Worldwide live births following the transfer of chromosomally “Abnormal” embryos after PGT/A: results of a worldwide web-based survey

Springer Science and Business Media LLC - Tập 36 - Trang 1599-1607 - 2019
Pasquale Patrizio1, Gon Shoham2, Zeev Shoham3,4, Milton Leong5, David H. Barad6,7, Norbert Gleicher6,7,8,9
1Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Reproductive Medicine and Infertility, Yale University, New Haven, USA
2Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
3Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Kaplan Hospital, Rehovot, Israel
4Hadassah School of Medicine, Hebrew University, Jerusalem, Israel
5IVF Clinic, The Women’s Clinic, Central, Hong Kong
6The Center for Human Reproduction, New York, USA
7The Foundation for Reproductive Medicine, New York, USA
8Laboratory for Stem Cell and Molecular Embryology, New York, USA
9The Department of Obstetrics and Gynecology, Vienna School of Medicine, Vienna, Austria

Tóm tắt

Preimplantation genetic testing for aneuploidy (PGT-A) has become increasingly controversial since normal euploid births have been reported following transfer of embryos diagnosed as “abnormal.” There is an increasing trend in transferring “abnormal” embryos; but it is still unknown how many IVF centers transfer “abnormal” embryos and with what efficiency. We performed a worldwide web-survey of IVF centers to elucidate PGT-A related practice patterns including transfer of human embryos found “abnormal” by PGT-A. Participating centers reflected in vitro fertilization (IVF) cycles in the USA, Canada, Europe, Asia, South America, and Africa. One hundred fifty-one IVF centers completed the survey; 125 (83%) reported utilization of PGT-A. Europe had the highest utilization (32.3%), followed by the USA and Canada combined at 29.1%. The leading indications for PGT-A were advanced maternal age (77%), followed by recurrent implantation failure (70%), unexplained pregnancy loss (65%), and sex determination (25%); 14% of respondents used PGT-A for all of their IVF cycles; 20% of IVF units reported transfers of chromosomally “abnormal” embryos, and 56% of these took place in the USA, followed by Asia in 20%. Remarkably, 106 (49.3%) cycles resulted in ongoing pregnancies (n = 50) or live births (n = 56). Miscarriages were rare (n = 20; 9.3%). The transfers of “abnormal” embryos by PGT-A offered robust pregnancy and live birth chances with low miscarriage rates. These data further strengthen the argument that PGT-A cannot reliably determine which embryos should or should not be transferred and leads to disposal of many normal embryos with excellent pregnancy potential.

Tài liệu tham khảo

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