Neonatal outcome after preimplantation genetic diagnosis

In 242 preimplantation genetic diagnoses, 242 intracytoplasmic sperm injections, and 733 spontaneous pregnancies, prematurity was more common after ICSI or PGD; intrauterine growth restriction was more common only after ICSI.

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Authors

Talia Eldar-Geva, M.D., Ph.D., Naama Srebnik, M.D., Gheona Altarescu, M.D., Irit Varshaver, M.Sc., Baruch Brooks, Ph.D., Ephrat Levy-Lahad, M.D., Ruben Bromiker, M.D., Michael S. Schimmel, M.D.

Volume 102, Issue 4, Pages 1016-1021

Abstract

Objective:

To examine whether embryo biopsy for preimplantation genetic diagnosis (PGD) influences neonatal outcomes.

Design:

Prospective follow-up cohort.

Setting:

Tertiary university-affiliated medical center.

Patient(s):

242 children born after PGD, 242 children born after intracytoplasmic sperm injection (ICSI) (158 singletons and 42 twins pairs in each group), and 733 children born after a spontaneous conception (SC) (493 singletons, 120 twins pairs), matched for maternal age, parity, and body mass index.

Intervention(s):

None.

Main Outcome Measure(s):

Gestational age, birth weight, prematurity (<37 and <34 weeks), low birth weight (<2,500 g, very low birth weight, <1,500 g), and intrauterine growth restriction (<10th percentile for gestational age). Result(s):

For singletons, the mean birth weight was higher after SC compared with ICSI but not compared with PGD. Mean gestational ages were lower after PGD and ICSI compared with SC. The low birth weight and intrauterine growth restriction rates were 4.4%, 12.0%, and 5.7% and 5.1%, 9.5%, and 5.5% for PGD, ICSI, and SC, respectively. Similar results were found when controlled for the number of embryos transferred and cryopreservation. The results for twins exhibited similar but less statistically significant trends. Polar body and blastomere biopsies provided similar outcomes.

Conclusion(s):

Embryo biopsy itself did not cause intrauterine growth restriction or low birth weight compared with SC, despite lower gestational ages with PGD. The worsened outcomes in ICSI compared with PGD pregnancies may be due to the infertility itself.

Read the full text at: http://www.fertstert.org/article/S0015-0282(14)00569-X/fulltext


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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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