A study highlights the usefulness of PGS in patients with repeated implantation failure
The usefulness of preimplantation genetic screening (PGS) in patients with repeated implantation failure remains to be scientifically proven due to the lack of randomised studies making use of current testing approaches. However, it is known that the presence of chromosomal abnormalities in the embryo is one of the main causes behind the problem.
However, a prospective non-randomized study in patients with a long history of previous implantation failure (more than 6 unsuccessful embryo transfers) conducted by Dr. Marta Devesa from the Reproductive Medicine Service of Dexeus Women's Health yielded very promising results in this regard, as it investigated the relationship between PGS with trophectoderm biopsy and testing of all chromosomes, and the cumulative rate of pregnancies and live births per patient.
A total of 38 couples participated in the study, which excluded women aged 39 years or older or with known possible causes for implantation failure, such as an abnormal karyotype, thrombophilia, autoimmune disorders, uterine abnormalities, severe male factor or hydrosalpinx.
For the purposes of PGS, trophectoderm biopsy was performed in embryos at the blastocyst stage. The percentage of euploid embryos obtained was 52%, and a total of 50 embryo transfers (ET) were performed, eight using a natural cycle and 42 using a substituted cycle. The implantation rate was 56.3% and the ongoing pregnancy (>20 weeks) or live birth rate after ET was 58%. The cumulative ongoing pregnancy and live birth rate per patient was 76.3%.
The authors of the study therefore concluded that PGS should be offered to women with a history of repeat implantation failure, although when the transfer of an euploid embryo fails, other factors must be ruled out, while it should be borne in mind that mosaicism cannot.
Cumulative live birth rate after implantation genetic screening in repeated implantation failure: is there still a place for replacing genetically unscreened embryos? Cumulative live birth rate after implantation genetic screening in repeated implantation failure: is there still a place for replacing genetically unscreened embryos?
Devesa M1, Coroleu B1, Parriego M1, Coll, L1, Martinez F1, Rodriguez I1, Barri PN1
1 Reproductive Medicine Service. Department of Obstetrics, Gynaecology and Reproductive Medicine. Dexeus University Hospital, Barcelona, Spain
See scientific poster (PDF)