Should every embryo undergo preimplantation genetic testing for aneuploidy? A review of the modern approach to in vitro fertilization

Best Practice & Research. Clinical Obstetrics & Gynaecology
Susan M Maxwell, James A Grifo

Abstract

Aneuploid conceptions constitute the majority of pregnancy failures in women of advanced maternal age. The best way to combat age-related decline in fertility is through preimplantation genetic testing for aneuploidy (PGT-A). PGT-A allows for better embryo selection, which improves implantation rates with single embryo transfer and reduces miscarriage rates. Single embryo transfers decrease multiple gestations and adverse pregnancy outcomes such as preterm or low birth weight infants. Advancements in extended embryo culture, blastocyst biopsy techniques, and 24-chromosome aneuploidy screening platforms have made PGT-A safe and accessible for all patients who undergo in vitro fertilization. Improved genomic coverage of new sequencing platforms, such as next-generation sequencing, has increased the identification and diagnosis of mosaicism and partial aneuploidies in preimplantation embryos. Mosaic embryos have decreased viability compared to euploid embryos when transferred, but some mosaic embryos result in normal live births. Whole genome amplification artifacts may contribute to a misdiagnosis of mosaicism, or some mosaic embryos may self-correct to euploid after implantation. For this reason, patients without euploid embryos...Continue Reading

Citations

Jan 10, 2019·Current Opinion in Obstetrics & Gynecology·Yiu-Man ChanLiona C Y Poon
Apr 18, 2019·Systems Biology in Reproductive Medicine·Michał KunickiKrzysztof Łukaszuk
Mar 11, 2020·Journal of Assisted Reproduction and Genetics·Yetunde IbrahimErica Johnstone
Oct 11, 2019·The CRISPR Journal·Manuel ViottiFrank L Barnes
Dec 11, 2020·American Journal of Reproductive Immunology : AJRI·Zahra Bahrami-AslFrancisco Dominguez
Aug 25, 2020·Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstétrique Et Gynécologie Du Canada : JOGC·Rhonda Zwingerman, Sylvie Langlois
Nov 16, 2020·Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstétrique Et Gynécologie Du Canada : JOGC·Rhonda Zwingerman, Sylvie Langlois
Jan 23, 2022·Journal of Assisted Reproduction and Genetics·Andrea AbdalaNeelke De Munck

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