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№3' 2018
OBSTETRICS AND GYNECOLOGYInternational Medical Journal, Vol. 24., Iss. 3, 2018, P. 40−44.
EFFICACY ASSESSMENT OF PREIMPLANTATION GENETIC TESTING FOR ANEUPLOIDY IN PATIENTS OF INCREASED REPRODUCTIVE AGE AT IVF
Kharkiv National Medical University, Ukraine
Preimplantation genetic testing is a method for detecting embryos with genetic or chromosomal abnormalities. Further transfer of embryos without genetic or chromosomal abnormalities enables prevention of the birth of a child with genetic diseases, reduction of the level of reproductive loss during pregnancy, as well as increase of the efficiency of auxiliary reproductive technologies cycles. Frequently the cause of chromosomal abnormalities is chromosome non−disjunction in the process of maturation of the sex cells. When conducting IVF, the first stages of the life of the embryo occur in vitro (outside the mother's body), therefore, it is possible to explore the chromosomes. This allows selection of embryos to be transferred to the uterine cavity with a normal chromosomal set, which, in turn, will significantly increase the chances of a healthy pregnancy. Genetic testing can be carried out using various molecular genetic methods, such as polymerase chain reaction, fluorescence hybridization, comparative genomic hybridization, next generation sequencing (NGS). The choice of diagnostic tactics is determined in each case on the basis of infertility history, the status of the body of the mother, the embryos and their number. To determine aneuploidy frequency in different age groups of patients and evaluate the efficacy of conducting preimplantation genetic testing (PGT−A) in programs of in vitro fertilization in older women of reproductive age 131 patients were investigated. PGT−A was performed following IVF procedures in all three groups of patients by means of intracytoplasmic sperm injection (ICSI). The obtained data showed that the frequency of obtaining aneuploid embryos progressively decreased with the age of the woman. But, in spite of the fact that the total number of aneuploid embryos decreased with age, this did not affect the ability to implant them. Importantly, implantation rates together with the incidence of developing pregnancies were found to be several times higher in the group where PGT−A was used in comparison to the group without genetic testing. Based on the results obtained, it is possible to conclude that the use of PGT−A in the group of patients of advanced reproductive age with the purpose to improve the clinical efficacy of treatment in the cycles of IVF with a selective transfer of one embryo.
Key words: preimplantation genetic testing, investigation of chromosomal disorders of embryos, increased reproductive age.