Does Preimplantation Genetic Diagnosis for Sex Selection Affect the Pregnancy and Miscarriage Rates in Women With an Expected Good Ovarian Response Undergoing IVF/ICSI Cycles?
Condition: Pregnancy
MeSH terms: Abortion, Spontaneous
Study type: Observational

Summary: 
      Records of women who had Pre-genetic diagnosis (PGD) over the last 3 years will be reviewed
      and its outcome will be compared to other records of women who had IVF/ICSI without PGD.
    

Detailed description: 
      Records of women who had PGD over the last 3 years will be reviewed and its outcome will be
      compared to other records of women who had IVF/ICSI without PGD Before starting the PGD
      process couples were seen by a geneticist to assess the feasibility of the procedure for each
      couple. Couples were then counselled by a gynaecologist specialised in IVF to assess their
      fertility status and explain the whole procedure including the expected success rates and
      risks of IVF.

      Women had standard pituitary down-regulation with GnRHa (Triptorelin 0.1mg, Decapeptyl®
      Ferring, Germany) day 7 after ovulation of previous cycle or on day 21 of the oral
      contraceptive cycles. GnRHa was continued for 2 weeks. Human menopausal gonadotrophin(HMG)
      (Merional ®IBSA) 150-300 IU/day was administered until the day of HCG administration,
      Transvaginal oocyte retrieval will be performed 34-36 h after the administration of HCG.

      After fertilization, biopsy was obtained from cleavage stage embryos. FISH analysis was used
      to distinguish embryos with balanced and unbalanced chromosomal abnormalities for carriers of
      structural chromosomal aberrations. In the analysis of translocations, unique FISH probes
      that flank the breakpoints of each translocation or that require the use of subtelomeric
      probes (specific to the chromosome ends of the translocated segments) for each affected
      individual must be designed and validated to detect normal and balanced products in embryonic
      tissue.

      The principle of PGD by FISH is that target-specific DNA probes labelled with different
      fluorochromes or haptens can be used to detect the copy number of specific loci, and thereby
      to detect chromosome imbalance associated with meiotic segregation of chromosome
      rearrangements which includes the Robertsonian translocations, reciprocal translocations,
      inversions, and complex rearrangements. FISH can also be used to select female embryos in
      families with X-linked disease Polymerase chain reaction (PCR) has been used to diagnose
      monogenic disorders. PCR is used to amplify sufficient DNA from embryo cells . A blastomere
      is placed in a solution that lyses the cell and releases the DNA and the PCR reaction mix is
      then added to begin the PCR. Because of its high sensitivity, contamination of the study
      sample with extraneous DNA is a danger and has led to the adoption of rigorous laboratory
      procedures and standards, such as the use of intracytoplasmic sperm injection.

      PGD analysis results were available on day 5 after oocyte retrieval. If possible, 2
      unaffected embryos were transferred and the rest of the unaffected embryos were
      cryopreserved.

      Women were followed up and a pregnancy test was performed to detect pregnancy, pregnant women
      were followed up and any pregnancy complications were recorded
    

Intervention name(s): Pre-genetic diagnosis
Intervention type(s): Genetic
Observational model: Case-Control
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        All women who had IVF/ICSI over the past 3 years in Dar AlTeb subfertility centre will be
        included in the study
      
Keywords: Pre-genetic diagnosis; ICSI