Role of preimplantation genetic screening in enhancing the effectiveness of assisted reproductive technology programs in late reproductive-aged patients
Objective. To investigate the effectiveness of assisted reproductive technology (ART) programs in late reproductive-aged (LRA) patients undergoing preimplantation genetic screening (PGS).Beik E.P., Korotchenko O.E., Gvozdeva A.D., Syrkasheva A.G., Dolgushina N.V.
Subjects and methods. The prospective cohort study enrolled 160 LRA patients (aged>35 years) with infertility of different genesis who were stratified according to PGS: Group 1 included 87 LRA patients who had not undergone PGS; Group 2 consisted of 73 LRA patients who had undergone PGS. The latter was performed by fluorescence in situ hybridization (FISH) or array-based comparative genomic hybridization (aCGH) on day 3 or day 5 of embryo culture, respectively.
Results. In LRA patients who had undergone PGS, the chances of getting pregnant were 2.1 times higher and those of live birth were 2 times higher than in LRA patients who had not undergone PGS (OR for pregnancy = 2.1 (95% CI = 1.04; 4.2); OR for live birth = 2.0 (95% CI = 0.98; 4.1)). In vitro fertilization (IVF) with PCS was most effective (by 2.6 times) in a group of patients aged 36 to 39 years. The most effective method of PGS was aCGH on day 5 of embryo culture, which can enhance the efficiency of ART programs by 3.1 times in LRA patients.
Conclusion. IVF/PGS in LRA patients aged 36 to 39 years is a technique that can increase the probability of pregnancy and live birth, by selecting euploid embryos.
Keywords
infertility
late reproductive age
assisted reproductive technologies (ART)
preimplantation genetic screening (PGS)
whole-genome hybridization
array-based comparative genomic hybridization (aCGH)
fluorescence in situ hybridization (FISH)
Supplementary Materials
- Table. Clinical and anamnestic data patients
- Fig. 1. Outcomes of ART programs in patients of late reproductive age without preimplantation genetic screening (group 1) and patients of late reproductive age with preimplantation genetical screening (group 2), * p <0.05
- Fig. 2 . The effectiveness of ART programs in patients of late reproductive age is dependent on the conduct and type of preimplantation genetic screening
- Fig. 3. The frequency of pregnancy in patients of different age groups, depending on the conduct of preimplantation genetic screening
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Received 08.12.2017
Accepted 22.12.2017
About the Authors
Beik Ekaterina Pavlovna, M.D., post-graduate student, Department of ART in the treatment of infertility, National Medical Research Center of Obstetrics, Gynecology,and Perinatology, Ministry of Health of Russia named after Academician V.I. Kulakov. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: e_beik@oparina4.ru
Korotchenko Olga Eugenievna, M.D., Post-graduate student, Department of ART in the treatment of infertility, National Medical Research Center of Obstetrics,
Gynecology, and Perinatology, Ministry of Health of Russia named after Academician V.I. Kulakov.
117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: okorotchenko@mail.ru
Gvozdeva Anna Dmitrievna, Undergraduate of the Faculty of Fundamental Medicine of M.V. Lomonosov Moscow State University.
117192, Russia, Moscow, Lomonosovsky Prospekt 31-5. E-mail: gvozdevaannalech@gmail.com
Syrkasheva Anastasia Grigorievna, M.D., Ph.D., Researcher of the Department of ART in the treatment of infertility, National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia named after Academician V.I. Kulakov.
117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: a_syrkasheva@oparina4.ru
Dolgushina Nataliya Vitalievna, M.D., Ph.D., M.P.H., Head of R&D Department, National Medical Research Center of Obstetrics, Gynecology, and Perinatology,
Ministry of Health of Russia named after Academician V.I. Kulakov. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: n_dolgushina@oparina4.ru
For citations: Beik E.P., Korotchenko O.E., Gvozdeva A.D., Syrkasheva A.G., Dolgushina N.V. Role of preimplantation genetic screening in enhancing the effectiveness of assisted reproductive technology programs in late reproductive-aged patients.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (4): 78-84. (in Russian)
https://dx.doi.org/10.18565/aig.2018.4.78-84
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