Aneuploid embryo transfer: clinical policies and provider opinions at United States fertility clinics

There is no consensus regarding clinical policies for transfer of aneuploid embryos. Provider opinions vary widely and were most agreeable for trisomy 21 but least agreeable for trisomy 18.

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Volume 114, Issue 1, Pages 110–117

Authors:

Rebecca McGowan, M.S., Valentina Pilipenko, Ph.D., Teresa A. Smolarek, Ph.D., FACMG, Elizabeth West, RN, BSN, Leandra K. Tolusso, M.S., CGC.

Abstract:

Objective

To describe institutional clinical policies and individual provider opinions regarding aneuploid embryo transfer (aET).

Design

A survey about clinical policies was electronically sent to Society for Assisted Reproductive Technology (SART) member laboratory directors, and a separate survey about personal opinions was electronically sent to all SART members.

Setting

Not applicable.

Patients

Patients pursuing preimplantation genetic testing for aneuploidy (PGT-A).

Intervention

Not applicable.

Main Outcome Measures

Current clinical policies about aET were described. Individual provider opinions about aET in the context of specific aneuploidies and mosaicism were also described.

Results

A total of 48 laboratory directors and 212 individual providers responded to their respective surveys. Twelve (25%) clinics report that they do not have a policy regarding aET, but clinics performing PGT-A in >100 cycles per year were more likely to have a policy. Half of the individual providers agree that an embryo with trisomy 21 should be available for aET, but most disagreed with aET of embryos with other aneuploidies and most were either unsure about or unwilling to transfer embryos with mosaicism. Those who worked in primarily patient-facing roles held more agreeable opinions regarding aET.

Conclusion

There is no consensus regarding ideal clinical policies for aET. The wide range of current clinical practices and individual provider opinions regarding under what circumstances, if any, aET should be available to patients indicates that this is a divisive issue among ART providers, and there is a clear need for specific professional guidelines to address this issue.

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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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