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Pre-implantation genetic screening reduces both ongoing pregnancy and live birth rates in over 35s

Lyon, France: Preimplantation genetic screening (PGS), often considered to hold out the best chance for older women undergoing IVF to have a pregnancy and birth, does not increase on-going pregnancy or live birth rates, an embryologist told the 23rd annual conference of the European Society of Human Reproduction and Embryology today (Wednesday 4 July). The research is published simultaneously in the New England Journal of Medicine*. Sebastiaan Mastenbroek, M.Sc, from the Centre for Reproductive Medicine of the Academic Medical Centre of the University of Amsterdam, The Netherlands, said that the results of his teams research suggested that PGS should not be carried out routinely in women of advanced maternal age.

In a randomised double-blind trial, the team compared three cycles of IVF with and without PGS in women from35 to 41 years of age. Of the 408 women, 206 of whom were given PGS and 202 were not, the ongoing pregnancy rate was considerably lower in the PGS group than in those who did not have PGS. We found that, at 12 weeks, 52 or 25% of the women in the PGS group were pregnant, whereas 74 or 37% of the control group had an ongoing pregnancy, said Mr. Mastenbroek. And the women in the PGS group also had a significantly lower live birth rate 49 or 24% as opposed to 71 or 35% of the controls.

The investigators believe that there may be a number of explanations for the failure of PGS to improve IVF outcomes in older women. It is possible that the biopsy of a cell from an early embryo on day 3 after conception hampers the potential of an embryo to successfully implant, said Mr. Mastenbroek, though the effect of biopsy alone on pregnancy rates has not been studied.

Furthermore, say the investigators, the limitation on the number of chromosomes that can be analysed could lead to the transfer of embryos that appear normal but are in fact abnormal for one or more chromosomes not tested. Finally, many embryos resulting fr
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Contact: Mary Rice
mary@mrcommunication.org
European Society for Human Reproduction and Embryology
4-Jul-2007


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