Genetic screening has negative effect on IVF succes rate
Wed Jul 04, 2007 at 12:20:33 PM PDT
Research published in the New England Journal of Medicine today indicates that fertilised eggs that are tested for genetic disorders have a significantly (about 33%) smaller chance of leading to a successful pregnancy. The research was carried out at a Dutch University, which is why I found a report of their press release here (sorry, it's in Dutch).
The news report notes that preimplantation genetic screening (PGS) is not currently used in The Netherlands (apart from in this trial), but that it is fairly common in the US (2 out of 3 clinics offering IVF offer PGS as well), Belgium and the UK. PGS is also very expensive and generates substantial revenue for the clinics. People considering IVF should be aware of this.
The original paper is published in the NEJM here and accompanied by an editorial from which I quote below the fold. Note that both links are probably to subscribed content. If anyone is interested, please let me know in the comments, and I will find a way to send you the paper (I have access at work).
The editorial by John A. Collins, M.D. from McMaster and Dalhousie Universities in Canada notes that
The effectiveness of preimplantation genetic diagnosis has been accepted without randomized trials, because its success in reducing transmission of genetic diseases is self-evident.
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Despite these drawbacks and the $3,000 to $5,000 cost of preimplantation genetic diagnosis in addition to the cost of the cycle of IVF or intracytoplasmic sperm injection, preimplantation genetic diagnosis is often considered a worthwhile alternative to prenatal testing and possible therapeutic abortion.
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the results [of the study pblished today] suggest that for every nine women who are 35 to 41 years of age who plan three cycles of IVF or IVF and intracytoplasmic sperm injection, there will be one more live birth if preimplantation genetic diagnosis for aneuploidy screening is not performed.
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Given the findings of Mastenbroek et al., preimplantation genetic diagnosis for aneuploidy screening should not be performed solely because of advanced maternal age.
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Furthermore, the present results underscore other pressing research needs, such as avoiding the increased likelihood of aneuploidy associated with standard ovarian-stimulation routines and finding means of identifying which embryos are most likely to survive and become healthy singleton live births.
