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Preimplantation Genetic Screening and The Success Rate of In Vitro Fertilization: A Three-Years Study on Iranian Population
Authors: Mehdi Totonchi, Babak Babaabasi, Hadi Najafi, Mojtaba Rezazadeh Valojerdi, Poopak Eftekhari-Yazdi, Lila Karimian, Navid Almadani, Anahita Mohseni Meybodi, Morteza Kimiai, Mehri Mashayekhi, Tahereh Madani, Hamid Gourabi

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Objective: In vitro fertilization (IVF) is one of the most efficient approaches within the context of assisted reproductive
technology (ART) to treat infertility. High pregnancy rates have become the major index of successful IVF in clinical
studies. It is not clear yet which factors are certainly responsible for IVF success, as various outcomes were obtained
in different IVF centers with different settings. In this study, we aimed to address controversies in the interpretation of
promising results of IVF with respect to preimplantation genetic screening (PGS).
Materials and Methods: In this retrospective case series study, we built a dataset containing data from 213 IVF
patient candidates for PGS (654 embryos) with blastomere biopsy at day 3 and trophectoderm biopsy in day 5, referred
to Royan Institute, Tehran, Iran from 2015 to 2018. Next, the data were analyzed to find influential factors affecting
success rate of ART cycles.
Results: Data analyses showed that regardless of PGS indications (ART failures, recurrent miscarriage, chromosomal
abnormalities, etc.), the pregnancy rate is influenced by maternal and embryonic factors such as the age of mother
as well as quantity and quality of transferred embryos. Furthermore, genotyping of embryos using array comparative
genomic hybridization (aCGH) depicted the highest rate of chromosomal aberrations for chromosomes 1, 16 and 19
while the lowest frequency for chromosomes 11 and 17. Similarly, we detected 463 genetically abnormal embryos by
aCGH, among which only 41.9% could be detected by classical fluorescent in situ hybridization (FISH) method.
Conclusion: This study not only highlighted the advantages of aCGH over the FISH method in detection of chromosomal
abnormalities, but also emphasized the importance of genetic abnormality as an indication for determination of IVF
success rate.