IVF Research Today is a free monthly online journal that collates and summarizes the latest research about IVF, including details on in vitro fertilization, infertility, treatment, procedure, pregnancy, success rates. | ||||||||
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Day-3 embryo morphology predicts euploidy among older subjects.Moayeri SE, Allen RB, Brewster WR, Kim MH, Porto M, Werlin LB Department of Obstetrics and Gynecology, Stanford University Medical Center, Stanford, California 94305, USA. smoayeri@stanford.edu OBJECTIVE: To evaluate whether day-3 embryo morphology predicts euploidy. DESIGN: Retrospective. SETTING: Private IVF center. PATIENT(S): Subjects (n = 144) undergoing in vitro fertilization and preimplantation genetic diagnosis (PGD). INTERVENTION(S): Translate day-3 embryo characteristics into a standardized score. MAIN OUTCOME MEASURE(S): Day-3 embryo morphology score and PGD fluorescence in situ hybridization results for chromosomes: 13, 15, 16, 17, 18, 21, 22, X, and Y. RESULT(S): Of 1,043 biopsied blastomeres, 67% (n = 696) were chromosomally abnormal. Women with advanced maternal age (AMA) were 1.3 times more likely to have chromosomal errors (95% CI 1.1-1.4) than younger subjects (<38 years old). Morphology predicted PGD results in the AMA group (n = 553), but not in younger women. Fragmentation predicted euploidy in both the younger and the AMA group, but cell number did not. CONCLUSION(S): Day-3 embryo morphology selects for euploidy among AMA subjects but not among younger women who may have other factors responsible for embryo dysmorphism. However, cellular fragmentation is a sensitive proxy for selecting chromosomally normal embryos in both age groups. It is unclear that PGD-aneuploidy screening is a better tool for selecting which embryos to transfer than the standard approach of using day-3 embryo features, particularly among older women, a group for whom this technology is targeted. Published 14 January 2008 in Fertil Steril, 89(1): 118-23.
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