[Preimplantation genetic diagnosis and neonatal outcome].

INTRODUCTION

Pregnancies achieved following in-vitro fertilization treatments are at high risk for preterm birth and low birth weight. It is not known whether the treatments or the infertility itself are responsible for this outcome.

OBJECTIVE

To examine whether embryo biopsy for pre-implantation genetic diagnosis (PGD) influences neonatal outcome.

MATERIALS AND METHODS

A retrospective cohort study was conducted including 291 children born following PGD (198 singleton, 49 twin pairs, 1 triplet), 244 children born following intracytoplasmic sperm injection (ICSI) (158 singletons and 43 twin pairs) and 663 children born following a spontaneous pregnancy (spontaneous conception (SC)) (429 singletons, 117 twin pairs), matched for maternal age, parity and BMI. The following parameters were compared: Gestational age, birth weight, prematurity (< 37 and < 34 weeks), low birth weight (LBW < 2500 gr, very LBW < 1500 gr) and intra-uterine growth restriction (IUGR < 10th percentile for gestational age).

RESULTS

For singletons, the mean birth weight was higher following PGD compared to ICSI, but not compared to SC. Mean gestational ages following PGD were lower compared to SC but higher compared to ICSI. LBW and IUGR rates were higher in ICSI pregnancies compared to PGD and SC. In twin pregnancies, birth weight was higher in PGD compared to ICSI and LBW rates were lower in PGD compared to ICSI and similar to SC. Polar-body and blastomere biopsies provided similar outcomes.

CONCLUSIONS

Embryo biopsy, per se, did not cause IUGR or LBW compared to SC, despite lower gestational age with PGD. The worse outcome in ICSI compared to PGD pregnancies may be due to the infertility itself.