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Denice Belandres, Mousa Shamonki, Nabil Arrach
In recent years, a growing body of literature has emerged investigating the clinical utility of spent embryo media (SEM) for preimplantation genetic testing for aneuploidy (PGT-A) (Hammond et al. in Fertil Steril. 107(1):220-8, 2017; Xu et al. in Proc Natl Acad Sci USA. 113(42):11907-12, 2016; Shamonki et al. in Fertil Steril. 106(6):1312-8, 2016; Feichtinger et al. in Reprod BioMed Online. 34(6):583-9, 2017; Vera-Rodriguez et al. in Hum Reprod. 33(4):745-56, 2018; Kuznyetsov et al. in PLoS One. 13(5):e0197262, 2018; Ho et al...
March 21, 2019: Journal of Assisted Reproduction and Genetics
Melanie R Freeman, M Shaun Hinds, Kay G Howard, Julie M Howard, George A Hill
PURPOSE: To provide clinicians with data showing the benefits of transferring a single blastocyst in frozen embryo transfer (FET) cycles so that they may counsel their patients accordingly. METHODS: This is a closed cohort study of 678 FET cycles occurring between January 2011 and December 2017 in a private IVF laboratory and associated physicians' practice. Patients included in the analysis were less than 38 years of age at oocyte collection, had at least two vitrified blastocysts, and were undergoing their first autologous FET cycle...
March 11, 2019: Journal of Assisted Reproduction and Genetics
M Popovic, L Dhaenens, J Taelman, A Dheedene, M Bialecka, P De Sutter, S M Chuva de Sousa Lopes, B Menten, B Heindryckx
STUDY QUESTION: What is the accuracy of preimplantation genetic testing for aneuploidies (PGT-A) when considering human peri-implantation outcomes in vitro? STUDY ANSWER: The probability of accurately diagnosing an embryo as abnormal was 100%, while the proportion of euploid embryos classified as clinically suitable was 61.9%, yet if structural and mosaic abnormalities were not considered accuracy increased to 100%, with a 0% false positive and false negative rate...
March 6, 2019: Human Reproduction
Noga Fuchs Weizman, Brandon A Wyse, Ran Antes, Zenon Ibarrientos, Mugundhine Sangaralingam, Gelareh Motamedi, Valeriy Kuznyetsov, Svetlana Madjunkova, Clifford L Librach
Improved embryo prioritization is crucial in optimizing the results in assisted reproduction, especially in light of increasing utilization of elective single embryo transfers. Embryo prioritization is currently based on morphological criteria and in some cases incorporates preimplantation genetic testing for aneuploidy (PGT-A). Recent technological advances have enabled parallel genomic and transcriptomic assessment of a single cell. Adding transcriptomic analysis to PGT-A holds promise for better understanding early embryonic development and implantation, and for enhancing available embryo prioritization tools...
February 27, 2019: Scientific Reports
Hayden Anthony Homer
Preimplantation genetic testing for aneuploidy (PGT-A) seeks to identify preimplantation embryos with a normal chromosome complement (euploid) during in vitro fertilisation (IVF). By sifting out embryos with abnormal chromosome numbers (aneuploid), PGT-A should theoretically improve pregnancy success. However, earlier versions of PGT-A were ineffective, and in some cases, detrimental, due to biopsy-induced trauma and because the technology at the time could analyse only a fraction of all chromosomes. More recently, the emergence of technologies enabling all chromosomes to be analysed and a switch to less traumatic blastocyst-stage biopsy have seen widespread uptake of PGT-A...
February 27, 2019: Australian & New Zealand Journal of Obstetrics & Gynaecology
Edgardo Somigliana, Andrea Busnelli, Alessio Paffoni, Paola Vigano, Alessandra Riccaboni, Carmen Rubio, Antonio Capalbo
OBJECTIVE: To evaluate the economical benefit of preimplantation genetic testing of aneuploidies (PGT-A) when applied in an extended culture and stringent elective single ET framework. DESIGN: Theoretical cost-effectiveness study. SETTING: Not applicable. PATIENTS/ANIMAL(S): None. INTERVENTION(S): Comparison of the cost-effectiveness between two IVF treatment strategies: serial transfer of all available blastocysts without genetic testing (first fresh transfer and subsequent frozen-thawed transfer); and systematic use of genetic testing (trophectoderm biopsy, freeze-all, and frozen-thawed transfers of euploid blastocysts)...
February 15, 2019: Fertility and Sterility
Sophelia H S Chan, Raymond H W Li, Vivian C Y Lee, Mary H Y Tang, Ernest H Y Ng
AIM: Increasing preimplantation genetic testing (PGT) cycles are being performed in Hong Kong. This study aims to evaluate the knowledge, attitude and ethical consideration of Chinese couples toward PGT. METHODS: Couples requesting PGT between June 2013 and March 2014 were invited to complete a questionnaire. RESULTS: Total 49 couples (49 women, 47 men) completed the questionnaires. Eighteen couples (37%) were waiting for PGT (pre-PGT group), 15 couples (31%) were undergoing PGT (PGT group) and 16 couples (32%) had completed at least one PGT cycle (post-PGT group)...
February 11, 2019: Journal of Obstetrics and Gynaecology Research
Yi-Hong Shao, Xiao Yun Zhang, William Buckett, Asangla Ao
OBJECTIVE(S): The aim of this study was to compare the patient characteristics, type of genetic disease and inheritance, volume of activity, practice patterns and pregnancy outcomes, in private versus publically funded IVF pre-implantation genetic testing (PGT) for translocation (IVF-PGT-SR) and aneuploidy (PGT-A) periods. STUDY DESIGN: This study retrospectively analyzed data during both privately funded period (PRP) and publically funded period (PUP) of assisted reproductive technology (ART) for a total of 275 patients...
February 8, 2019: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Haibin Zhao, Wenrong Tao, Mei Li, Hui Liu, Keliang Wu, Shuiying Ma
PURPOSE: To compare the effectiveness of two protocols of blastocyst biopsy submitted to preimplantation genetic testing for aneuploidies (PGT-A). METHODS: This is a randomized controlled trial of a cohort of 221 patients undergoing PGT-A. 106 female patients aged ≤ 40 years with no less than 8 mature oocytes retrieved and ≥ 3 good-quality embryos on day 3 were randomly assigned to the day-3 hatching-based TE biopsy. The remaining 115 females aged ≤ 40 years with ≥ 8 MII oocytes obtained and no less than 3 high-quality embryos on day 3 were assigned to the TE biopsy without hatching group (also called the new biopsy group)...
February 8, 2019: Archives of Gynecology and Obstetrics
Andrea Busnelli, Chiara Dallagiovanna, Marco Reschini, Alessio Paffoni, Luigi Fedele, Edgardo Somigliana
OBJECTIVES: To establish the risk factors for monozygotic twin (MZT) and monochorionic twin (MCT) pregnancies after in vitro fertilization (IVF). DESIGN: Systematic review and meta-analysis. SETTING: Not applicable. PATIENT(S): Women who achieved MZT and non-MZT pregnancies through IVF. INTERVENTION(S): Systematic search of Medline from January 1995 to October 2018 with cross-checking of references from relevant articles in English...
February 2019: Fertility and Sterility
Bo Liang, Yuan Gao, Jiabao Xu, Yizhi Song, Liming Xuan, Ting Shi, Ning Wang, Zhaoxu Hou, Yi-Lei Zhao, Wei E Huang, Zi-Jiang Chen
OBJECTIVE: To develop and validate Raman metabolic footprint analysis to determine chromosome euploidy and aneuploidy in embryos fertilized in vitro. DESIGN: Retrospective study. SETTING: Academic hospital. PATIENT(S): Unselected assisted reproductive technology population. INTERVENTION(S): To establish the analysis protocol, spent embryo culture medium samples with known genetic outcomes from 87 human embryos were collected and measured with the use of Raman spectroscopy...
January 22, 2019: Fertility and Sterility
Robert Fischer, Fabiana Y Nakano, Matheus Roque, Fabiola C Bento, Vera Baukloh, Sandro C Esteves
BACKGROUND: Ovarian stimulation (OS) is crucial for pregnancy success in assisted reproductive technology (ART) treatments. The possibility of programming the OS cycle and oocyte pick-up (OPU) is advantageous to Fertility Centers operating under quality management systems (QMS) as it might increase efficiency and safety. Moreover, cycle programming is patient-centered as it might help IVF patients to most optimally manage domestic and work commitments. In this study, we describe the so-called "Fischer protocol" to IVF cycle programming and present the clinical results of using this approach in two independent Fertility Centers certified according to DIN EN ISO 9001 standards...
March 2019: Panminerva Medica
Jacqueline Savard, Chriselle Hickerton, Rigan Tytherleigh, Bronwyn Terrill, Erin Turbitt, Ainsley J Newson, Brenda Wilson, Kathleen Gray, Clara Gaff, Anna Middleton, Elaine Stackpoole, Sylvia A Metcalfe
Personal genomic tests (PGTs) for multiple purposes are marketed to ostensibly healthy people in Australia. These tests are generally marketed and purchased online commercially or can be ordered through a health professional. There has been minimal engagement with Australians about their interest in and experience with ordering a PGT. As part of a multistage, interdisciplinary project, an online survey (Stage 2 of the Genioz study) was available from May 2016 to May 2017. In total, 3253 respondents attempted the survey, with 2395 completed Australian responses from people with and without experience of having a PGT: 72% were female; 59% of the whole sample were undertaking/or had a university education; and, overall, age ranged from 18-over 80...
January 21, 2019: European Journal of Human Genetics: EJHG
Sally F Vitez, Eric J Forman, Zev Williams
Miscarriage is a frequent outcome seen in obstetrics with 1 in 5 pregnancies ending in an early pregnancy loss. Aneuploidy is the most significant single factor affecting early pregnancy failure and miscarriage. The risk of aneuploidy increases significantly with increasing maternal age. There has been tremendous advancement in technology that has made preimplantation genetic testing for aneuploidy reliable and accessible. For women in their mid-to-late 30s there is great utility in the use of PGT-A to facilitate single embryo transfer, reduce the risk of clinical miscarriage and ongoing aneuploidy gestations...
December 20, 2018: Seminars in Perinatology
A Alteri, L Corti, A M Sanchez, E Rabellotti, E Papaleo, P Viganò
The recently re-named preimplantation genetic testing for determining embryo aneuploidies (PGT-A) is presently very popular although its acceptance by the scientific community is controversial. This approach still encounters drawbacks. This paper uses a SWOT (strengths, weaknesses, opportunities and threats) analysis to discuss salient points to be considered when examining the PGT-A strategy in order to gather information from a range of perspectives. One of the strength associated with the procedure is represented by an increase in implantation rate although data from the highest level of evidence do not support an increase in cumulative pregnancy rates...
January 17, 2019: Clinical Genetics
Julie Benard, Célia Targa, Fabien Murisier, Ariane Paoloni-Giacobino, Isabelle Streuli
Preimplantation genetic testing avoids the transmission of monogenic diseases or structural chromosome abnormality to the offspring in fertile couples. Furthermore, it allows screening for aneuploidies (PGT-A, Preimplantation genetic testing for aneuploidy), with the aim of selecting one euploid embryo before transfer in infertile couples undergoing in vitro fertilization (IVF). Indeed, aneuploidies are frequent and explain most IVF failures and early miscarriages. The indications for PGT-A remain controversial, due to the lack of clear evidence of improved outcomes after IVF...
January 9, 2019: Revue Médicale Suisse
Yiu-Man Chan, Tin-Chiu Li, Liona C Y Poon
PURPOSE OF REVIEW: To provide updated information on preimplantation genetic testing for aneuploidy (PGT-A), focusing on its implications on prenatal diagnostic approaches after transferal of mosaic aneuploid embryos. RECENT FINDINGS: PGT-A is a technology to screen for chromosome aneuploidy or major chromosome structural rearrangement in embryos before implantation using different cytogenetic analyses. PGT-A has been shown to reduce the negative effect of increasing maternal age on in-vitro fertilization (IVF) outcomes...
January 7, 2019: Current Opinion in Obstetrics & Gynecology
Kemal Ozgur, Murat Berkkanoglu, Hasan Bulut, Gonul Didem Akay Yoruk, Nevrah Nal Candurmaz, Kevin Coetzee
PURPOSE: This paper aims to investigate the efficacy of IVF with preimplantation genetic testing for aneuploidy (PGT-A), using only best-scoring blastocysts from young (≤ 35 years) infertile patients undergoing single blastocyst frozen embryo transfers (FET). METHOD: In this randomized controlled trial (RCT) registered 29 March 2017, 302 infertile patient-couples eligible to participate underwent autologous ICSI blastocyst freeze-all cycles. Two-hundred and twenty patient-couples satisfied the inclusion criteria (i...
January 7, 2019: Journal of Assisted Reproduction and Genetics
John B Whitney, Katie Balloch, Robert E Anderson, Nancy Nugent, Mitchel C Schiewe
OBJECTIVE: To determine if Day 7 blastocysts merit biopsy, vitrification and transfer consideration by contrasting their aneuploidy and implantation rates to Day 5 and 6 blastocysts. METHODS: A total of 1,925 blastocysts were biopsied from 402 PGT-A cycles over a 12 to 16 month interval. All embryos were cultured under tri-gas, humidified conditions (37ºC) for up to 7 days (168 hours post-insemination). Biopsied blastocysts were vitrified and trophectoderm samples analyzed using NextGen sequencing...
January 7, 2019: JBRA Assisted Reproduction
Julija Gorodeckaja, Samantha Neumann, Abeo McCollin, Christian S Ottolini, Jinjun Wang, Kamal Ahuja, Alan Handyside, Michael Summers
This study reports the results of a 2-year long IVF programme ('One by One') in which all patients (median age 40 years; range 27-45 years) were offered preimplantation genetic testing for aneuploidy (PGT-A) and had all blastocysts vitrified (freeze-only), followed later by single vitrified-warmed blastocyst transfer (vSET) in managed cycles. Between January 2016 and December 2017, a total of 155 patients started 222 treatment cycles and 99 (45%) cycles resulted in one or more vitrified blastocysts (untested or with normal copy number for all chromosomes) available for transfer...
January 7, 2019: Human Fertility: Journal of the British Fertility Society
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