title: Preimplantation genetic screening: who benefits?
abstract: OBJECTIVE
  To compare IVF outcomes between women undergoing frozen transfers of blastocysts verified as euploid by preimplantation genetic screening (PGS) with patients undergoing fresh nonbiopsied blastocyst transfers.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  All patients undergoing IVF-PGS cycles between January 2010 and November 2014 were included (n = 274). Patients were compared with a control group consisting of all fresh blastocyst transfers that occurred during the same period (n = 863).
  
  
  METHODS
  Patients underwent IVF-PGS with 24-chromosome screening. Patients with euploid embryos had transfer of one to two embryos in a subsequent frozen ET cycle.
  
  
  METHODS
  Implantation, clinical intrauterine gestation (CIG), miscarriage, biochemical pregnancy (BC), and live birth (LB) rates were compared.
  
  
  RESULTS
  Odds ratios (ORs) were estimated for outcomes in women undergoing PGS versus controls. Among patients ≤37 years old, there were no differences in CIG and LB rates for single (adjusted ORs [aORs], 1.20 [95 %confidence interval {CI}, 0.66-2.21]; 1.21 [95% CI, 0.66-2.2]) and double ETs (aORs, 1.09 [95% CI, 0.54-2.18]; 0.87 [95% CI, 0.44-1.7]). BC and miscarriage rates were also similar. For patients >37 years old, CIG and LB rates were increased for single (aORs, 3.86 [95% CI, 1.25-11.9]; 8.2 [95% CI, 2.28-29.5]) and double ETs (aORs, 9.91 [95% CI, 2.0-49.6]; 8.67 [95% CI, 2.08-36.2]) with no difference in BC and miscarriage rates. A per-retrieval analysis of the >37 group failed to demonstrate any difference in CIG or LB rates.
  
  
  CONCLUSIONS
  Among patients ≤37, IVF-PGS does not improve CIG, LB, and miscarriage rates. IVF-PGS in women >37 improved CIG and LB rates. However, per cycle, the PGS advantage in this age group does not persist.
authors.affiliation: The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, New York.
authors.forename: Hey-Joo
authors.initials: HJ
authors.lastname: Kang
authors.affiliation: The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, New York. Electronic address: alm2036@med.cornell.edu.
authors.forename: Alexis P
authors.initials: AP
authors.lastname: Melnick
authors.affiliation: The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, New York.
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Stewart
authors.affiliation: The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, New York.
authors.forename: Kangpu
authors.initials: K
authors.lastname: Xu
authors.affiliation: The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, New York.
authors.forename: Zev
authors.initials: Z
authors.lastname: Rosenwaks
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology; D000328:Adult; D001755:Blastocyst / Q000473:pathology*; D016009:Chi-Square Distribution; D002869:Chromosome Aberrations; D015925:Cryopreservation; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D005298:Fertility; D005307:Fertilization in Vitro / Q000009:adverse effects; D005820:Genetic Testing; D006801:Humans; D007246:Infertility / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D050498:Live Birth; D016015:Logistic Models; D015999:Multivariate Analysis; D016017:Odds Ratio; D011003:Ploidies; D011237:Predictive Value of Tests; D011247:Pregnancy; D018873:Pregnancy Rate; D019836:Preimplantation Diagnosis / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: IVF; blastocyst transfer; preimplantation genetic screening; trophectoderm biopsy