%0 Journal Article
%T Lessons from elective in vitro fertilization (IVF) in, principally, non-infertile women
%A Norbert Gleicher
%A Ann Kim
%A Andrea Weghofer
%A David H Barad
%J Reproductive Biology and Endocrinology
%D 2012
%I BioMed Central
%R 10.1186/1477-7827-10-48
%X We investigated 88 females without history of infertility in 109 consecutive elective IVF cycles, almost exclusively performed for purposes of preimplantation genetic screening (PGS; i.e., elective gender selection). The following questions were addressed: (i) impact of PGS on IVF pregnancy chances; (ii) impact of transfer of 1 vs. ¡Ý2 embryos on IVF pregnancy chances; (iii) correlation of anti-M¨¹llerian hormone (AMH) levels to embryo ploidy (iv) effect of gonadotropin dosage used in stimulation on available embryos for transfer; and (v) in form of a 1:1 case control study, compared 33 elective PGS cycles with matched control cycles without PGS, performed in couples with either prior tubal ligations and/or severe male factor infertility as indication of IVF.The overall clinical pregnancy rate for the group was 36.7%; pregnancy was associated with number of euploid (P£¿=£¿0.009) and number of embryos transferred (P£¿=£¿0.001). Odds of pregnancy were 3.4-times higher if ¡Ý4 euploid embryos were produced in comparison to <4 (95% CI 1.2 to 9.2; P£¿=£¿0.019), and odds of pregnancy were 6.6-times higher if greater than or equal to 2 rather than <1 euploid embryos were transferred (95% CI 2.0 to 21.7; P£¿=£¿0.002). Increasing AMH (P£¿=£¿0.001) and gonadotropin dosage used in ovarian stimulation (P£¿=£¿0.024), was, independently, associated with number of available euploid embryos. Increasing AMH, but not follicle stimulating hormone (FSH), was associated with number of embryos available for biopsy and PGS (P£¿=£¿0.0001). Implantation rates were 26.4% with PGS and 9.5% without (P£¿=£¿0.008). Women undergoing PGS, demonstrated 4.58-times higher odds of pregnancy than matched controls (95% CI 1.102 to 19.060, Exp 4.584, P£¿=£¿0.036).This study suggests that outcomes of elective IVF cycles may significantly deviate from infertility-associated cycles. Affirming proof of concept for PGS, utilizing day-3 embryo biopsy and fluorescence in-situ hybridization (FISH), both widely held responsible for ea
%K In vitro fertilization (IVF)
%K Preimplantation genetic diagnosis (PGD)
%K Preimplantation genetic screening (PGS)
%K Aneuploidy
%K Pregnancy rates
%K Gonadotropin dosage
%K Anti-M¨¹llerian hormone (AMH)
%K Single embryo transfer
%U http://www.rbej.com/content/10/1/48/abstract