Neonatal outcome after preimplantation genetic diagnosis

Capsule:
In 242 preimplantation genetic diagnoses, 242 intracytoplasmic sperm injections, and 733 spontaneous pregnancies, prematurity was more common after ICSI or PGD; intrauterine growth restriction was more common only after ICSI.

Authors:
Talia Eldar-Geva, M.D., Ph.D., Naama Srebnik, M.D., Gheona Altarescu, M.D., Irit Varshaver, M.Sc., Baruch Brooks, Ph.D., Ephrat Levy-Lahad, M.D., Ruben Bromiker, M.D., Michael S. Schimmel, M.D.

Volume 102, Issue 4, Pages 1016-1021

Abstract:

Objective:
To examine whether embryo biopsy for preimplantation genetic diagnosis (PGD) influences neonatal outcomes.

Design:
Prospective follow-up cohort.

Setting:
Tertiary university-affiliated medical center.

Patient(s):
242 children born after PGD, 242 children born after intracytoplasmic sperm injection (ICSI) (158 singletons and 42 twins pairs in each group), and 733 children born after a spontaneous conception (SC) (493 singletons, 120 twins pairs), matched for maternal age, parity, and body mass index.

Intervention(s):
None.

Main Outcome Measure(s):
Gestational age, birth weight, prematurity (<37 and <34 weeks), low birth weight (<2,500 g, very low birth weight, <1,500 g), and intrauterine growth restriction (<10th percentile for gestational age). Result(s):
For singletons, the mean birth weight was higher after SC compared with ICSI but not compared with PGD. Mean gestational ages were lower after PGD and ICSI compared with SC. The low birth weight and intrauterine growth restriction rates were 4.4%, 12.0%, and 5.7% and 5.1%, 9.5%, and 5.5% for PGD, ICSI, and SC, respectively. Similar results were found when controlled for the number of embryos transferred and cryopreservation. The results for twins exhibited similar but less statistically significant trends. Polar body and blastomere biopsies provided similar outcomes.

Conclusion(s):
Embryo biopsy itself did not cause intrauterine growth restriction or low birth weight compared with SC, despite lower gestational ages with PGD. The worsened outcomes in ICSI compared with PGD pregnancies may be due to the infertility itself.

  • Reshef Tal

    Thank you for this well-thought study which provides important reassurance for the use of PGD technology. It is nice to see that even though PGD was associated with
    slightly lower gestational age at birth as compared to spontaneous conception,
    this was not clinically significant as the overall preterm birth rate and neonatal
    birth weight were not different between the groups. Kudos to the authors!

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