What should we focus on before preimplantation genetic diagnosis/screening?

Area of Science:

• Reproductive Medicine
• Genetics
• Embryology

Background:

• Preimplantation genetic diagnosis/screening (PGD/PGS) is crucial for detecting embryonic chromosomal abnormalities.
• Embryo availability is a prerequisite for successful PGD/PGS.
• Not all couples undergoing fertility treatments can produce embryos suitable for PGD/PGS.

Purpose of the Study:

• To identify factors influencing the formation of embryos suitable for PGD/PGS.
• To predict the likelihood of obtaining testable embryos for couples undergoing PGD/PGS.

Main Methods:

• Retrospective study of couples undergoing PGD/PGS from January 2015 to December 2016.
• Comparison between patients who developed blastocysts and those who did not.
• Analysis of demographic, hormonal, and karyotypic factors.

Main Results:

• 57 out of 359 couples (15.9%) did not obtain blastocysts for PGD/PGS.
• The non-blastocyst group was significantly older (32.37 vs. 30.69 years) and had lower anti-Müllerian hormone (AMH) levels (3.07 vs. 4.80 ng/ml).
• Women with aneuploid karyotypes (47, XXX or 45, X) had fewer retrieved oocytes, irrespective of age.

Conclusions:

• Advanced maternal age, diminished ovarian reserve (low AMH), and specific chromosomal abnormalities (47, XXX or 45, X) are associated with a lower likelihood of achieving blastocyst formation for PGD/PGS.
• Couples at risk should be counseled on these factors to make informed decisions about PGD/PGS.
• These findings aid in predicting PGD/PGS embryo availability and managing patient expectations.