Noninvasive preimplantation genetic testing for aneuploidy: Is the glass half-empty or half-full?

Reflections

Like Comment
Related Content

VOLUME 115, ISSUE 6, P1426-1427

Authors:

Carmen Rubio, Ph.D., Carlos Simón, M.D., Ph.D.

Abstract:

Reflections on "Noninvasive preimplantation genetic testing for aneuploidy exhibits high rates of DNA amplification failure and poor correlation with results obtained using trophectoderm biopsy" by Hanson et al.

Read the full text here. 

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. 

Comments

Go to the profile of Pandiyan  Natarajan
about 5 hours ago
Noninvasive preimplantation genetic testing for aneuploidy: Is the glass half-empty or half-full?

The Glass has untested water. It does not matter if it is Half Empty or Half Full.

I read with interest the thought provoking article by the authors. On the face of it, it looks like that Non invasive Preimplantation Genetic Testing is the way forward compared with the currently practiced Invasive Trophoblast Biopsy. However, with the current uncertainty about the usefullness of PGT-A in low risk patients, should we be moving forward with Non invasive preimplantation genetic testing. We still do not know as to where do these cell free DNA come from. Are they from the Inner Cell mass which forms the fetus or from the trophoblast which forms the placenta. Placental mosaicism is well documented. 

We need a leap of faith at this stage to consider cfDNA in spent culture media as representative of the fetus. We do not yet know for sure the Positive Predicative and the Negative Predictive Value of this test. Early introduction without adequate data may lead to healthy embryos being lost and abnormal embryos being replaced.

At the present stage I feel the glass has untested water. So, it is safer to wait until more data is available to put this into clinical practice. (outside of Registered clinical trials).

Professor Dr Pandiyan Natarajan,

Chief Consultant in Andrology and Reproductive Medicine, ( Retired )

Chettinad Super Speciality Hospital,

Kelambakkam, Chennai, India- 603103.