November 2, 2017

Embryo Selection Based on Preimplantation Genetic Screening Does Not Improve Pregnancy Rates

By Denise Baez

SAN ANTONIO, Tex -- November 2, 2017 -- There appears to be no benefit to selecting an embryo based on preimplantation genetic information, compared with embryo selection based on morphologic assessment, in women undergoing in vitro fertilisation (IVF) with frozen embryo transfer, according to a study presented here on October 30 at the 2017 Annual Meeting of the American Society for Reproductive Medicine (ASRM).

The ongoing pregnancy rate (OPR) at 20 weeks’ gestation -- the primary endpoint of the study -- was 49.6% among the 274 women who received preimplantation genetic screening and 45.9% among the 314 women whose embryo was selected based on morphology (P = .3369).

“This multicentre study did not replicate earlier, more tightly controlled, single-centre studies which showed a benefit of preimplantation genetic screening in all patients,” reported Santiago Munne, CooperGenomics, Livingston, New Jersey, and colleagues.

However, a small benefit was observed for women aged 35 to 40 years, with an OPR of 50.8% among those who received preimplantation genetic screening and an OPR of 37.2% in the control arm. Miscarriage rates in this subgroup were 8.2% and 11.0%, respectively.

“A benefit with preimplantation genetic screening in women 35 years and older, despite the low miscarriage rate in the control arm, is consistent with the 2014 SART data,” the authors noted.

The current study included 323 women aged 25 to 34 years, 170 women aged 35 to 37 years, and 95 women aged 38 to 40 years who were undergoing IVF at 34 sites in 4 countries between 2014 and 2016.

Women were randomised 1:1 on day 5 or 6 of embryo culture to embryo selection by next-generation sequencing-based preimplantation screening or to embryo selection based on morphologic assessment. In both arms, blastocyst-stage embryos underwent vitrification for single embryo transfer in a later cycle.

Preimplantation genetic screening was performed at 9 laboratories, with each lab following its own internally validated testing and reporting processes for IVF procedures.

“These results suggest that standardisation of clinical and laboratory protocols are essential for future studies,” the authors concluded.

Funding for this study was provided by Illumina, Inc.

[Presentation title: Global Multicenter Randomized Controlled Trial Comparing Single Embryo Transfer With Embryo Selected by Preimplantation Genetic Screening Using Next-Generation Sequencing Versus Morphologic Assessment. Abstract O-43]

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