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- W2016350498 abstract "Reply of the Authors:We appreciate the interest in our article and comments by Dr. Musters and colleagues. The article described the genetic abnormalities seen in the miscarriages of our infertility patients and compared those abnormalities with currently available PGS probe panels (1Lathi R.B. Westphal L.M. Milki A.A. Aneuploidy in the miscarriages of infertile women and the potential benefit of preimplanation genetic diagnosis.Fertil Steril. 2008; 89: 353-357Abstract Full Text Full Text PDF PubMed Scopus (56) Google Scholar). Although the randomized controlled trial performed by Mastenbroek et al. (2Mastenbroek S. Twisk M. van Echten-Arends J. Sikkema-Raddatz B. Korevaar J.C. Verhoeve H.R. et al.In vitro fertilization with preimplantation genetic screening.N Engl J Med. 2007; 357: 9-17Crossref PubMed Scopus (565) Google Scholar) was not available at the time of submission of our article, we agree that it brings up important concerns about the clinical efficacy of PGS as it is currently performed. It is unclear from the current literature if the lower-than-expected implantation rates seen in that study are due to damage to the embryos as a result of the biopsy or to misdiagnosis due to mosaicism or technique. Both of these aspects of embryo diagnostics could potentially be improved as science and laboratory techniques advance. For example, trophectoderm biopsy removes a smaller percentage of the total embryo cell number, and preliminary studies have shown improved implantation rates compared with cleavage-stage biopsy (3Kokkali G. Traeger-Synodinos J. Vrettou C. Stavrou D. Jones G.M. Cram D.S. et al.Blastocyst biopsy versus cleavage stage biopsy and blastocyst transfer for preimplantation genetic diagnosis of beta-thalassaemia: a pilot study.Hum Reprod. 2007; 22: 1443-1449Crossref PubMed Scopus (118) Google Scholar, 4McArthur S.J. Leigh D. Marshall J.T. de Boer K.A. Jansen R.P. Pregnancies and live births after trophectoderm biopsy and preimplantation genetic testing of human blastocysts.Fertil Steril. 2005; 84: 1628-1636Abstract Full Text Full Text PDF PubMed Scopus (200) Google Scholar). In addition, single nucleotide polymorphism and microarray technology is rapidly advancing and may be able to overcome some of the diagnostic errors that can occur with fluorescence in-situ hybridization. The purpose of our study was not to universally advocate PGS as it is currently performed, but to add to the growing body of knowledge of human embryonic development and to aid in the design of future applications of this field. We remain hopeful that preimplantation diagnostics will evolve with continued research and discussion. Therefore, many more studies are needed on the risks and potential benefits of this technique. Reply of the Authors: We appreciate the interest in our article and comments by Dr. Musters and colleagues. The article described the genetic abnormalities seen in the miscarriages of our infertility patients and compared those abnormalities with currently available PGS probe panels (1Lathi R.B. Westphal L.M. Milki A.A. Aneuploidy in the miscarriages of infertile women and the potential benefit of preimplanation genetic diagnosis.Fertil Steril. 2008; 89: 353-357Abstract Full Text Full Text PDF PubMed Scopus (56) Google Scholar). Although the randomized controlled trial performed by Mastenbroek et al. (2Mastenbroek S. Twisk M. van Echten-Arends J. Sikkema-Raddatz B. Korevaar J.C. Verhoeve H.R. et al.In vitro fertilization with preimplantation genetic screening.N Engl J Med. 2007; 357: 9-17Crossref PubMed Scopus (565) Google Scholar) was not available at the time of submission of our article, we agree that it brings up important concerns about the clinical efficacy of PGS as it is currently performed. It is unclear from the current literature if the lower-than-expected implantation rates seen in that study are due to damage to the embryos as a result of the biopsy or to misdiagnosis due to mosaicism or technique. Both of these aspects of embryo diagnostics could potentially be improved as science and laboratory techniques advance. For example, trophectoderm biopsy removes a smaller percentage of the total embryo cell number, and preliminary studies have shown improved implantation rates compared with cleavage-stage biopsy (3Kokkali G. Traeger-Synodinos J. Vrettou C. Stavrou D. Jones G.M. Cram D.S. et al.Blastocyst biopsy versus cleavage stage biopsy and blastocyst transfer for preimplantation genetic diagnosis of beta-thalassaemia: a pilot study.Hum Reprod. 2007; 22: 1443-1449Crossref PubMed Scopus (118) Google Scholar, 4McArthur S.J. Leigh D. Marshall J.T. de Boer K.A. Jansen R.P. Pregnancies and live births after trophectoderm biopsy and preimplantation genetic testing of human blastocysts.Fertil Steril. 2005; 84: 1628-1636Abstract Full Text Full Text PDF PubMed Scopus (200) Google Scholar). In addition, single nucleotide polymorphism and microarray technology is rapidly advancing and may be able to overcome some of the diagnostic errors that can occur with fluorescence in-situ hybridization. The purpose of our study was not to universally advocate PGS as it is currently performed, but to add to the growing body of knowledge of human embryonic development and to aid in the design of future applications of this field. We remain hopeful that preimplantation diagnostics will evolve with continued research and discussion. Therefore, many more studies are needed on the risks and potential benefits of this technique. Benefits of PGD in patients with recurrent miscarriages?Fertility and SterilityVol. 90Issue 1PreviewTo the Editor: Full-Text PDF" @default.
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- W2016350498 title "Reply of the Authors: Benefits of PGD in patients with recurrent miscarriages?" @default.
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