Preimplantation genetic screening for aneuploidy of embryos after in vitro fertilization in women aged at least 35 years: a prospective randomized trial

Objective: To test the hypothesis that patients with advanced maternal age (AMA) have a higher implantation rate (IR) after embryo transfer of embryos with a normal chromosomal pattern for the chromosomes studied with preimplantation genetic screening (PGS) compared with patients who had an embryo transfer without PGS. Design: Prospective randomized controlled trial (RCT). Setting: Academic tertiary setting Patient(s): Patients with AMA (>= 35 years). Intervention(s): In an RCT the clinical IR per embryo transferred was compared after embryo transfer on day 5 or 6 between the PGS group (analysis of chromosomes 13, 167 18, 21 22, X, and Y) and them Control group without PGS. Main Outcome Measure(s): No differences were observed between the PGS group and the Control group for the clinical IR (15.1%; 14.9%; rate ratio 1.01; exact confidence interval [CI], 0.25-5.27), the ongoing IR (at 12 weeks) (9.4%; 14.9%), and the live born rate per embryo transferred (9.4%; 14.9%; rate ratio 0.63; exact CI, 0.08-3.37). Fewer embryos were transferred in the PGS group (1.6 +/- 0.6) than in the Control group (2.0 +/- 0.6). A normal diploid status was observed in 30.3% of the embryos screened by PGS. Conclusion(s): In this RCT, the results did not confirm the hypothesis that PGS results in improved reproductive outcome in patients with AMA. (Fertil Steril (R) 2010;93:364-73. (C)2010 by American Society for Reproductive Medicine.)