Authors: Man Li MD PhD1 Catherine Marin DeUgarte MD2, Alan DeCherney MD2, Hal Danzer MD1, Mark Surrey MD1 David L. Hill PhD1. 1ART Reproductive Center, 450 N. Roxbury Dr. Beverly Hills, Ca 90210 USA 2Division of OBGYN, UCLA, CA, USA
Objective: The purpose of this study is to evaluate the pregnancy rate of patients who undergo PGD (Preimplantation Genetic Diagnosis) and to compare it to patients who have IVF (In Vitro Fertilization) without PGD.
Materials and Methods: 912 patients that had IVF with or without PGD from 1/4/03 to 3/31/04 at our clinic were included in the study. Of these, 296 patients had PGD and 616 women had IVF without PGD. These patients had ovarian stimulation with gonadotropins and most received either GnRH agonists or antagonists as part of their stimulation protocol.
Ovulation was induced with HCG when at least two follicles were mature, and oocyte retrieval was performed 36 hours after HCG. In the women that desired PGD, PGD was performed 3 days after retrieval and embryo transfer was performed day 3-6. Pregnancy rates were then determined by HCG level and were compared among the 2 groups. Statistical analysis was performed using the Fisher’s exact test.
Results: The patient characteristics are seen in table 1. The average age for the 296 PGD patients was 38.76 and the average age for the 616 non PGD patients was 38.56. Of these, 52 patients in the PGD group had no embryos transferred, usually secondary to the fact that all embryos were diagnosed as abnormal.
Among the IVF patients, 110 had no embryo transferred due to multiple reasons such as desire for cryopreservation, poor embryos or risk for ovarian hyperstimulation syndrome. When comparing the pregnancy rate in the patients that had embryo transfers, the pregnancy rate among the PGD and non-PGD patients did not vary significantly (45.08% vs. 38.54 % respectively).
Conclusion: Preimplantation Genetic Diagnosis, when indicated may help physicians select normal embryos while at the same time reassure patients that the embryos transferred have a high chance of being normal. Despite the fact that no statistical difference was found in pregnancy rates among the PGD and non-PGD group, PGD technologies are evolving and may hold the key to less embryos transferred and reducing multiple pregnancy rates while maintaining or even improving pregnancy rates.