Parental translocations and need for preimplantation genetic diagnosis? Distorting effects of ascertainment bias and the need for information-rich families

摘要

To the Editor:I read with interest the Society for Assisted Reproductive Technology (SART) and the American Society for Reproductive Medicine (ASRM) Practice Committee Opinion on preimplantation genetic diagnosis/preimplantation genetic screening (PGD/PGS), a timely document following two recent landmark randomized controlled trials (1). However, the Opinion document falls short of addressing the evidence-based use of IVF/PGD for recurrent pregnancy loss (RPL), notably in carriers of a structural chromosome rearrangement, and concludes that, "Generally, because the birth of a healthy child validates the efficacy of PGD, randomized controlled trials are not necessary." Three cohort studies have reported higher live birth rates without IVF/PGD, therefore, this conclusion is erroneous.