Preimplantation Genetic Screening in Women of Advanced Maternal Age
Randomized Controlled Trial (RCT) of Preimplantation Genetic Screening (PGS) in Women of Advanced Maternal Age (AMA)
An increased incidence of aneuploid pregnancies has been reported in women of advanced maternal age, with higher miscarriage rates. Cytogenetic studies in preimplantation embryos have shown elevated aneuploidy rate, particularly in women over 38 years. For these reasons, PGS has been applied to these patients to improve ongoing implantation rates, and most importantly, to decrease the risk of further miscarriages and affected offspring. In the past two years, several RCT have raised the question whether PGS is benefitial or not in AMA patients.
In our experience, PGS outcome in these patients offers higher ongoing implantation rates than the previously published in RCT studies, where no benefits for PGS were found. In these papers, poor technical skills, as well as unclear patients selection could explain the reported lack of PGS benefits.
Therefore, the objective of the present RCT is to analyze the outcome of IVF cycles with and without PGS in two age groups:
- Patients 38-39 years of age: 200 cyles per arm reaching embryo transfer should be performed
- Patients 40-44 years of age: 120 cycles per arm reaching embryo transfer Sample size has been calculated according to our retrospective experience with higher differences in ongoing implantation rates between cycles with and without PGS in patients of 40-44 years of age. In all patients embryo transfer will be performed on day 5. In the PGS group one cell will be biopsy in embryos with ≥5 cells on day-3 and chromosomes 13, 15, 17, 18, 21, 22, X and Y will be analyzed in two rounds. In the third round, nuclei with undoubtful or non-conclusive results will be analyzed using subtelomeric probes.
研究概览
研究类型
注册 (预期的)
阶段
- 不适用
联系人和位置
学习地点
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-
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Valencia、西班牙、46015
- Instituto Valenciano de Infertilidad
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- Female Patients over 37 years old, attending a fertility clinic
Exclusion Criteria:
- Azoospermic partners
- Female patients with uterine malformations
- number of retreived oocytes below 5
学习计划
研究是如何设计的?
设计细节
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
---|---|
有源比较器:with PGS
IVF cycles with Preimplantation Genetic Screening (PGS)
|
Preimplantation Genetic Screening
|
有源比较器:Without PGS
IVF cycle without Preimplantation Genetic Screening
|
Preimplantation Genetic Screening
IVF without PGS
|
研究衡量的是什么?
主要结果指标
结果测量 |
大体时间 |
---|---|
ongoing implantation per embryo and per pacient
大体时间:one month
|
one month
|
次要结果测量
结果测量 |
大体时间 |
---|---|
Take home baby
大体时间:9 months
|
9 months
|
合作者和调查者
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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