Five years' experience of preimplantation genetic diagnosis in the Parisian center: outcome of the first 441 started cycles

Objective: To investigate the evolution of techniques and strategies and to evaluate the results of preimplantation genetic diagnosis (PGD) from January 2000 to December 2004 in chromosomal, monogenic and mithochrondial DNA disorders treated at our institution. Design: Retrospective study. Setting: Single French Parisian PGD center. Patient(s): Patients at risk of transmitting a serious genetic disorder to their offspring. Intervention: 121 couples enrolled in the program undergoing stimulated and frozen embryo replacement cycles with PGD. Main Outcome Measure(s): Results of the 441 first PGD cycles performed for various genetic conditions. Result(s): During 5 years, 416 stimulation and 24 frozen embryo replacement cycles were started, among which 52 clinical and 47 ongoing pregnancies occured. In stimulation cycles, the overall ongoing pregnancy rate was 24% per embyro transfer, 11% per started-cycle, and 27% per couple. The implantation rate was 16%. Conclusion(s): These encouraging results demonstrate that PGD might be considered as as valid alternative to prenatal diagnosis. Nevertheless, couples referred for PGD must be selected and counseled appropriately considering the complexity of the treatment and the relatively low take-home baby rate.