Study On The Outcome And Safty Of Preimplantation Genetic Diagnosis

Objective To review a 6-year experience of preimplantation genetic diagnosis(PGD) in our in vitro fertilization center(IVF) center,and to determine if there were any observable effects of PGD on maternal pregnancy complications,infant growth parameters and birth defects.Design Retrospective analysis of data from a single centre.Setting IVF center,Women's Hospital,School of Medicine,Zhejiang University.Method(s) The PGD cycles included 99 cycles for chromosome disorders,5 cycles for X-linked diseases,which were also single-gene diseases,and 4 cycles for recurrent miscarriage or affected birth.Intracytoplasmic sperm injection(ICSI) was used in all PGD cycles.Fluorescence in situ hybridization with appropriate probes and polymerase chain reaction were used.All pregnancies were followed till update.ICSI cycles of the same period in our center were selected as a control group.Main Outcome Measure(s) Cycle cancelled rate,pregnancy rate,implantation rate,miscarriage rate,gestational age,birth weight,birth length,the presence of pregnancy complications and birth defects. Result(s) The main indication for PGD in our IVF center was chromosomal rearrangement.PGD group had a significantly higher cancelled cycle rate(33.33%vs 8.31%,p＜0.01).The cleavage rate was significantly lower in PGD group(97.75%vs 98.80%,p＜0.01),however,no statistically significant differences were found between the PGD and control group with respect to excellent embryo rate(64.75%vs 63.97%), clinical pregnancy rate(33.33%vs 38.02%),implantation rate(23.85%vs 21.34%) and spontaneous miscarriage rate(16.67%vs 13.22%).The clinical pregnancy rate was significantly improved when 3 embryos were transfer instead of 1(61.54%vs 22.22%, p＜0.05).The live birth/ongoing pregnancy rate was comparative between two groups. In 24 pregnancy cycles,there was 1 cycle with oligohydramnios and 1 cycle with premature rupture of membrane.No misdiagnoses were detected.The birth length and weight of the offspring were within normal range.No specific patterns of pregnancy complications or birth defects were observed.Conclusion(s) PGD cycles are more apt to be cancelled.The embryo biopsy procedure has no deleterious effects on implantation rate,clinical pregnancy rate or miscarriage rate.The clinical outcome of PGD cycles is satisfying and is affected by the number of embryos genetically suitable for transfer.PGD can avoid affected birth effectively.There are no observable detrimental effects of PGD on pregnancy or children born after the procedure.