Case Report: Successful Pregnancy and Birth of a Healthy Baby with PGT-A for Woman with Advanced Maternal Age
Introduction: The most common cause of failed implantation and miscarriage is embryonic aneuploidy and the risk of aneuploidy increases significantly with increasing maternal age. Pre-implantation genetic testing for aneuploidy (PGT-A) can be an option to improve the prognosis of women with advanced...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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World Scientific Publishing
2022-09-01
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| Series: | Fertility & Reproduction |
| Online Access: | https://www.worldscientific.com/doi/10.1142/S2661318222741054 |
| _version_ | 1828135189467889664 |
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| author | Shaw Ni Amy LEE Chiou Fen TO Mei Jing ONG Rui Shan WONG Su Ling YU |
| author_facet | Shaw Ni Amy LEE Chiou Fen TO Mei Jing ONG Rui Shan WONG Su Ling YU |
| author_sort | Shaw Ni Amy LEE |
| collection | DOAJ |
| description | Introduction: The most common cause of failed implantation and miscarriage is embryonic aneuploidy and the risk of aneuploidy increases significantly with increasing maternal age. Pre-implantation genetic testing for aneuploidy (PGT-A) can be an option to improve the prognosis of women with advanced maternal age by extracting 3-5 trophectoderm cells from Day 5 and Day 6 blastocysts for genetic testing. Case History: A 37 years old patient tried to conceive for 5 years was recruited into our PGS research study initiated by Ministry of Health in Singapore. She had 3 previous implantation failure and one miscarriage between 2015-2018. The patient had regular menses every 30-35 days. Antral follicle count was 48 and her husband’s semen analysis was normal with Density 87 million/ml, motility 34% and morphology 4%. Results: Patient underwent an IVF cycle with PGT-A in December 2018 at our IVF Centre. 23 eggs were retrieved, 21 eggs were mature to undergo ICSI and 11 fertilized. The eggs were cultured in EmbryoGen immediately after ICSI and the embryos were transferred to BlastGen on Day 3 for extended culture. A total of 5 embryos were suitable for biopsy, 3 on Day 5 and 2 on Day 6. Embryos were vitrified while waiting for the genetic results. Chromosomal analysis of the biopsied trophectoderm cells was performed using NGS platform. Out of the 5 embryos tested, 2 embryos were euploid, giving 60% aneuploidy rate. One euploid embryo was thawed and transferred in a regulated frozen-thawed cycle in March 2020. The patient became pregnant and delivered a healthy baby boy. She returned in January 2022 to put back the remaining euploid embryo, she was again pregnant. Conclusion: PGT-A for comprehensive chromosome screening in selecting and transferring euploid embryos in assisted reproduction has an immediate impact on implantation, reduces the rate of clinical miscarriages and results in higher live birth rates. |
| first_indexed | 2024-04-11T17:44:50Z |
| format | Article |
| id | doaj.art-ceef70b60a8c413e80a58c5189efa14b |
| institution | Directory Open Access Journal |
| issn | 2661-3182 2661-3174 |
| language | English |
| last_indexed | 2024-04-11T17:44:50Z |
| publishDate | 2022-09-01 |
| publisher | World Scientific Publishing |
| record_format | Article |
| series | Fertility & Reproduction |
| spelling | doaj.art-ceef70b60a8c413e80a58c5189efa14b2022-12-22T04:11:24ZengWorld Scientific PublishingFertility & Reproduction2661-31822661-31742022-09-010403n0419419410.1142/S2661318222741054Case Report: Successful Pregnancy and Birth of a Healthy Baby with PGT-A for Woman with Advanced Maternal AgeShaw Ni Amy LEE0Chiou Fen TO1Mei Jing ONG2Rui Shan WONG3Su Ling YU4Department of Obstetrics & Gynaecology, Centre for Assisted Reproduction, Singapore General Hospital, SingaporeDepartment of Obstetrics & Gynaecology, Centre for Assisted Reproduction, Singapore General Hospital, SingaporeDepartment of Obstetrics & Gynaecology, Centre for Assisted Reproduction, Singapore General Hospital, SingaporeDepartment of Obstetrics & Gynaecology, Centre for Assisted Reproduction, Singapore General Hospital, SingaporeDepartment of Obstetrics & Gynaecology, Centre for Assisted Reproduction, Singapore General Hospital, SingaporeIntroduction: The most common cause of failed implantation and miscarriage is embryonic aneuploidy and the risk of aneuploidy increases significantly with increasing maternal age. Pre-implantation genetic testing for aneuploidy (PGT-A) can be an option to improve the prognosis of women with advanced maternal age by extracting 3-5 trophectoderm cells from Day 5 and Day 6 blastocysts for genetic testing. Case History: A 37 years old patient tried to conceive for 5 years was recruited into our PGS research study initiated by Ministry of Health in Singapore. She had 3 previous implantation failure and one miscarriage between 2015-2018. The patient had regular menses every 30-35 days. Antral follicle count was 48 and her husband’s semen analysis was normal with Density 87 million/ml, motility 34% and morphology 4%. Results: Patient underwent an IVF cycle with PGT-A in December 2018 at our IVF Centre. 23 eggs were retrieved, 21 eggs were mature to undergo ICSI and 11 fertilized. The eggs were cultured in EmbryoGen immediately after ICSI and the embryos were transferred to BlastGen on Day 3 for extended culture. A total of 5 embryos were suitable for biopsy, 3 on Day 5 and 2 on Day 6. Embryos were vitrified while waiting for the genetic results. Chromosomal analysis of the biopsied trophectoderm cells was performed using NGS platform. Out of the 5 embryos tested, 2 embryos were euploid, giving 60% aneuploidy rate. One euploid embryo was thawed and transferred in a regulated frozen-thawed cycle in March 2020. The patient became pregnant and delivered a healthy baby boy. She returned in January 2022 to put back the remaining euploid embryo, she was again pregnant. Conclusion: PGT-A for comprehensive chromosome screening in selecting and transferring euploid embryos in assisted reproduction has an immediate impact on implantation, reduces the rate of clinical miscarriages and results in higher live birth rates.https://www.worldscientific.com/doi/10.1142/S2661318222741054 |
| spellingShingle | Shaw Ni Amy LEE Chiou Fen TO Mei Jing ONG Rui Shan WONG Su Ling YU Case Report: Successful Pregnancy and Birth of a Healthy Baby with PGT-A for Woman with Advanced Maternal Age Fertility & Reproduction |
| title | Case Report: Successful Pregnancy and Birth of a Healthy Baby with PGT-A for Woman with Advanced Maternal Age |
| title_full | Case Report: Successful Pregnancy and Birth of a Healthy Baby with PGT-A for Woman with Advanced Maternal Age |
| title_fullStr | Case Report: Successful Pregnancy and Birth of a Healthy Baby with PGT-A for Woman with Advanced Maternal Age |
| title_full_unstemmed | Case Report: Successful Pregnancy and Birth of a Healthy Baby with PGT-A for Woman with Advanced Maternal Age |
| title_short | Case Report: Successful Pregnancy and Birth of a Healthy Baby with PGT-A for Woman with Advanced Maternal Age |
| title_sort | case report successful pregnancy and birth of a healthy baby with pgt a for woman with advanced maternal age |
| url | https://www.worldscientific.com/doi/10.1142/S2661318222741054 |
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