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Shelby A Neal, Scott J Morin, Jason M Franasiak, Linnea R Goodman, Caroline R Juneau, Eric J Forman, Marie D Werner, Richard T Scott
OBJECTIVE: To determine if preimplantation genetic testing for aneuploidy (PGT-A) is cost-effective for patients undergoing in vitro fertilization (IVF). DESIGN: Decision analytic model comparing costs and clinical outcomes of two strategies: IVF with and without PGT-A. SETTING: Genetics laboratory. PATIENTS: Women ≤ 42 years of age undergoing IVF. INTERVENTION(S): Decision analytic model applied to the above patient population utilizing a combination of actual clinical data and assumptions from the literature regarding the outcomes of IVF with and without PGT-A...
October 2018: Fertility and Sterility
Antonio Capalbo, Valeria Romanelli, Cristina Patassini, Maurizio Poli, Laura Girardi, Adriano Giancani, Marta Stoppa, Danilo Cimadomo, Filippo Maria Ubaldi, Laura Rienzi
OBJECTIVE: To determine whether blastocoel fluid (BF) or spent blastocyst medium (SBM) is a suitable template for genotype and/or karyotype assessment of in vitro fertilization-generated embryos. DESIGN: Prospective blinded study. SETTING: Genetic laboratory. PATIENT(S): From 26 patients undergoing preimplantation genetic testing (PGT) treatments, 103 trophectoderms (TE), 92 BF samples, and 72 SBM samples. INTERVENTION(S): The BF and SBM were retrieved at the time of TE biopsy...
October 2018: Fertility and Sterility
Tesia G Kim, Michael F Neblett, Lisa M Shandley, Kenan Omurtag, Heather S Hipp, Jennifer F Kawwass
BACKGROUND: The growing use of preimplantation genetic testing (PGT) with in-vitro fertilization has provided clinicians with more information about the genetics of embryos. Embryos, however, sometimes result with a mixed composition of both aneuploid and euploid cells, called "mosaic embryos." The interpretation of these results has varied, leading some clinicians to transfer mosaic embryos and some opt not to. In addition, labs providing PGT for aneuploidy have differing thresholds for determining an embryo aneuploid, mosaic, or euploid...
September 29, 2018: American Journal of Obstetrics and Gynecology
Danilo Cimadomo, Antonio Capalbo, Paolo Emanuele Levi-Setti, Daria Soscia, Giovanna Orlando, Elena Albani, Valentina Parini, Marta Stoppa, Lisa Dovere, Luisa Tacconi, Elena Ievoli, Roberta Maggiulli, Filippo Maria Ubaldi, Laura Rienzi
STUDY QUESTION: Are trophectoderm biopsy or other pre-vitrification features or laboratory practices associated with differences in blastocyst post-warming behavior (degeneration, re-expansion and live birth after single embryo transfer (SET))? SUMMARY ANSWER: Blastocyst morphology, day of full development and artificial shrinkage (either laser-assisted or biopsy-induced) are the pre-vitrification parameters/practices most strongly associated with post-warming behavior and implantation potential while there was no association with trophectoderm biopsy...
September 28, 2018: Human Reproduction
Danilo Cimadomo, Laura Rienzi, Valeria Romanelli, Erminia Alviggi, Paolo Emanuele Levi-Setti, Elena Albani, Ludovica Dusi, Letizia Papini, Claudia Livi, Francesca Benini, Antonella Smeraldi, Cristina Patassini, Filippo Maria Ubaldi, Antonio Capalbo
STUDY QUESTION: Can a second round of biopsy, vitrification and chromosomal testing provide a valid diagnosis where the first attempt fails? SUMMARY ANSWER: The risk of inconclusive chromosomal-assessment after trophectoderm biopsy was 2.5% but a further biopsy and vitrification-warming appeared not to impair the competence of euploid blastocysts. WHAT IS KNOWN ALREADY: The increasing implementation of multicell trophectoderm biopsy has significantly reduced the risk of inconclusive diagnosis after preimplantation-genetic-testing (PGT)...
September 18, 2018: Human Reproduction
Santiago Munné
At the recent 2018 PGDIS congress, a review of randomized controlled trials of preimplantation genetic testing for aneuploidies (PGT-A) showed improved ongoing pregnancy rates per transfer in experienced centres and in women aged 35 years and older. Young women produce 40% abnormal embryos (20-60% range), but not all centres see a selection advantage; this indicates the need for more emphasis in improving biopsy and case management. Some chromosome abnormalities are iatrogenic; PGT-A could, therefore, be used as assisted reproductive technology (ART) quality control...
August 20, 2018: Reproductive Biomedicine Online
Shuang Zhou, Dehua Cheng, Qi Ouyang, Pingyuan Xie, Changfu Lu, Fei Gong, Liang Hu, Yueqiu Tan, Guangxiu Lu, Ge Lin
RESEARCH QUESTION: What is the prevalence and authenticity of de-novo segmental aneuploidies (>16 Mb) detected by next-generation sequencing (NGS) in human preimplantation blastocysts? DESIGN: Between April 2013 and June 2016, 5735 blastocysts from 1854 couples (average age 33.11 ± 5.65 years) underwent preimplantation genetic testing for chromosomal structural rearrangement (PGT-SR) or for aneuploidy (PGT-A) using NGS on trophectoderm (TE) biopsy samples. The prevalence of de-novo segmental aneuploidy was calculated from these results...
August 29, 2018: Reproductive Biomedicine Online
Kabir Sachdeva, Divyesh Upadhyay, Richard Discutido, Merlin Mary Varghese, Firas Albuz, Rawan Almekosh, Linda Bouhafs, Sadika Solkar, Martina Stevikova, Braulio Peramo
BACKGROUND: Retrospective analysis of embryo aneuploidy in patients undergoing in vitro fertilization (IVF) cycles. AIM: To evaluate factors that might affect the incidence of embryo aneuploidy during IVF cycles. METHODS: Three hundred twelve IVF cases were included in the present study. Preimplantation genetic testing for aneuploidy (PGT-A) was performed for all the subjects involved in the study. Subject stratification was done based on maternal age, gonadotropin drug dosage, and IVF outcomes data...
September 7, 2018: Genetic Testing and Molecular Biomarkers
Monica Parriego, Lluc Coll, Francesca Vidal, Montserrat Boada, Marta Devesa, Buenaventura Coroleu, Anna Veiga
The transition in biopsy timing from blastomere to trophectoderm biopsy has led to a remarkable decrease in the percentage of undiagnosed blastocysts. However, patients with few or no euploid blastocysts can be affected by this residual percentage of diagnosis failure. The aim of this study is to assess whether blastocyst rebiopsy and revitrification is an efficient and safe procedure to be applied in cases of no results after analysis. Fifty-three patients agreed to the warming of 61 blastocysts to perform a second biopsy and PGT-A by aCGH...
September 5, 2018: Gynecological Endocrinology
Susan M Maxwell, James A Grifo
Aneuploid conceptions constitute the majority of pregnancy failures in women of advanced maternal age. The best way to combat age-related decline in fertility is through preimplantation genetic testing for aneuploidy (PGT-A). PGT-A allows for better embryo selection, which improves implantation rates with single embryo transfer and reduces miscarriage rates. Single embryo transfers decrease multiple gestations and adverse pregnancy outcomes such as preterm or low birth weight infants. Advancements in extended embryo culture, blastocyst biopsy techniques, and 24-chromosome aneuploidy screening platforms have made PGT-A safe and accessible for all patients who undergo in vitro fertilization...
July 25, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
Alberto Liñán, Barbara Lawrenz, Ibrahim El Khatib, Asina Bayram, Ana Arnanz, Carmen Rubio, Rupali Chopra, Human M Fatemi
One of the most important limitations of genetic testing in preimplantation embryos is embryonic mosaicism, especially when performed on D3 with only a single blastomere evaluated. Previous publications, using Array-Comparative Genomic Hybridization (a-CGH) to compare day 3 (D3) biopsies versus trophectoderm biopsies for the analysis of aneuploid embryos, showed similar high concordance rates per embryo diagnosis for D3 biopsies and trophectoderm biopsies. Next generation sequencing (NGS) was introduced lately as a new technique for preimplantation genetic testing for aneuploidies (PGT-A)...
2018: PloS One
Willem Verpoest, Catherine Staessen, Patrick M Bossuyt, Veerle Goossens, Gheona Altarescu, Maryse Bonduelle, Martha Devesa, Talia Eldar-Geva, Luca Gianaroli, Georg Griesinger, Georgia Kakourou, Georgia Kokkali, Jana Liebenthron, Maria-Cristina Magli, Monica Parriego, Andreas G Schmutzler, Monica Tobler, Katrin van der Ven, Joep Geraedts, Karen Sermon
STUDY QUESTION: Does preimplantation genetic testing for aneuploidy (PGT-A) by comprehensive chromosome screening (CCS) of the first and second polar body to select embryos for transfer increase the likelihood of a live birth within 1 year in advanced maternal age women aged 36-40 years planning an ICSI cycle, compared to ICSI without chromosome analysis? SUMMARY ANSWER: PGT-A by CCS in the first and second polar body to select euploid embryos for transfer does not substantially increase the live birth rate in women aged 36-40 years...
September 1, 2018: Human Reproduction
Brandy Lamb, Erin Johnson, Leslie Francis, Melinda Fagan, Naomi Riches, Isabella Canada, Alena Wilson, Amber Mathiesen, Maya Sabatello, Shawn Gurtcheff, Erica Johnstone, Erin Rothwell
PURPOSE: Embryo testing to improve pregnancy outcomes among individuals who are seeking assisted reproduction technologies is increasing. The purpose of this study was to assess decisional factors through in-depth interviews for why women would accept or decline preimplantation genetic testing for aneuploidy (PGT-A) with in vitro fertilization (IVF). METHODS: Semi-structured telephone interviews were conducted with 37 women who were offered PGT-A with IVF during the summer 2017...
September 2018: Journal of Assisted Reproduction and Genetics
Randi H Goldman, Catherine Racowsky, Leslie V Farland, Janis H Fox, Santiago Munné, Lia Ribustello, Elizabeth S Ginsburg
PURPOSE: To determine the expected out-of-pocket costs of IVF with preimplantation genetic testing for aneuploidy (PGT-A) to attain a 50%, 75%, or 90% likelihood of a euploid blastocyst based on individual age and AMH, and develop a personalized counseling tool. METHODS: A cost analysis was performed and a counseling tool was developed using retrospective data from IVF cycles intended for PGT or blastocyst freeze-all between January 1, 2014 and August 31, 2017 (n = 330) and aggregate statistics on euploidy rates of > 149,000 embryos from CooperGenomics...
September 2018: Journal of Assisted Reproduction and Genetics
S J Morin, G Patounakis, C R Juneau, S A Neal, R T Scott, E Seli
STUDY QUESTION: Do infertile women aged <38 years with quantitative evidence of diminished ovarian reserve and/or poor response to stimulation also exhibit poor oocyte quality as measured by blastulation rates, aneuploidy rates, and live birth rates? SUMMARY ANSWER: Young women with evidence of accelerated follicular depletion, either by precycle ovarian reserve testing or postcycle evidence of low oocyte yield, exhibit equivalent blastulation rates, aneuploidy rates and live birth rates per euploid embryo transfer as age-matched controls with normal precycle and postcycle parameters...
July 11, 2018: Human Reproduction
Xavier Viñals Gonzalez, Rabi Odia, Suzanne Cawood, Matthew Gaunt, Wael Saab, Srividya Seshadri, Paul Serhal
PURPOSE: The aim of the study is to investigate how blastocyst contraction behaviour affects the reproductive competence in high-quality euploid embryos. METHODS: Eight hundred ninety-six high-quality blastocysts derived from 190 patients (mean age 38.05 (SD = 2.9) years) who underwent preimplantation genetic testing for aneuploidies (PGT-A) from January 2016 to October 2017 were included in this study. PGT-A results were reported as euploid or aneuploid. Aneuploid embryos were sub-classified into three categories: monosomy, trisomy and complex aneuploid...
August 2018: Journal of Assisted Reproduction and Genetics
Jacqueline R Ho, Nabil Arrach, Katherine Rhodes-Long, Ali Ahmady, Sue Ingles, Karine Chung, Kristin A Bendikson, Richard J Paulson, Lynda K McGinnis
OBJECTIVE: To determine the accuracy of cell-free DNA (cfDNA) in spent embryo medium (SEM) for ploidy and sex detection at the cleavage and blastocyst stages. To determine if assisted hatching (AH) and morphologic grade influence cfDNA concentration and accuracy. DESIGN: Prospective cohort. SETTING: Academic fertility center. PATIENT(S): Nine patients undergoing IVF; 41 donated two-pronuclei embryos and 20 embryos from patients undergoing preimplantation genetic testing for aneuploidy (PGT-A)...
August 2018: Fertility and Sterility
Darren K Griffin, Cagri Ogur
Designed to minimize chances of genetically abnormal embryos, preimplantation genetic diagnosis (PGD) involves in vitro fertilization (IVF), embryo biopsy, diagnosis and selective embryo transfer. Preimplantation genetic testing for aneuploidy (PGT-A) aims to avoid miscarriage and live born trisomic offspring and to improve IVF success. Diagnostic approaches include fluorescence in situ hybridization (FISH) and more contemporary comprehensive chromosome screening (CCS) including array comparative genomic hybridization (aCGH), quantitative polymerase chain reaction (PCR), next-generation sequencing (NGS) and karyomapping...
July 2018: Reproduction: the Official Journal of the Society for the Study of Fertility
Danilo Cimadomo, Alberto Vaiarelli, Silvia Colamaria, Elisabetta Trabucco, Carlo Alviggi, Roberta Venturella, Erminia Alviggi, Ramona Carmelo, Laura Rienzi, Filippo Maria Ubaldi
STUDY QUESTION: Are the mean numbers of blastocysts obtained from sibling cohorts of oocytes recruited after follicular phase and luteal phase stimulations (FPS and LPS) in the same ovarian cycle similar? SUMMARY ANSWER: The cohorts of oocytes obtained after LPS are larger than their paired-FPS-derived cohorts and show a comparable competence, thus resulting in a larger mean number of blastocysts. WHAT IS KNOWN ALREADY: Three theories of follicle recruitment have been postulated to date: (i) the 'continuous recruitment' theory, (ii) the 'single recruitment episode' theory and (iii) the 'wave' theory...
June 15, 2018: Human Reproduction
Alexander L Simon, Michelle Kiehl, Erin Fischer, J Glenn Proctor, Mark R Bush, Carolyn Givens, Matthew Rabinowitz, Zachary P Demko
OBJECTIVE: To measure in vitro fertilization (IVF) outcomes following 24-chromosome single‒nucleotide-polymorphism (SNP)-based preimplantation genetic testing for aneuploidy (PGT-A) and euploid embryo transfer. DESIGN: Retrospective. SETTING: Fertility clinics and laboratory. PATIENT(S): Women 20-46 years of age undergoing IVF treatment. INTERVENTION(S): Twenty-four-chromosome SNP-based PGT-A of day 5/6 embryo biopsies...
July 1, 2018: Fertility and Sterility
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