to be determined. A systematic review of randomized controlled trials was conducted on PGS-v2. Three trials met full inclusion criteria, comparing PGS-v2 and routine IVF care. PGS-v2 is associated with higher clinical implantation rates, and higher ongoing pregnancy rates when the same number of embryos is transferred in both PGS and control groups. Additionally, PGS-v2 improves embryo selection in eSET practice, maintaining the same ongoing pregnancy rates between PGS and control groups, while sharply decreasing multiple pregnancy rates. These results stem from good-prognosis patients undergoing IVF. Whether these findings can be extrapolated to poor-prognosis patients with decreased ovarian reserve remains to be determined.
authors.affiliation: ART-PGD Center, CHU Sainte-Justine, University of Montreal, Canada, H3T 1C5; PROCREA Clinics, Montreal, Canada, H3P 2W3; Department of Obstetrics and Gynecology, University of Montreal, Montreal, Canada, H3T 1C5. Electronic address: elias.dahdouh@umontreal.ca.
authors.forename: Elias M
authors.initials: EM
authors.lastname: Dahdouh
authors.affiliation: Department of Obstetrics and Gynecology, University of Montreal, Montreal, Canada, H3T 1C5.
authors.forename: Jacques
authors.initials: J
authors.lastname: Balayla
authors.affiliation: Instituto Valenciano de Infertilidad (IVI) Madrid, and Rey Juan Carlos University, Madrid 28023, Spain.
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: García-Velasco
mesh_terms: D000782:Aneuploidy; D001706:Biopsy; D001755:Blastocyst / Q000166:cytology* / Q000378:metabolism / Q000473:pathology; D002869:Chromosome Aberrations / Q000196:embryology*; D004477:Ectogenesis; D046149:Embryo Culture Techniques; D004624:Embryo Transfer / Q000009:adverse effects*; D047108:Embryonic Development; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects; D005820:Genetic Testing; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D008297:Male; D011247:Pregnancy; D011255:Pregnancy Maintenance; D018873:Pregnancy Rate; D019836:Preimplantation Diagnosis / Q000009:adverse effects / Q000379:methods*; D016032:Randomized Controlled Trials as Topic
keywords: array comparative genomic hybridization; comprehensive chromosome screening; embryo selection; preimplantation genetic screening; quantitative polymerase chain reaction