Preimplantation aneuploidy testing for infertile patients of advanced maternal age: a randomized prospective trial

Objective: To assess the potential benefit of preimplantation aneuploidy testing on the outcome of in vitro fertilization (IVF) for women of advanced maternal age (AMA). Design: Prospective randomized clinical trial. Setting: Private IVF clinic. Patient(s): Sixty-two infertile AMA couples undergoing fertility treatment. Intervention(s): Fluorescent in situ hybridization (FISH) for chromosomes X, Y, 13, 15, 16, 17, 18, 2 1, and 22. Main Outcome Measure(s): Preimplantation aneuploidy testing of biopsied blastomeres on day 3 of development. Result(s): Fertilization and blastocyst developmental rates were similar for the test and control groups: 80% versus 77.4% and 49% versus 48.2%, respectively. The average number of embryos transferred was comparable at 2.2 for the test group and 2.7 for the control group. Implantation rates were also equivalent across the two groups: 37.3% in the control group versus 36.5% in the test group. Nevertheless, the spontaneous abortion rate was observed to be lower for the test group: 25.9% versus 32.26% in the control group. This resulted in an observed increase in delivery rates for the test group: 78% versus 67.74% in the control group. Conclusion(s): Preimplantation aneuploidy testing does not appear to statistically significantly improve outcome parameters in infertile AMA patients; however, a trend toward a decrease in the spontaneous abortion rate with a subsequent higher delivery rate was observed. (Fertil Steril (R) 2009;92:157-62. (C)2009 by American Society for Reproductive Medicine.)