Scientific study carried out by CREA comes to the conclusion that CGHarray technique reduces negative effects in advanced age.

Valencia 21.10.14 The progressive increase of the age at which women have their first child, over than 30 years, is more and more frequent not only in Spain but also in the rest of European Countries. The research for economic stability and job security lead us to postpone maternity. 

It is a fact that fertility decreases progressively as the woman’s age increases, as both quantity and quality of her oocytes are gradually decreasing. For this reason, it’s more and more frequent that women in advanced age turn to assist-ed reproduction centers looking for pregnancy. 

Despite the advances in assisted reproduction treatments, pregnancy chances obtained with In Vitro Fertilization in women from 38 years are lower than in younger women given that less embryos are obtained, with lower quality and with higher occurrence of aneuploidies (alteration in number of chromosomes).

Pre-implantation Genetic Screening (SGP) allows to analyze chromosomes alterations in the embryos obtained through in vitro fertilization and to transfer into maternal uterus only euploid embryos, that is, embryos with the correct number of chrosomomes. The technique used for SGP since 1997, called F.I.S.H., allowed to study a limited series of chromosomes involved in miscar-riages but , many other chromosomes were not studied. Eventually, a new technique called CGHarray has been developed, allowing to study the 24 chromosomes of the embryo in a quickly and effective way. 

The use of this technique in patients in advanced age performing an In vitro fertilization seems to improve pregnancy chances and to reduce miscarriage rates, allowing to select the embryos not affected by aneuploidies for their transfer into uterus. But we should bear in mind that SGP cannot “cure” the embryo, that is, if the embryo has an alteration in the number of its chromosomes it cannot be repaired. Thus, if all the embryos of the couple are affected by any alteration, it won’t be possible to obtain any “healthy” embryo to be transferred. 

Here at CREA (Assisted Reproduction Medical Centre in Valencia) we carried out a review study of all cases of SGP with CGHarray in patients with poor chances due to advanced age (older than 40) or to repeated miscarriages (more than 2 miscarriages) or to implantation failure (transfer of 4 good quality embryos with no gestation achieved) and we have concluded that CGha allows to reduce the maternal age’s effect on pregnancy and miscarriages rates. Results of the study, presented this year during the Spanish Society for Fertility’s conference, show that indeed, in those cases where it’s possible to transfer euploid embryos, that is with the correct number of chromosomes, after carrying out SGP by CGHa, implantation, gestation and miscarriage rates in advanced age women are equal to younger women. 

Our data match with others published on national and international scope, confirming this beneficial effect of SGP with CGHa in women in advanced age. For this reason, here at Crea we carry out SGP technique through CGHa in patiens with poor chances since 2011. At the end of 2013 we reviewed our data to check the possible beneficial effect of CGHa in women in advanced age. 

Nowadays new techniques are being developed to simplify and improve pre-implantation genetic screening. Combination of specific methods for embryos culture to blastocyst stage, together with new procedures based on laser tech-nology use for blastomere biopsy, allows to improve pregnancy rates even more. 

It’s more and more frequent that women in advanced age turn to reproductive medicine centers. For this reason, these results seem encouraging in regards to obtaining higher pregnancy and health born baby rates in these patients. 

However, we would like to remind that it’s important for women to be aware that assisted reproduction techniques success decreases in advanced ages, as there are less eggs and of lower quality, implying an higher risk of having em-bryos with chromosome alterations. Moreover, we must not forget that gesta-tions in women in advanced age are associated with more complications, such as gestational diabetes, pre-eclampsia or premature birth. 

For all this, it’s fundamental to properly inform couples, encouraging them to have children in younger age and in those cases where this was not possible, to incite them to turn to specialized centers as soon as possible to be helped to achieve their dream of being parents.