Abstract
Vol.37 No.2
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Influence of the diagnostic resolution, sensitivity, and specificity of the preimplantation genetic test for aneuploidy on reproductive outcomes
JMOR, 37(2) 73-86, 2020
The majority of articles assessing the strategy of performing a preimplantation genetic test for aneuploidy (PGT-A) together with morphological assessment of embryos have reported a higher clinical pregnancy or live birth rate per embryo. However, several studies have demonstrated a lack of efficacy in improving reproductive outcomes. Some researchers state that high rates of mosaicism decrease the diagnostic sensitivity of PGT-A and consequently diminish the reproductive outcome. However, we achieved live birth rates per transfer of 80% in a clinical study of the Japan Society of Obstetrics and Gynecology. From this result, we consider that PGT-A had a sensitivity of 97%, a result which was calculated using our hypothetical blastocyst model. Damage to the blastocyst caused by a trophectoderm (TE) biopsy may interfere with normal implantation, resulting in poor reproductive outcomes. Hence, skillful TE biopsy is important for successful PGT-A outcomes. We consider that PGT-A confers benefits such as improved clinical pregnancy and live birth rates per embryo transfer. However, underdeveloped biopsy techniques and low diagnostic specificity can reduce the chances of delivery. Finally, the decision-making process should involve couples who are considering the use of this technique.
