In vitro fertilization (IVF) outcomes from over 1,000 treatment cycles spanning 2010 through 2012 demonstrate a significant improvement in successful pregnancies when pre-implantation genetic screening (PGS) of blastocyst embryos is utilized prior to uterine transfer, reports Reproductive Associates of Delaware (RAD). PGS utilizes molecular DNA tests for the presence of normal chromosomes within embryos.
Of 416 delivered and ongoing healthy pregnancies, 68 (16%) occurred when PGS was performed. In patients over 34, PGS led to 43% of RAD's successful IVF pregnancies, and over 90% of these pregnancies occurred after single embryo transfer. When compared to IVF data published annually by the Centers for Disease Control, RAD had the highest total percentage of single embryo transfers and the lowest IVF multiple pregnancy rate in the U.S.
"Our results with IVF and PGS have clearly had an important impact on success rates, as well as increased utilization of single embryo transfer," noted Dr. Ronald F. Feinberg, IVF Medical Director at RAD. "The higher implantation and ongoing pregnancy rates with PGS are both statistically and clinically significant for patients over age 34. Most IVF clinics utilize multiple embryo transfer to enhance pregnancy rates in these patients, whereas PGS allows us to select single embryos for uterine transfer yielding a safer and higher chance of pregnancy." Embryos with abnormal chromosomes either fail to implant or commonly cause miscarriage, and are increasingly common in women over age 34.
When PGS is utilized, implantation and pregnancy rates for patients over age 34 at RAD are almost identical to the rates seen in younger women, and far surpass the rates seen in fresh non-PGS IVF transfer cycles. When PGS combined with frozen/thaw embryo transfer were carried out at RAD, the embryo implantation rates were over 60% across all ages, with a successful pregnancy rate of 56.2% and an average of 1.1 embryos transferred. The miscarriage rate was 10.5% in PGS cycles across all ages, whereas in non-PGS cycles the overall miscarriage rate was 18% in both fresh and frozen/thaw embryo transfers. Miscarriage prevention is a common indication for IVF and PGS.
"Our results suggest that PGS could prove to be highly cost-effective to help our patients maximize their singleton IVF pregnancy chances, along with much lower miscarriage risk, stated Linda Morrison, Director of Laboratory Services at RAD. "This should ultimately reduce the number of treatment cycles that many patients will need to achieve a safe and healthy pregnancy."
IVF pregnancy outcome following embryo transfer is also enhanced when the uterine environment has been optimized. During a frozen/thaw treatment cycle, the uterus has not been subjected to very high hormone levels commonly created during fresh IVF cycles. And other risks of fresh IVF transfer, such as ovarian hyperstimulation syndrome, can be virtually eliminated when frozen/thaw transfers are employed. "Recently, a respected research group at New York University published their results with PGS and single embryo transfer during frozen/thaw cycles, and demonstrated a 58% implantation rate over a four-year period," noted Dr. Feinberg. "This provides further evidence that single embryo transfer in conjunction with PGS is safe and effective."
RAD (ivf-de.org) has previously presented its IVF and PGS results at the American Society for Reproductive Medicine annual meetings. To view details of RAD's comprehensive PGS and non-PGS results for the three-year period visit the RAD website.
RAD's IVF Center, established in 1995, is part of a full service subspecialty fertility practice with locations in Newark, Wilmington, and Dover, Delaware. RAD’s Board certified physicians are Drs. Barbara McGuirk, Ronald Feinberg, George Kovalevsky, Adrienne Neithardt, and Lenore Tietjens-Grillo. RAD’s IVF, Fertility Care, and Fertility Wellness Centers are located on the main campus of the Christiana Care Health System in Newark. For more information about Reproductive Associates of Delaware visit our website.