The Israel Participation in Preimplantation Genetic Testing for Aneuploidy (PGT-A) by Microarray Analysis of Polar Bodies in Advanced Maternal Age: The ESTEEM Randomised Controlled Trial

Rubinshtain Ester 1 Talia Geva 1 Geona Alterescu 2 Hananel Holzer 1 Oshrat Schonberger 1 Aharon Peretz 1 Rafi Ronel 3 Devorah Strassburger 3 Esti Kasterstein 3 Pinhas Renbaum 2 Sharon Zeligson 2 Rachel Beeri 2
1IVF Department, Shaare Zedek Medical Centre
2Genetics Department, Shaare Zedek Medical Centre
3IVF Department, Asaf Harofeh Medical Centre

This multi-centre, randomised, controlled study was to investigate if comprehensive chromosome screening of the first and second polar body would increase the chance of live birth in women of advanced maternal age, within one year of treatment.

A total of 396 eligible women between the ages of 36 and 40, matched by age, BMI and number of previous cycles of IVF/ICSI, were randomised to either the control group (ICSI without chromosome screening) or to the study group (CGH array of polar bodies using 24sure array of Illumina) between June 2012 and December 2016. Of these, 50 were from Shaare Zedek Medical Centre and Asaf Harofeh Medical Centre.

If in the first cycle of treatment all embryos were aneuploid, a second cycle with PB array CGH was offered.

23% of patients with screening had a live birth within one year of treatment versus 24% in the group without intervention. This shows that screening does not substantially increase the chance of live birth.

In the Israeli group, there were 7 births from each strand, i.e. a slightly higher live birth rate than average for the study.

However, it was shown that the similarity in birth rates was achieved with fewer transfers, less cryopreservation and fewer miscarriages. Therefore, this form of embryo selection may be considered to minimise the number of interventions to achieve success with ICSI.

Rubinshtain Ester
Rubinshtain Ester








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