The predictive value of sperm chromatin structure assay
2005; Oxford University Press; Volume: 20; Issue: 8 Linguagem: Inglês
10.1093/humrep/dei014
ISSN1460-2350
Autores Tópico(s)Prenatal Screening and Diagnostics
ResumoThe issue raised by Cohen and Munne ´brings us to a more delicate point that has been a target of discussion for a long time.The biopsy of one blastomere may be less detrimental for the further development of the embryo, but may jeopardize the accuracy of the diagnosis.The references mentioned by Cohen and Munne ´are not convincing: Bahc ¸e ( 2003) is comparing 383 embryos from which in 99% (379) one blastomere was removed and in 1% (four) two cells were removed.The implantation rate was 41.17% after one blastomere biopsy versus 18.6% in the two-blastomere biopsy.The reference of Magli et al. (2004), which actually does not deal with the comparison of one-and two-cell biopsies, indeed mentioned in the Introduction a retrospective analysis of data: 29% implantation after one-cell biopsy versus 16% after two-cell biopsy.No other data, such as the number of embryos analysed, are presented.Cohen and Munne ´infer that the low implantation rate of blastocysts was due to suboptimal culture conditions, an argument that overlooks the mean age of the patients included and their unfavourable infertility history.Also, there were no exclusions because of higher day 3 FSH, failure on previous attempts or insufficient follicles during stimulation.In a typical European setting with IVF reimbursement, implantation rates tend to be lower because of the lack of selection criteria that tend to include 'optimal' patients. ReferencesBahc ¸e M (2003) Effect of different biopsy procedures on implantation rates.
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