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• W2019909358 abstract "Class I data have demonstrated that CCS provides meaningful increases in implantation and delivery rates while reducing multiple gestations. Optimal counseling regarding CCS requires discussion of both enhanced outcomes and the clinical misdiagnosis rate. This study seeks to determine the clinical misdiagnosis rate with qPCR based CCS. Prospective observational. Outcomes following transfer of CCS euploid embryos at 8 centers were studied. Data included the number of transfers, embryos transferred, clinical pregnancies, clinical gestations (ie gestational sacs), and aneuploid gestations. CCS misdiagnoses (aneuploid gestations) were further divided into those in spontaneous abortions and those which were ongoing. When products of conception were available to the CCS team, cells were analyzed to determine if mosaicism was present. Error rates are reported per patient, per pregnancy, per euploid embryo transferred, and per clinical gestation. 3168 transfers led to 2354 pregnancies (73.5%). A total of 4794 CCS euploid embryos resulted in 2976 gestational sacs reflecting a clinical implantation rate of 62.1%. From these, there were 13 aneuploid gestations. 10 were identified in products of conception and 3 in ongoing pregnancies. The clinical misdiagnosis rate per embryo transferred was 0.27% (13/4794) and per gestational sac was 0.44% (13/2976). The error per transfer was 0.41% (13/3168) and per clinical pregnancy was 0.55% (13/2354). 3 products of conception from aneuploid losses were examined and all had fetal mosaicism. The clinical error rate with qPCR based CCS is quite low, but not zero. Although only evaluable in limited specimens, mosaicism appears to play a prominent role in misdiagnoses. Clinical errors from mosaicism are likely unavoidable as they occur in the absence of any technical clinical or laboratory issue. Discussion of the limits of these technologies based on actual outcome data may be integrated into all patient counseling regarding CCS." @default.
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• W2019909358 date "2013-09-01" @default.
• W2019909358 modified "2023-09-28" @default.
• W2019909358 title "The clinical misdiagnosis rate with qPCR based comprehensive chromosomal screening (CCS) for embryonic aneuploidy is low and may commonly reflect mosaicism" @default.
• W2019909358 doi "https://doi.org/10.1016/j.fertnstert.2013.07.1602" @default.
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