A literature review on the effect preimplantation genetic screening in combination with in vitro fertilization has on live birth rates in women over the age of 35 with a proposal for research to analyze the reasons behind the choice to elect for or aganist preimplantation genetic screening.

摘要

Problem: Preimplantation genetic screening (PGS) has been suggested as a means to select healthy embryos for transfer in women over the age of 35 with age related infertility. This research review is aimed at focusing on whether selective embryo implantation increases the likelihood of a woman over the age of 35 to reach the goal of a live birth by decreasing the likelihood of a miscarriage and/or elective abortion due to chromosomal anomaly. Methods: The following studies were obtained through the Weill Cornell Medical College (WCMC) library website as well as the New England Journal of Medicine database with dates ranging from 1987 to 2009. Randomized controlled trials, retrospective cohort studies, and prospective studies were included in this review. The search was limited to those articles that discussed In Vitro fertilization (IVF) with PGS in addition to either advanced maternal age or chromosomal abnormalities. The articles were chosen only if they were full text articles and accessible through the WCMC library. Results: Fifteen articles were reviewed, six included in this review, seven used to support evidence in the discussion section. Two articles were excluded because they used PGS to identify a specific gene. Leaving seven articles that pertained to either advanced maternal age or chromosomal abnormalities in IVF and PGS. Conclusion: PGS is an effective means of determining the genetic composition of embryos, allowing practitioners the ability to implant a chromosomally healthy embryo during an IVF cycle. However, as the majority of the literature outlines, successful implantation and live birth rates following a cycle of PGS with IVF are significantly lower than a cycle of IVF alone.