Abstract
Despite improvements in assisted reproduction techniques (ARTs), live birth rates
remain suboptimal, particularly in women with advanced maternal age (AMA). The leading
cause of poor reproductive outcomes demonstrated in women with AMA, as well as women
with recurrent miscarriage and repetitive implantation failure, is thought to be due
to high rates of embryonic aneuploidy. Preimplantation genetic testing for aneuploidies
(PGT-A) aims to select an euploid embryo for transfer and therefore improve ART outcomes.
Early PGT-A studies using fluorescent in situ hybridization on mainly cleavage-stage
biopsies failed to show improved delivery rates and, in certain cases, were even found
to be harmful. However, the development of comprehensive chromosome screening, as
well as improvements in culture media and vitrification techniques, has resulted in
an emerging body of evidence in favor of PGT-A, demonstrating higher implantation,
pregnancy, and live birth rates. While there are concerns regarding the potential
harm of invasive biopsy and the cost implications of PGT-A, the introduction of noninvasive
techniques and the development of new high-throughput methods which lower costs are
tackling these issues. This review aims to assess the evidence for PGT-A, address
possible concerns regarding PGT-A, and also explore the future direction of this technology.
Keywords
preimplantation genetic testing for aneuploidies - assisted reproduction technique
- in vitro fertilization - aneuploidy
