Human Reproduction, Vol 12, 1762-1767, Copyright © 1997 by Oxford University Press
L Gianaroli, MC Magli, S Munne, A Fiorentino, N Montanaro and AP Ferraretti
PGD (preimplantation genetic diagnosis) of aneuploidy for chromosomes X, Y,
13, 18 and 21 was carried out on 196 embryos from 36 infertile patients
classified with a poor prognosis due to (i) maternal age, (ii) repeated
in-vitro fertilization (IVF) failures and (iii) mosaic karyotype. The
percentage of abnormal embryos was comparable in the three groups of
patients: maternal age 63%, repeated IVF failure 57%, and mosaic karyotype
62%. The analysis of the overall data revealed an increased incidence of
abnormal embryos in the older age categories (predominantly due to
aneuploidy), even in embryos at the 7- to 8-cell stage. In addition, the
percentage of chromosomally abnormal embryos was directly proportional to
the number of IVF failures, where the increase in chromosomal abnormalities
was not correlated to aneuploidy but to other aberrations such as mosaicism
and polyploidy. Following PGD, 28 patients had at least one embryo
transferred that appeared normal by fluorescent in-situ hybridization
(FISH). Four clinical pregnancies resulted, with an implantation rate of
10% per normal embryo. In conclusion, the high rate of chromosomally
abnormal embryos in poor prognosis patients may have been the cause of
implantation failure in their previous IVF cycles. Therefore, the
possibility of transferring embryos with a normal FISH complement could
improve the chance of pregnancy in this category of patients.
ARTICLES
Will preimplantation genetic diagnosis assist patients with a poor prognosis to achieve pregnancy?
S.I.S.M.E.R., Reproductive Medicine Unit, Bologna, Italy.
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