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39A - PGT-A Should Be Offered for Recurrent Implantation Failure

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from Section VII - Genetics

Published online by Cambridge University Press:  25 November 2021

Roy Homburg
Affiliation:
Homerton University Hospital, London
Adam H. Balen
Affiliation:
Leeds Centre for Reproductive Medicine
Robert F. Casper
Affiliation:
Mount Sinai Hospital, Toronto
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Summary

In order to discuss the benefits of preimplantation genetic testing for aneuploidies (PGT-A) for recurrent implantation failure (RIF), we first need to define this condition. However, despite extensive research and due to numerous contributing factors, there is not yet a single agreed-upon definition. It is well established that the major cause of pregnancy loss is chromosomal aneuploidy. Sato et al. showed that even though PGT-A could not improve the live birth rate per patient, it reduced the overall incidence of pregnancy loss in patients with repeated implantation failure (RIF) [1]. Pirtea et al. had a different perspective, suggesting that true RIF is rare for those patients with the ability to produce euploid blastocysts. In analyzing 4,515 patients, 94.9% of them achieved clinical pregnancy in up to three consecutive transfers of frozen single euploid embryos [2].

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Chapter
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Publisher: Cambridge University Press
Print publication year: 2021

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References

Sato, T, Sugiura-Ogasawara, M, Ozawa, F, et al. Preimplantation genetic testing for aneuploidy: a comparison of live birth rates in patients with recurrent pregnancy loss due to embryonic aneuploidy or recurrent implantation failure. Hum Reprod. 2019;34(12):2340–8.CrossRefGoogle ScholarPubMed
Pirtea, P, De Ziegler, D, Marin, D, et al. The rate of true recurrent implantation failure (RIF) is low: results of three successive frozen euploid single embryo transfers (SET). Fertil Steril. 2019;112(3, Supplement):e438–9.CrossRefGoogle Scholar
Munné, S, Spinella, F, Grifo, J, et al. Clinical outcomes after the transfer of blastocysts characterized as mosaic by high resolution Next Generation Sequencing- further insights. Eur J Med Genet. 2020;63(2):103741.CrossRefGoogle ScholarPubMed
Patrizio, P, Shoham, G, Shoham, Z, Leong, M, Barad, DH, Gleicher, N. Worldwide live births following the transfer of chromosomally ‘Abnormal’ embryos after PGT/A: results of a worldwide web-based survey. J Assist Reprod Genet. 2019;36(8):1599–607.CrossRefGoogle ScholarPubMed
Munné, S, Nakajima, ST, Najmabadi, S, et al. First PGT-A using human in vivo blastocysts recovered by uterine lavage: comparison with matched IVF embryo controls. Hum Reprod. 2020;35(1):7080.CrossRefGoogle Scholar

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