Effectiveness of in vitro fertilization with preimplantation genetic screening: a reanalysis of United States assisted reproductive technology data 2011–2012

Preimplantation genetic screening performed in fresh in vitro fertilization cycles during 2011–2012 decreased chances of live birth for most patients. Older women observed small improvements, which are likely consequence of favorable patient selection biases.

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Authors

Vitaly A. Kushnir, M.D., Sarah K. Darmon, Ph.D., David F. Albertini, Ph.D., David H. Barad, M.D., Norbert Gleicher, M.D.

Abstract

Objective

To assess effectiveness of preimplantation genetic screening (PGS) in fresh IVF cycles.

Design

Reanalysis of retrospective US national data.

Setting

Not applicable.

Patient(s)

A total of 5,471 fresh autologous IVF cycles with PGS and 97,069 cycles without PGS, reported in 2011–2012 to the Centers for Disease Control and Prevention.

Intervention(s)

Not applicable.

Main Outcome Measure(s)

Cycles that reached ET, miscarriage rates, live birth rates per cycle and per transfer.

Result(s)

More PGS than non-PGS cycles reached ET (64.2% vs. 62.3%), suggesting favorable patient selection bias for patients using PGS. Nevertheless, live births rates per cycle start (25.2% vs. 28.8%) and per ET (39.3% vs. 46.2%) were significantly better in non-PGS cycles, whereas miscarriage rates were similar (13.7% vs. 13.9%). With a maternal age >37 years significantly more cycles in the PGS group reached ET (53.1% vs. 41.9%), suggesting a significant selection bias for more favorable patients in the PGS population. This bias rather than the PGS procedure may partially explain the observed improved live birth rate per cycle (17.7% vs. 12.7%) and lower miscarriage rate (16.8% vs. 26.0%) in the older PGS group.

Conclusion(s)

Overall, PGS decreased chances of live birth in association with IVF. National improvements in live birth and miscarriage rates reported with PGS in older women are likely the consequence of favorable patient selection biases.

Read the full text at: http://www.fertstert.org/article/S0015-0282(16)001...

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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