Capsule Outcome of donor egg FET cycles with and without PGS.
Darren K. Griffin and Santiago Munne are joint last authors.
This study aims to test the hypothesis, in a single-center retrospective analysis, that live birth rates are significantly different when utilizing preimplantation genetic screening (PGS) compared to not utilizing PGS in frozen–thawed embryo transfers in our patients that use eggs from young, anonymous donors. The question therefore arises of whether PGS is an appropriate intervention for donor egg cycles.
Live birth rates per cycle and live birth rates per embryo transferred after 398 frozen embryo transfer (FET) cycles were examined from patients who elected to have PGS compared to those who did not. Blastocysts derived from donor eggs underwent trophectoderm biopsy and were tested for aneuploidy using array comparative genomic hybridization (aCGH) or next-generation sequencing (NGS), then vitrified for future use (test) or were vitrified untested (control). Embryos were subsequently warmed and transferred into a recipient or gestational carrier uterus. Data was analyzed separately for single embryo transfer (SET), double embryo transfer (DET), and for own recipient uterus and gestational carrier (GC) uterus recipients.
Rates of implantation of embryos leading to a live birth were significantly higher in the PGS groups transferring two embryos (DET) compared to the no PGS group (GC, 72 vs. 56 %; own uterus, 60 vs. 36 %). The live birth implantation rate in the own uterus group for SET was higher in the PGS group compared to the control (58 vs. 36 %), and this almost reached significance but the live birth implantation rate for the SET GC group remained the same for both tested and untested embryos. Live births per cycle were nominally higher in the PGS GC DET and own uterus SET and DET groups compared to the non-PGS embryo transfers. These differences almost reached significance. The live birth rate per cycle in the SET GC group was almost identical.
Significant differences were noted only for DET; however, benefits need to be balanced against risks associated with multiple pregnancies. Results observed for SET need to be confirmed on larger series and with randomized cohorts.
SART. Published IVF data 2013.
SART. ORM live birth rates 2012.
Scott Jr RT, Upham KM, Forman EJ, Hong KH, Scott KL, Taylor D, et al. Blastocyst biopsy with comprehensive chromosome screening and fresh embryo transfer significantly increases in vitro fertilization implantation and delivery rates: a randomized controlled trial. Fertil Steril. 2013;100(3):697–703.
Dahdouh EM, Balayla J, Audibert F, Wilson RD, Audibert F, Brock JA, et al. Technical update: preimplantation genetic diagnosis and screening. J Obstet Gynaecol Can JOGC J d’obstetrique et gynecologie du Can JOGC. 2015;37:451–63.
Haddad G, Deng M, Wang CT, Witz C, Williams D, Griffith J, et al. Assessment of aneuploidy formation in human blastocysts resulting from donated eggs and the necessity of the embryos for aneuploidy screening. J Assist Reprod Genet. 2015;32(6):999–1006.
GGardner D, Schoolcraft W. In Vitro Culture of human Blastocysts. Jansen R, Mortimer D (Eds). Toward Reproductive certainty: Fertility, Genetics and Beyond. Carnforth, UK. Parthenon Publishing; 1999. P. 378–88.
Styer AK, Luke B, Vitek W, Christianson MS, Baker VL, Christy AY, et al. Factors associated with the use of elective single-embryo transfer and pregnancy outcomes in the United States, 2004–2012. Fertil Steril. 2016;104(3):e102.
Forman EJ, Hong KH, Franasiak JM, Scott Jr RT. Obstetrical and neonatal outcomes from the BEST Trial: single embryo transfer with aneuploidy screening improves outcomes after in vitro fertilization without compromising delivery rates. Am J Obstet Gynecol. 2014;210:157.e1–6. CrossRef
Ubaldi FM, Capalbo A, Colamaria S, Ferrero S, Maggiulli R, Vajta G, et al. Reduction of multiple pregnancies in the advanced maternal age population after implementation of an elective single embryo transfer policy coupled with enhanced embryo selection: pre- and post-intervention study. Hum Reprod. 2015;30:2097–106. CrossRefPubMedPubMedCentral
Munne S, Alikani M, Barritt J, Hesla J, Kaplan B, Alper M, McCulloh D. Egg donor aneuploidy rates significantly differ between fertility centers. ASRM abstract submitted. 2015.
Hook EB, Cross PK, Schreinemachers DM. Chromosomal abnormality rates at amniocentesis and in live-born infants. JAMA J Am Med Assoc. 1983;249:2034–8. CrossRef
- Differences in pregnancy outcomes in donor egg frozen embryo transfer (FET) cycles following preimplantation genetic screening (PGS): a single center retrospective study
Brandon J. Bankowski
Darren K. Griffin
- Springer US
Neu im Fachgebiet Gynäkologie und Geburtshilfe
Meistgelesene Bücher aus dem Fachgebiet
Mail Icon II