Tuesday, July 10, 2007

Pre-implantation Genetic Screening May not Improve Outcomes

While we're on the subject of fertility treatments, here's one on preimplantation genetic screening (PGD), a popular new treatment to make sure your kid is "perfect" before you even implant him/her (someone recently told me to try this--no lie):

July 5, 2007 — In women of advanced maternal age, preimplantation genetic screening significantly reduces, rather than increases, the rates of ongoing pregnancies and live births after in vitro fertilization, according to the results of a large, multicenter, randomized trial published in the July 5 issue of The New England Journal of Medicine.

"Pregnancy rates in women of advanced maternal age undergoing in vitro fertilization (IVF) are disappointingly low," write Sebastiaan Mastenbroek, MSc, from University of Amsterdam, the Netherlands, and colleagues. "It has been suggested that the use of preimplantation genetic screening of cleavage-stage embryos for aneuploidies may improve the effectiveness of IVF in these women."

This double-blind trial compared 3 cycles of IVF with and without preimplantation genetic screening in women aged 35 through 41 years. The main endpoint was ongoing pregnancy at 12 weeks of gestation, and secondary endpoints were biochemical pregnancy, clinical pregnancy, miscarriage, and live birth....

"Preimplantation genetic screening did not increase but instead significantly reduced the rates of ongoing pregnancies and live births after IVF in women of advanced maternal age," the authors write. "These results argue strongly against routinely performing preimplantation genetic screening as an adjunct to IVF in this group of women."


N Engl J Med. 2007;357:9-17, 61-63.

Hmm, I don't know for sure, but something tells me this is an "extra" that probably costs extra money, too!