Preimplantation Genetic Testing for Aneuploidy - a Castle Built on Sand.

Area of Science:

• Reproductive medicine
• Genetics
• Embryology

Background:

• Preimplantation genetic testing for aneuploidy (PGT-A) is commonly used in in vitro fertilization (IVF) to assess embryo chromosomal status.
• Claims of improved IVF outcomes with PGT-A often lack robust clinical validation and employ questionable statistical methods.
• PGT-A lacks regulatory or professional endorsement for clinical use in defining embryo ploidy.

Purpose of the Study:

• To critically evaluate the clinical validity and efficacy of PGT-A in IVF.
• To examine the biological, mathematical, and technical basis of the PGT-A hypothesis.
• To determine the appropriate clinical application of PGT-A.

Main Methods:

• Review of existing literature on PGT-A and IVF outcomes.
• Analysis of statistical methodologies used in PGT-A studies.
• Evaluation of biological and technical factors influencing PGT-A accuracy.

Main Results:

• Studies supporting PGT-A benefits often use biased patient selection or flawed statistics.
• PGT-A has a significant false-positive rate, potentially decreasing live birth rates in IVF.
• Recent research indicates fundamental flaws in the PGT-A hypothesis across multiple domains.

Conclusions:

• PGT-A is not clinically validated for determining embryo chromosomal status.
• The high false-positive rate of PGT-A can negatively impact IVF success.
• PGT-A should be restricted to research protocols, not routine clinical practice.