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	Full Text PDF PDA Full Text PowerPoint Slide Set Editorial by Collins, J. A. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

Background Pregnancy rates in women of advanced maternal age undergoing in vitro fertilization (IVF) are disappointingly low. It has been suggested that the use of preimplantation genetic screening of cleavage-stage embryos for aneuploidies may improve the effectiveness of IVF in these women.

Methods We conducted a multicenter, randomized, double-blind, controlled trial comparing three cycles of IVF with and without preimplantation genetic screening in women 35 through 41 years of age. The primary outcome measure was ongoing pregnancy at 12 weeks of gestation. The secondary outcome measures were biochemical pregnancy, clinical pregnancy, miscarriage, and live birth.

Results Four hundred eight women (206 assigned to preimplantation genetic screening and 202 assigned to the control group) underwent 836 cycles of IVF (434 cycles with and 402 cycles without preimplantation genetic screening). The ongoing-pregnancy rate was significantly lower in the women assigned to preimplantation genetic screening (52 of 206 women [25%]) than in those not assigned to preimplantation genetic screening (74 of 202 women [37%]; rate ratio, 0.69; 95% confidence interval [CI], 0.51 to 0.93). The women assigned to preimplantation genetic screening also had a significantly lower live-birth rate (49 of 206 women [24%] vs. 71 of 202 women [35%]; rate ratio, 0.68; 95% CI, 0.50 to 0.92).

Conclusions Preimplantation genetic screening did not increase but instead significantly reduced the rates of ongoing pregnancies and live births after IVF in women of advanced maternal age. (Current Controlled Trials number, ISRCTN76355836 [controlled-trials.com] .)

Source Information

From the Center for Reproductive Medicine (S.M., M.T., J.W.A.V., S.R., F.V.) and the Department of Clinical Epidemiology and Biostatistics (J.C.K., P.M.B.), Academic Medical Center, University of Amsterdam, Amsterdam; the Section of Reproductive Medicine, Department of Obstetrics and Gynecology (M.T., J.E.-A., N.E.A.V., E.G.J.M.A., M.J.H.), and the Department of Genetics (B.S.-R., C.H.C.M.B.), University Medical Center Groningen, University of Groningen, Groningen; and the Department of Obstetrics and Gynecology, Onze Lieve Vrouwe Gasthuis, Amsterdam (H.R.V.) — all in the Netherlands.

Address reprint requests to Dr. Repping at the Center for Reproductive Medicine, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, the Netherlands, or at s.repping{at}amc.uva.nl.

Full Text of this Article

Related Letters:

In Vitro Fertilization with Preimplantation Genetic Screening
Munné S., Cohen J., Simpson J. L., Wilton L. J., Handyside A. H., Thornhill A. R., Mastenbroek S., van der Veen F., Repping S.
Extract | Full Text | PDF  
N Engl J Med 2007; 357:1769-1771, Oct 25, 2007. Correspondence

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