4.6 Article

Commentary on two recently published formal guidelines on management of mosaic embryos after preimplantation genetic testing for aneuploidy (PGT-A)

Journal

REPRODUCTIVE BIOLOGY AND ENDOCRINOLOGY
Volume 19, Issue 1, Pages -

Publisher

BMC
DOI: 10.1186/s12958-021-00716-1

Keywords

Preimplantation genetic testing for aneuploidy (PGT-A); In vitro fertilization (IVF); Mosaicism; Guidelines; Professional organizations

Funding

  1. Foundation for Reproductive Medicine

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There are three main shortcomings in the guidelines regarding the clinical management of PGT-A: lack of clear endorsement, reliance on previous guidance lacking professional requirements, contradiction with basic biological characteristics of embryos.
Two professional societies recently published opinions on the clinical management of mosaic results from preimplantation genetic testing for aneuploidy (PGT-A) in human blastocyst-stage embryos in associations with in vitro fertilization (IVF). We here point out three principal shortcomings: (i) Though a most recent societal opinion states that it should not be understood as an endorsement of the use of PGT-A, any discussion of how PGT-A should be clinically interpreted for all practical purposes does offer such an endorsement. (ii) The same guideline derived much of its opinion from a preceding guidance in favor of utilization of PGT-A that did not follow even minimal professional requirements for establishment of practice guidelines. (iii) Published guidelines on so-called mosaic embryos from both societies contradict basic biological characteristics of human preimplantation-stage embryos. They, furthermore, are clinically unvalidated and interpret results of a test, increasingly seen as harmful to IVF outcomes for many infertile women. Qualified professional organizations, therefore, should finally offer transparent guidelines about the utilization of PGT-A in association with IVF in general.

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