Posts Tagged ‘preimplantation genetic screening’

Reproductive Partners makes outreach to China

Saturday, May 28th, 2011

Two Reproductive Partners physicians have been invited to China to present the latest advances in fertility treatment and screening for genetic diseases at a major hospital in Bejing. Drs. Bill Yee and Greg Rosen  are currently lecturing on preimplantation genetic screening, molecular technology to screen for a variety of recessive genetic diseases and criteria for maximizing the success rate for elective single embryo transfer to reduce the chance of multiple pregnancy, including twins.

 

In conjunction with this outreach, the RPMG website has been translated and is now available in Mandarin Chinese. Portions of the website will shortly be translated into Japanese as Japanese-speaking staff is being added to the Redondo Beach location to better serve the Japanese-speaking community.

 

Question on Comparative Genomic Hybridization (CGH) for PGS

Thursday, September 30th, 2010

An interesting question on the Reproductive Partners Fertility Forum about possiblility of doing preimpantation geneic screening for chromosomes (PGS) on frozen blastocysts raises some important points.

Q. I currently have frozen embryo's in La Jolla, we have a 17 month old son and are now starting to discuss a second child. My question is if CGH can be perfomed on frozen 5 day embryos or do they need to be fresh for this procedure? I also understand that it is best if they were frozen via vitrification, but can it still be done if the embryos were not frozen in this manner? Finally is this procedure offered through RPMG?

A. Technically, CGH can be done on trophectoderm biopsies on frozen blastocysts. We have done it.

The problem is that by the time you get results the embryos are beyond the normal time for transfer; not 5 day embryos, but now 7 day embryos and there are no studies I am aware of showing consistent success transferring that late. They could be refrozen, but that would probably seriously impair the embryos.

So this is something that has to be worked out better before I would recommend it for frozen embryos. We will be recommending it in appropriate cases in fresh cycles, then freezing the embryos by vitrification and doing frozen transfers.

Comment: The most recent evidence shows that PGS done on Day 3 embryos using the florescence-in-situ-hybridization (FISH) technique has not been shown to improve live birth rates
in the patients for whom it's been traditionally recommended. Thus the American Society for Reproductive Medicine has deemed it generally not recommended for maternal age, repeated miscarriage or other common indications.

The new technique of biopsying the surrounding cells of a blastocyst and checking all chromosomes, then freezing the embryo by the newer technique of vitrification, and transferring in a frozen embryo cycle should overcome most of the pitfalls of the older technique. Unfortunately there is not enough experience with already frozen blastocysts at this time to recommend it to the person who posed the question,

RPMG moves to CGH for PGS for chromosomes

Tuesday, April 27th, 2010

RPMG will now be using comparative genomic hybridization (CGH) for preimplantation genetic screening (PGS) for chromosome screening of embryos (including for sex selection). CGH is a technique that involves amplifying the DNA and uses many thousands of probes to check all 23 chromosome pairs. As long as an intact nucleus is biopsied, it is virtually error-free, whereas with the older technique, fluorescence in-situ hybridization (FISH), many errors may occur because FISH relies on binding of a single probe to each chromosome, and there are potential cell fixation artifacts, overlapping signals, and a subjective microscopic analysis is required. It also does not analyze all chromosomes. Unfortunately many normal embryos have been discarded with that technique due to these artifacts, and false negative results have also occurred where an embryo appeared normal but was actually abnormal.

For more information on PGS for chromosomes please check our our PGS for chromsomes page.

Does preimplantation genetic screening (PGS) improve IVF success rates in women over 35?

Friday, March 5th, 2010

Some fertility centers promote preimplantation genetic screening as a way of improving IVF success rates in women over 35 (defining advanced maternal age).

Now a study in the January 2010 edition of Fertility & Sterility shows that PGS does not significantly improve implantation, pregnancy or live birth rates. In this randomized control study from Belgium, the clinical implantation rate per embryo transferred was compared between the PGS group (analysis of chromosomes 13, 16, 18, 21, 22, X, and Y by FISH) and the control group without PGS.

No differences were observed between the PGS group and the control group for the clinical implantation rate, the ongoing pregnancy rate at 12 weeks and the live born rate per embryo transferred.  A normal chromosome component was observed in only 30.3% of the embryos screened by PGS.

In this randomized controlled trial, the results did not confirm the hypothesis that PGS by FISH in 3-Day embryos results in improved reproductive outcome in patients with "advanced maternal age.".

In the future newer techniques of chromosome analysis such as comparative genomic hybridization (CGH) which can analyze all chromosome pairs and the ability to analyze blastocyst cells, freeze the embryos and transfer only chromosomally normal embryos may result in better outcomes and the need to transfer fewer embryos and reduce high-order multiple pregnancies as well.