PMID- 18156649
OWN - NLM
STAT- MEDLINE
DCOM- 20080317
LR  - 20080229
IS  - 1460-2350 (Electronic)
IS  - 0268-1161 (Linking)
VI  - 23
IP  - 3
DP  - 2008 Mar
TI  - Diagnostic efficiency, embryonic development and clinical outcome after the 
      biopsy of one or two blastomeres for preimplantation genetic diagnosis.
PG  - 481-92
AB  - BACKGROUND: Preimplantation genetic diagnosis or screening (PGD, PGS) involves 
      embryo biopsy on Day 3. Opting for one- or two-cell biopsy is a balance between 
      the lowest risk for misdiagnosis on the one hand and the highest chance for a 
      pregnancy on the other hand. METHODS: A prospective controlled trial was designed 
      and 592 ICSI cycles were randomly assigned to the one-cell (group I) or the 
      two-cell group (group II). Primary outcomes were diagnostic efficiency and 
      embryonic development to delivery with live birth (analysed by cycle). The 
      false-positive rate for the PCR cycles is presented as a secondary outcome 
      (analysed by embryo). RESULTS: A strong significant correlation was observed 
      between embryonic developmental stage on Day 3 and post-biopsy in vitro 
      development on Day 5 (P < 0.0001). The influence of the intervention on Day 3 was 
      less significant (P = 0.007): the biopsy of one cell is less invasive than the 
      biopsy of two cells. PCR diagnostic efficiency was 88.6% in group I and 96.4% in 
      group II (P = 0.008). For the fluorescence in situ hybridization (FISH) PGD 
      cycles no significant difference in efficiency was obtained (98.2 and 97.5% in 
      group I and II, respectively). Similar delivery rates with live birth per started 
      cycle were obtained [58/287 or 20.2% in group I versus 52/303 or 17.2% in group 
      II, P = 0.358; the absolute risk reduction = 3.05%; 95% confidence interval (CI): 
      -3.24, 9.34]. Post-PGD PCR reanalysis showed six false positives in 97 embryos 
      (6.2%) in group II and none in group I (91 embryos reanalysed). No false 
      negatives were found. CONCLUSIONS: While removal of two blastomeres decreases the 
      likelihood of blastocyst formation, compared with removal of one blastomere, Day 
      3 in vitro developmental stage is a stronger predictor for Day 5 developmental 
      potential than the removal of one or two cells. The biopsy of only one cell 
      significantly lowers the efficiency of a PCR-based diagnosis, whereas the 
      efficiency of the FISH PGD procedure remains similar whether one or two cells are 
      removed. Delivery rates with live birth per started cycle were not significantly 
      different.
FAU - Goossens, Veerle
AU  - Goossens V
AD  - Department of Embryology and Genetics, Universitair Ziekenhuis Brussel, Vrije 
      Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium.
FAU - De Rycke, Martine
AU  - De Rycke M
FAU - De Vos, Anick
AU  - De Vos A
FAU - Staessen, Catherine
AU  - Staessen C
FAU - Michiels, An
AU  - Michiels A
FAU - Verpoest, Willem
AU  - Verpoest W
FAU - Van Steirteghem, Andre
AU  - Van Steirteghem A
FAU - Bertrand, Catherine
AU  - Bertrand C
FAU - Liebaers, Inge
AU  - Liebaers I
FAU - Devroey, Paul
AU  - Devroey P
FAU - Sermon, Karen
AU  - Sermon K
LA  - eng
SI  - ISRCTN/ISRCTN20762192
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20071222
PL  - England
TA  - Hum Reprod
JT  - Human reproduction (Oxford, England)
JID - 8701199
SB  - IM
CIN - Hum Reprod. 2008 Mar;23(3):493-8. PMID: 18158290
MH  - Biopsy/methods
MH  - Blastomeres/*cytology/metabolism
MH  - *Embryonic Development
MH  - False Positive Reactions
MH  - Female
MH  - Humans
MH  - In Situ Hybridization, Fluorescence
MH  - Polymerase Chain Reaction
MH  - Predictive Value of Tests
MH  - Pregnancy
MH  - Pregnancy Outcome
MH  - Preimplantation Diagnosis/adverse effects/*methods
MH  - Sperm Injections, Intracytoplasmic
EDAT- 2007/12/25 09:00
MHDA- 2008/03/18 09:00
CRDT- 2007/12/25 09:00
PHST- 2007/12/25 09:00 [pubmed]
PHST- 2008/03/18 09:00 [medline]
PHST- 2007/12/25 09:00 [entrez]
AID - dem327 [pii]
AID - 10.1093/humrep/dem327 [doi]
PST - ppublish
SO  - Hum Reprod. 2008 Mar;23(3):481-92. doi: 10.1093/humrep/dem327. Epub 2007 Dec 22.