To test or not to test embryos to increase chance of a live birth?

The chance of having a baby with IVF depends largely on the woman’s age and after the age of 35 the chance drops quite dramatically. This is because, the number of chromosomally abnormal eggs produced in the ovaries increases as women age. To improve their chance of pregnancy, women over 35 are sometimes offered a procedure called preimplantation genetic testing for chromosome abnormality (PGT-A). In this procedure the embryos that develop are tested by removing a few cells from the part of the embryo that will form the placenta a few days after egg collection. Once the results are known only embryos with the right number of chromosomes are transferred to the woman.

But does this actually increase the chance of having a baby? This was the question a recent study was hoping to answer. In this study almost 400 women aged between 36 and 40 years who were having IVF were randomized to either have or not have PGT-A performed on their embryos. A year later the outcomes for two groups were compared and this showed that the chance of a live birth was the same for both groups (24%). So, the researchers concluded that PGT-A does not improve chance of IVF success. But, having PGT-A reduced the number of embryo transfers a woman needed before having a baby and also reduced the risk of miscarriage.

The findings from this study can help women and couples make informed decisions about whether to have the PGT-A procedure performed on their embryos. At the end of the day, knowing that the ultimate chance of having a baby is not affected, it will be about balancing the benefits of fewer miscarriages and fewer treatment cycles against the cost of PGT-A and the invasive nature of the procedure.

Source:

Verpoest, W., C. Staessen, et al. (2018). "Preimplantation genetic testing for aneuploidy by microarray analysis of polar bodies in advanced maternal age: a randomized clinical trial." Human Reproduction: dey262-dey262.