Genetics Session: Established and Emerging Information on Outcomes from Non-Euploid Embryo Transfer

Dr. Alyssa Snider

 0.75 CME

• PGT-A is a screening test performed on a biopsy of preimplantation embryos and is used to make critical decisions regarding embryo transfer, storage, or disposal. Ideally, diagnostic tests are utilized in making medical decisions; however, a diagnostic test that could be performed on an embryo is not available prior to transfer. Furthermore, without the availability of a diagnostic test to assess the performance of a screening test, predictive values can be difficult to determine. Recent studies have explored the predictive value of PGT-A results using clinical outcomes after embryo transfer or multifocal biopsy performed on donated embryos. Fortunately, most embryos have either euploid or simple aneuploid PGT-A results, both with high predictive value. Result categories with reduced predictive value include mosaic, segmental aneuploid, and aneuploid with many chromosomes (~6 or more) involved. My presentation will include a review of the current knowledge surrounding the predictive values of non-euploid results and an explanation of the possible biological, procedural, and technical reasons for reduced predictive values. Lastly, I will present some potential clinical pitfalls of expecting all PGT-A results to be diagnostic. Genetic counseling can assist patients in making informed treatment decisions based on PGT-A results.

• Classify PGT-A as a screening test while recognizing its frequent use as a diagnostic test
• Synthesize current literature surrounding the predictive values of various PGT-A result categories
• Identify which PGT-A result categories have reduced predictive value and explain potential explanations

• Evaluate different result categories to facilitate decision making, including whether to transfer, store, rebiopsy, or discard embryos