Pregnancy and child developmental outcomes after preimplantation genetic screening: a meta-analytic and systematic revie
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REVIEW ARTICLE
Pregnancy and child developmental outcomes after preimplantation genetic screening: a meta‑analytic and systematic review Misaki N. Natsuaki1 · Laura M. Dimler2 Received: 5 March 2018 / Accepted: 3 July 2018 © Children’s Hospital, Zhejiang University School of Medicine 2018
Abstract Background In in vitro fertilization (IVF) treatment, preimplantation genetic diagnosis/screening (PGD/S) attempts to detect chromosomal abnormalities in embryos before implantation. Using the meta-analytic and qualitative review approaches, this study aims to evaluate the effect of PGD/S on clinical pregnancy, live births, and childhood outcomes. Methods We conducted a literature search using 1) PubMed and other search engines, and 2) an ancestry search by tracking references cited in prior work. After screening the studies, we extracted information pertinent to the meta-analysis. We calculated the effect sizes for clinical pregnancy and live birth rates, and performed a moderation analysis by maternal age, type of genetic screening, and timing of the biopsy. For childhood outcomes, we conducted a systematic review of studies reporting the anthropometric, psychomotor, cognitive, behavioral, and family functioning of PGD/S children. Results We included 26 studies for clinical pregnancy and live births, and 18 studies for childhood outcomes. Results indicated that women who underwent comprehensive chromosome screening-based PGD/S had significantly higher clinical pregnancy rates (rr 1.207, 95% CI 1.017–1.431) and live birth rates (rr 1.362, 95% CI 1.057–1.755) than those whose IVF treatment did not include PGD/S. Early childhood outcomes of PGD/S children did not differ from those of non-PGD/S children. Conclusions Comprehensive chromosome screening-based PGD/S can improve clinical pregnancy and live birth rates without adversely affecting functioning in childhood at least up to age 9. Results are discussed in the context of bioethical, financial, legal, and psychological issues surrounding PGD/S. Keywords Child development · In vitro fertilization · Pregnancy · Preimplantation genetic diagnosis/screening
Introduction Forty years have passed since the first child conceived through in vitro fertilization (IVF) was born in 1978. Despite impressive technological and scientific advances, the rate of success (i.e., having a healthy baby) is far from patient expectations. One of the major causes for IVF failure is aneuploidy or chromosome abnormalities in the human embryo [1]. Aneuploidy is common in human reproduction and is known to have a deleterious effect on fetus implantation and growth [1]. * Misaki N. Natsuaki [email protected] 1
Department of Psychology, University of California, Riverside, 900 University Ave., Riverside, CA 92521, USA
Department of Psychology, Regent University, 1000 Regent University Dr., Virginia Beach, VA 23474, USA
2
One solution to aneuploidy in the context of IVF is to detect embryo abnormalities before implantation and select only healthy embryos for implantation. While e
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