Can Comprehensive Chromosome Screening Technology Improve IVF/ICSI Outcomes? A Meta-Analysis

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2015 Oct 16

PMID 26470028

Citations 48

Authors

Minghao Chen

Shiyou Wei

Junyan Hu

Song Quan

Affiliations

Soon will be listed here.

Abstract

Objective: To examine whether comprehensive chromosome screening (CCS) for preimplantation genetic screening (PGS) has an effect on improving in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes compared to traditional morphological methods.

Methods: A literature search was conducted in PubMed, EMBASE, CNKI and ClinicalTrials.gov up to May 2015. Two reviewers independently evaluated titles and abstracts, extracted data and assessed quality. We included studies that compared the IVF/ICSI outcomes of CCS-based embryo selection with those of the traditional morphological method. Relative risk (RR) values with corresponding 95% confidence intervals (CIs) were calculated in RevMan 5.3, and subgroup analysis and Begg's test were used to assess heterogeneity and potential publication bias, respectively.

Results: Four RCTs and seven cohort studies were included. A meta-analysis of the outcomes showed that compared to morphological criteria, euploid embryos identified by CCS were more likely to be successfully implanted (RCT RR 1.32, 95% CI 1.18-1.47; cohort study RR 1.74, 95% CI 1.35-2.24). CCS-based PGS was also related to an increased clinical pregnancy rate (RCT RR 1.26, 95% CI 0.83-1.93; cohort study RR 1.48, 95% CI 1.20-1.83), an increased ongoing pregnancy rate (RCT RR 1.31, 95% CI 0.64-2.66; cohort study RR 1.61, 95% CI 1.30-2.00), and an increased live birth rate (RCT RR 1.26, 95% CI 1.05-1.50; cohort study RR 1.35, 95% CI 0.85-2.13) as well as a decreased miscarriage rate (RCT RR 0.53, 95% CI 0.24-1.15; cohort study RR 0.31, 95% CI 0.21-0.46) and a decreased multiple pregnancy rate (RCT RR 0.02, 95% CI 0.00-0.26; cohort study RR 0.19, 95% CI 0.07-0.51). The results of the subgroup analysis also showed a significantly increased implantation rate in the CCS group.

Conclusions: The effectiveness of CCS-based PGS is comparable to that of traditional morphological methods, with better outcomes for women receiving IVF/ICSI technology. The transfer of both trophectoderm-biopsied and blastomere-biopsied CCS-euploid embryos can improve the implantation rate.

Citing Articles

Preimplantation Genetic Testing for Aneuploidy in Fertilization Using Comprehensive Chromosome Screening: A Systematic Review and Meta-Analysis.

Taskin O, Hochberg A, Tan J, Adye-White L, Albert A, Tan S Int J Fertil Steril. 2024; 18(3):185-194.

PMID: 38973269 PMC: 11245579. DOI: 10.22074/ijfs.2023.1996379.1450.

Which factors affect the live birth outcome of the first single euploid frozen-thawed blastocyst transfer in couples with balanced chromosomal translocations?.

Zhang R, Hu Y, Cui C, Zhang C Front Endocrinol (Lausanne). 2024; 15:1378635.

PMID: 38737550 PMC: 11082334. DOI: 10.3389/fendo.2024.1378635.

Comparing Day 5 versus Day 6 euploid blastocyst in frozen embryo transfer and developing a predictive model for optimizing outcomes: a retrospective cohort study.

Yin B, Li S, Sun L, Yao Z, Cui Y, Zhang C Front Endocrinol (Lausanne). 2024; 14:1302194.

PMID: 38239982 PMC: 10794779. DOI: 10.3389/fendo.2023.1302194.

Systematic review and meta-analysis: does pre-implantation genetic testing for aneuploidy at the blastocyst stage improve live birth rate?.

Kasaven L, Marcus D, Theodorou E, Jones B, Saso S, Naja R J Assist Reprod Genet. 2023; 40(10):2297-2316.

PMID: 37479946 PMC: 10504192. DOI: 10.1007/s10815-023-02866-0.

Towards Automation in IVF: Pre-Clinical Validation of a Deep Learning-Based Embryo Grading System during PGT-A Cycles.

Cimadomo D, Chiappetta V, Innocenti F, Saturno G, Taggi M, Marconetto A J Clin Med. 2023; 12(5).

PMID: 36902592 PMC: 10002983. DOI: 10.3390/jcm12051806.

References

Johnson D, Cinnioglu C, Ross R, Filby A, Gemelos G, Hill M . Comprehensive analysis of karyotypic mosaicism between trophectoderm and inner cell mass. Mol Hum Reprod. 2010; 16(12):944-9. PMC: 2989828. DOI: 10.1093/molehr/gaq062. View

Harper J, Wilton L, Traeger-Synodinos J, Goossens V, Moutou C, SenGupta S . The ESHRE PGD Consortium: 10 years of data collection. Hum Reprod Update. 2012; 18(3):234-47. DOI: 10.1093/humupd/dmr052. View

Nagy Z, Sakkas D, Behr B . Symposium: innovative techniques in human embryo viability assessment. Non-invasive assessment of embryo viability by metabolomic profiling of culture media ('metabolomics'). Reprod Biomed Online. 2008; 17(4):502-7. DOI: 10.1016/s1472-6483(10)60236-2. View

Polanski L, Coelho Neto M, Nastri C, Navarro P, Ferriani R, Raine-Fenning N . Time-lapse embryo imaging for improving reproductive outcomes: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2014; 44(4):394-401. DOI: 10.1002/uog.13428. View

Kramer Y, Kofinas J, Melzer K, Noyes N, McCaffrey C, Buldo-Licciardi J . Assessing morphokinetic parameters via time lapse microscopy (TLM) to predict euploidy: are aneuploidy risk classification models universal?. J Assist Reprod Genet. 2014; 31(9):1231-42. PMC: 4156952. DOI: 10.1007/s10815-014-0285-1. View

Treff N, Su J, Tao X, Northrop L, Scott Jr R . Single-cell whole-genome amplification technique impacts the accuracy of SNP microarray-based genotyping and copy number analyses. Mol Hum Reprod. 2010; 17(6):335-43. PMC: 3097071. DOI: 10.1093/molehr/gaq103. View

Forman E, Tao X, Ferry K, Taylor D, Treff N, Scott Jr R . Single embryo transfer with comprehensive chromosome screening results in improved ongoing pregnancy rates and decreased miscarriage rates. Hum Reprod. 2012; 27(4):1217-22. PMC: 3303493. DOI: 10.1093/humrep/des020. View

Dahdouh E, Balayla J, Garcia-Velasco J . Impact of blastocyst biopsy and comprehensive chromosome screening technology on preimplantation genetic screening: a systematic review of randomized controlled trials. Reprod Biomed Online. 2015; 30(3):281-9. DOI: 10.1016/j.rbmo.2014.11.015. View

Mir P, Rodrigo L, Mercader A, Buendia P, Mateu E, Milan-Sanchez M . False positive rate of an arrayCGH platform for single-cell preimplantation genetic screening and subsequent clinical application on day-3. J Assist Reprod Genet. 2012; 30(1):143-9. PMC: 3553356. DOI: 10.1007/s10815-012-9918-4. View

10.

Yang Z, Liu J, Collins G, Salem S, Liu X, Lyle S . Selection of single blastocysts for fresh transfer via standard morphology assessment alone and with array CGH for good prognosis IVF patients: results from a randomized pilot study. Mol Cytogenet. 2012; 5(1):24. PMC: 3403960. DOI: 10.1186/1755-8166-5-24. View

11.

Schoolcraft W, Katz-Jaffe M . Comprehensive chromosome screening of trophectoderm with vitrification facilitates elective single-embryo transfer for infertile women with advanced maternal age. Fertil Steril. 2013; 100(3):615-9. DOI: 10.1016/j.fertnstert.2013.07.1972. View

12.

Tan Y, Tan K, Zhang S, Gong F, Cheng D, Xiong B . Single-nucleotide polymorphism microarray-based preimplantation genetic diagnosis is likely to improve the clinical outcome for translocation carriers. Hum Reprod. 2013; 28(9):2581-92. DOI: 10.1093/humrep/det271. View

13.

Kotze D, Hansen P, Keskintepe L, Snowden E, Sher G, Kruger T . Embryo selection criteria based on morphology VERSUS the expression of a biochemical marker (sHLA-G) and a graduated embryo score: prediction of pregnancy outcome. J Assist Reprod Genet. 2010; 27(6):309-16. PMC: 2914589. DOI: 10.1007/s10815-010-9403-x. View

14.

Mastenbroek S, Twisk M, van Echten-Arends J, Sikkema-Raddatz B, Korevaar J, Verhoeve H . In vitro fertilization with preimplantation genetic screening. N Engl J Med. 2007; 357(1):9-17. DOI: 10.1056/NEJMoa067744. View

15.

Moher D, Liberati A, Tetzlaff J, Altman D . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009; 6(7):e1000097. PMC: 2707599. DOI: 10.1371/journal.pmed.1000097. View

16.

Siristatidis C, Komitopoulou M, Makris A, Sialakouma A, Botzaki M, Mastorakos G . Morphokinetic parameters of early embryo development via time lapse monitoring and their effect on embryo selection and ICSI outcomes: a prospective cohort study. J Assist Reprod Genet. 2015; 32(4):563-70. PMC: 4380900. DOI: 10.1007/s10815-015-0436-z. View

17.

Ginsburg E, Baker V, Racowsky C, Wantman E, Goldfarb J, Stern J . Use of preimplantation genetic diagnosis and preimplantation genetic screening in the United States: a Society for Assisted Reproductive Technology Writing Group paper. Fertil Steril. 2011; 96(4):865-8. DOI: 10.1016/j.fertnstert.2011.07.1139. View

18.

Nasseri A, Mukherjee T, Grifo J, Noyes N, Krey L, Copperman A . Elevated day 3 serum follicle stimulating hormone and/or estradiol may predict fetal aneuploidy. Fertil Steril. 1999; 71(4):715-8. DOI: 10.1016/s0015-0282(98)00525-1. View

19.

Treff N, Su J, Tao X, Levy B, Scott Jr R . Accurate single cell 24 chromosome aneuploidy screening using whole genome amplification and single nucleotide polymorphism microarrays. Fertil Steril. 2010; 94(6):2017-21. DOI: 10.1016/j.fertnstert.2010.01.052. View

20.

Kahraman S, Sertyel S, Findikli N, Kumtepe Y, Oncu N, Melil S . Effect of PGD on implantation and ongoing pregnancy rates in cases with predominantly macrocephalic spermatozoa. Reprod Biomed Online. 2004; 9(1):79-85. DOI: 10.1016/s1472-6483(10)62114-1. View