Pasquale Patrizio1, Gon Shoham2, Zeev Shoham3,4, Milton Leong5, David H Barad6,7, Norbert Gleicher6,7,8,9. 1. Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Reproductive Medicine and Infertility, Yale University, New Haven, CT, USA. pasquale.patrizio@yale.edu. 2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 3. Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Kaplan Hospital, Rehovot, Israel. 4. Hadassah School of Medicine, Hebrew University, Jerusalem, Israel. 5. IVF Clinic, The Women's Clinic, 12F, Central Tower, 28 Queen's Road Central, Central, Hong Kong. 6. The Center for Human Reproduction, New York, NY, USA. 7. The Foundation for Reproductive Medicine, New York, NY, USA. 8. Laboratory for Stem Cell and Molecular Embryology, The Rockefeller University, New York, NY, USA. 9. The Department of Obstetrics and Gynecology, Vienna School of Medicine, Vienna, Austria.
Abstract
PURPOSE: 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. METHODS: 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. RESULTS: 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%). CONCLUSIONS: 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.
PURPOSE: 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. METHODS: 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. RESULTS: 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%). CONCLUSIONS: 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.
Authors: Gayathree Murugappan; Lora K Shahine; Candice O Perfetto; Lee R Hickok; Ruth B Lathi Journal: Hum Reprod Date: 2016-06-07 Impact factor: 6.918
Authors: Santiago Munné; Joshua Blazek; Michael Large; Pedro A Martinez-Ortiz; Haley Nisson; Emmeline Liu; Nicoletta Tarozzi; Andrea Borini; Amie Becker; John Zhang; Susan Maxwell; James Grifo; Dhruti Babariya; Dagan Wells; Elpida Fragouli Journal: Fertil Steril Date: 2017-06-01 Impact factor: 7.329
Authors: Norbert Gleicher; Andrea Vidali; Jeffrey Braverman; Vitaly A Kushnir; David H Barad; Cynthia Hudson; Yang-Guan Wu; Qi Wang; Lin Zhang; David F Albertini Journal: Reprod Biol Endocrinol Date: 2016-09-05 Impact factor: 5.211
Authors: Min Yang; Tiago Rito; Jakob Metzger; Jeffrey Naftaly; Rohan Soman; Jianjun Hu; David F Albertini; David H Barad; Ali H Brivanlou; Norbert Gleicher Journal: Nat Cell Biol Date: 2021-04-09 Impact factor: 28.824
Authors: Lewis Nancarrow; Nicola Tempest; Andrew J Drakeley; Roy Homburg; Richard Russell; Dharani K Hapangama Journal: J Clin Med Date: 2021-06-27 Impact factor: 4.241