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Hum. Reprod. Advance Access published online on January 17, 2008
Human Reproduction, doi:10.1093/humrep/dem424
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© The Author 2007. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

NEW DEBATE

What next for preimplantation genetic screening?

Joyce Harper1,13, Karen Sermon2, Joep Geraedts3, Katerina Vesela4, Gary Harton5, Alan Thornhill6, Tugce Pehlivan7, Francesco Fiorentino8, Sioban SenGupta1, Christine de Die-Smulders9, Cristina Magli10, Celine Moutou11 and Leeanda Wilton12

1 UCL Centre for PGD, Institute for Women's Health, University College London, 86-96 Chenies Mews, WC1E6HX London, UK 2 Department of Embryology and Genetics, Vrije Universiteit Brussel, Laarbeeklaan, 101, 1090 Brussels, Belgium 3 AZ Maastricht, Klinische Genetica, PO Box 5800, 6202 AZ Maastricht, The Netherlands 4 Sanatorium Repromeda, Vinini 235, 615 00 Brno, Czech Republic 5 Genetics and IVF Institute, 3015 Williams Drive, Fairfax, VA 22031, USA 6 The London Bridge Fertility, Gynaecology and Genetics Centre, 1 St Thomas Street, London Bridge, London SE1 9RY, UK 7 Instituto Valenciano de Infertilidad, Plaza de la Policía Local, 3, 46015 Valencia, Spain 8 GENOMA, Molecular Genetics Laboratory, Via Po 102, 00198 Rome, Italy 9 PGD Working Group Maastricht, Department of Clinical Genetics, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands 10 SISMER, Via Mazzini 12, 40138 Bologna, Italy 11 Service de la Biologie de la Reproduction, SIHCUS-CMCO, 19, Rue Louis Pasteur, BP120, 67303 Schiltigheim, France 12 Melbourne IVF, 320 Victoria Parade, East Melbourne, 3002 VIC, Australia

13 Correspondence address. E-mail: joyce.harper{at}ucl.ac.uk

Preimplantation genetic diagnosis for aneuploidy screening (preimplantation genetic screening—PGS) has been used to detect chromosomally normal embryos from subfertile patients. The main indications are advanced maternal age (AMA), repeated implantation failure, repeated miscarriages and severe male factor infertility. Many non-randomized PGS studies have been published and report an increase in implantation rate, and/or a decrease in miscarriage rate. Recently, two randomized controlled trials have been conducted on patients with AMA as the only indication. Neither study showed a benefit in performing PGS using live birth rate as the measure of success. The debate on the usefulness of PGS is ongoing; the only effective way to resolve the debate is to perform more well-designed and well-executed randomized clinical trials.

Key words: preimplantation genetic screening/randomized controlled trials/miscarriage/live birth rate

Submitted on October 8, 2007; resubmitted on November 16, 2007; accepted on December 13, 2007.


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