Healthy births and ongoing pregnancies obtained by preimplantation geneticdiagnosis in patients with advanced maternal age and recurrent implantation failure

Preimplantation genetic diagnosis (PGD) and subsequent embryo development w as evaluated in 72 couples presenting at our centre for intracytoplasmic sp erm injection (ICSI) due to severe male factor. The embryo biopsies were pe rformed in Ca2+/Mg2+-free medium. These patients were further divided into those with advanced maternal age (AMA, n = 49) and those with recurrent imp lantation failure (RIF, n = 23), Fluorescence in-situ hybridization (FISH) was carried out on 329 blastomeres (91.3%) with probes for the X, Y, 13, 18 and 21 chromosomes. The chromosomal abnormality rate was 41.3% with no sig nificant difference between the AMA and RIF groups. Aneuploidy accounted fo r the majority (72.8%) of chromosomal abnormalities. Out of 329 embryos, 84 .2% had cleaved after 24h and 15.1% had arrested. Embryos were transferred in 70 patients and 22 pregnancies were achieved (31.4% with an ongoing preg nancy rate of 28.5%), There were no significant differences between the pre gnancy rates of the AMA and RTF groups (32.5 and 30% respectively). Therefo re PGD should be offered to patients with AMA and RIF. Furthermore, the use of Ca2+/Mg2+-free medium during the blastomere biopsy facilitates the proc edure, while further embryo cleavage, ongoing pregnancies and healthy birth s are possible.