The role of preimplantation genetic diagnosis in women of advanced reproductive age

Abstract

More than half of in-vitro fertilization patients are of advanced reproductive age and at risk for producing offspring with age-related aneuploidies, which contribute significantly to spontaneous abortions and implantation failure. Fluorescent in-situ hybridization analysis of thousands of oocytes and preimplantation embryos obtained from these patients revealed an aneuploidy rate of over 50%, suggesting practical relevance of preimplantation genetic diagnosis for aneuploidy to women of advanced reproductive age. The overall preimplantation genetic diagnosis experience for age-related aneuploidies comprising more than 3000 clinical cycles indicates the positive impact of preselection and transfer of aneuploidy-free embryos on implantation and pregnancy rates and outcome of pregnancies in women of advanced reproductive age. These patients will need to be informed about preimplantation genetic diagnosis availability, in order use this option to improve their relatively poor chances of becoming pregnant, especially with the current tendency of limiting the number of transferred embryos to avoid complications due to multiple pregnancies. This may contribute significantly to improving standards of assisted reproduction technology, substituting the current practice of selection of embryos for transfer using morphological parameters with the preselection of aneuploidy-free embryos with a higher potential to result in pregnancy.