title: Increasing live birth rate by preimplantation genetic screening of pooled polar bodies using array comparative genomic hybridization.
abstract: Meiotic errors during oocyte maturation are considered the major contributors to embryonic aneuploidy and failures in human IVF treatment. Various technologies have been developed to screen polar bodies, blastomeres and trophectoderm cells for chromosomal aberrations. Array-CGH analysis using bacterial artificial chromosome (BAC) arrays is widely applied for preimplantation genetic diagnosis (PGD) using single cells. Recently, an increase in the pregnancy rate has been demonstrated using array-CGH to evaluate trophectoderm cells. However, in some countries, the analysis of embryonic cells is restricted by law. Therefore, we used BAC array-CGH to assess the impact of polar body analysis on the live birth rate. A disadvantage of polar body aneuploidy screening is the necessity of the analysis of both the first and second polar bodies, resulting in increases in costs for the patient and complex data interpretation. Aneuploidy screening results may sometimes be ambiguous if the first and second polar bodies show reciprocal chromosomal aberrations. To overcome this disadvantage, we tested a strategy involving the pooling of DNA from both polar bodies before DNA amplification. We retrospectively studied 351 patients, of whom 111 underwent polar body array-CGH before embryo transfer. In the group receiving pooled polar body array-CGH (aCGH) analysis, 110 embryos were transferred, and 29 babies were born, corresponding to live birth rates of 26.4% per embryo and 35.7% per patient. In contrast, in the control group, the IVF treatment was performed without preimplantation genetic screening (PGS). For this group, 403 embryos were transferred, and 60 babies were born, resulting in live birth rates of 14.9% per embryo and 22.7% per patient. In conclusion, our data show that in the aCGH group, the use of aneuploidy screening resulted in a significantly higher live birth rate compared with the control group, supporting the benefit of PGS for IVF couples in addition to the suitability and effectiveness of our polar body pooling strategy.
authors.affiliation: Wunschbaby Institut Feichtinger, Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Feichtinger
authors.affiliation: Wunschbaby Institut Feichtinger, Vienna, Austria.
authors.forename: Tina
authors.initials: T
authors.lastname: Stopp
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Göbl
authors.affiliation: Wunschbaby Institut Feichtinger, Vienna, Austria.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Feichtinger
authors.affiliation: Wunschbaby Institut Feichtinger, Vienna, Austria.
authors.forename: Enrico
authors.initials: E
authors.lastname: Vaccari
authors.affiliation: Wunschbaby Institut Feichtinger, Vienna, Austria.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Mädel
authors.affiliation: Institute of Medical Genetics, Medical University of Vienna, Vienna, Austria.
authors.forename: Franco
authors.initials: F
authors.lastname: Laccone
authors.affiliation: Wunschbaby Institut Feichtinger, Vienna, Austria.
authors.forename: Monika
authors.initials: M
authors.lastname: Stroh-Weigert
authors.affiliation: Wunschbaby Institut Feichtinger, Vienna, Austria; Institute of Medical Genetics, Medical University of Vienna, Vienna, Austria.
authors.forename: Markus
authors.initials: M
authors.lastname: Hengstschläger
authors.affiliation: Wunschbaby Institut Feichtinger, Vienna, Austria.
authors.forename: Wilfried
authors.initials: W
authors.lastname: Feichtinger
authors.affiliation: Institute of Medical Genetics, Medical University of Vienna, Vienna, Austria.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Neesen
mesh_terms: D000782:Aneuploidy; D016022:Case-Control Studies; D055028:Comparative Genomic Hybridization; D004624:Embryo Transfer; D005260:Female; D005820:Genetic Testing; D006801:Humans; D050498:Live Birth; D059705:Polar Bodies; D011247:Pregnancy; D019836:Preimplantation Diagnosis