Fertility failure

Treatment that is designed to increase the chances of older women giving birth after fertility treatment may actually reduce their chances of having a baby, according to a recent paper in the New England Journal of Medicine. Pre-implantation genetic diagnosis (PGD) involves removing one or two cells from the early embryo and screening these cells for chromosome abnormalities that are associated with miscarriage. This technique is widely offered to women undergoing IVF, who are at risk of producing embryos with the wrong number of chromosomes.

Sebastian Mastenbroek and colleagues looked at 408 women aged between 35 to 41 who were undergoing IVF; 206 were given PGD. Twelve weeks after the embryos were implanted, 25% of the women who had PGD had become pregnant, compared with 37% of women whose embyros were selected using appearance – the standard method of embryo selection. Women in the PGD group also had a significantly lower live birth rate compared to those whose embyros were selected in the standard way.

Mastenbroek suggests that removing a cell may harm the embryo and lead to lower survival and the cell may also not carry a representative number of chromosomes. He suggests that women stick to traditional IVF treatment and save themselves the cost of PGD, given these results.