39B - PGT-A Should Be Offered for Recurrent Implantation Failure

Summary

Pre-implantation genetic testing for aneuploidies (PGT-A) has been described as the solution for embryo selection for use universally and in select patient cohorts, including those with recurrent implantation failure (RIF) and recurrent miscarriages. However, there is considerable doubt about the accuracy of the test itself; even when using the most up-to-date technique of next generation DNA sequencing on a blastocyst biopsy, there is a risk of generating a false-positive result, and subsequently discarding healthy embryos. Indeed, there are reports of multiple cases of healthy euploid children born following the transfer of an alleged aneuploid embryo. Furthermore, mosaic embryos generate difficult challenges, and when transferred may also result in a healthy child; but are often discarded. Multiple large randomised controlled studies have failed to demonstrate a statistically significant improvement in live birth following PGT-A, and given the additional stress fragile embryos must endure during the process of biopsying, there is no conceivable value in the use of PGT-A either for use universally or in RIF patients.