PGD/PGS in RPL: Is It Really Beneficial?

The Genetics Committee of the Society of Obstetricians and Gynaecologists of Canada concluded in 2015 that "the use of comprehensive chromosome screening technology coupled with trophectoderm biopsy in preimplantation genetic diagnosis in couples carrying chromosomal translocations is recommended because it is associated with favorable clinical outcomes".

The American Society for Reproductive Medicine reported in 2016 that "the use of PGS as a universal screening test for IVF may demonstrate higher live birth rates with increased elective single embryo transfer for good prognosis patients" but did not specifically address RPL. Recent reports have suggested that expectant management was equal to PGS in clinical pregnancy rates and that the use of PGS could not be justified. In addition, many aspects of this invasive practice remain a matter of debate.

During this lecture, some crucial questions will be addressed:

- Does PGD/PGS improve clinical pregnancy rates when compared to expectant treatment in RPL?

- Is PGD/PGS cost-effective?

- What are the technical limitations of the genetic testing?

Following the conclusion of this presentation, participants should be able to:

1. Understand that preimplantation genetic diagnosis improves clinical outcomes in patients with RPL who have balanced translocations.
2. Review data that show that preimplantation genetic screening improves clinical outcome in good prognosis patients when using single embryo transfer.
3. Consider the potential role that PGS may play in couples with unexplained RPL