Sequential embryo scoring as a predictor of aneuploidy in poor-prognosis patients.

The delivery rates of 298 patients having preimplantation genetic diagnosis with aneuploidy screening (PGS) were compared with the delivery rates of 144 PGS patients that cancelled the plan for PGS with embryo transfer on day 2 or day 3. The goal of this study was to compare the impact of embryo de-selection with PGS to embryo selection using sequential embryo scoring (SES) on outcome in poor-prognosis patients. Embryos with good sequential scores were more likely to have a normal PGS result than embryos with poor SES scores (34% versus 12%; P<0.05). Patients proceeding with PGS had an overall delivery rate of 15% per oocyte retrieval. There was a significant difference in delivery rates between patients with less than six embryos and patients with greater than six embryos (6% versus 19%; P<0.005). The overall delivery rate for patients having transfers without PGS was 23% (P<0.05 compared with PGS patients) with no difference between low and good responders. It was concluded that PGS neither enhanced nor impaired delivery rates in high responding poor-prognosis patients yet SES may be more accurate than PGS as a means of selection for low-responding poor-prognosis patients.