Role of preimplantation genetic screening in a case of recurrent in vitro fertilization failure

In-vitro fertilization (IVF) is a process by which egg is fertilized by sperm outside the body or coined as in-vitro. IVF is the most clearly indicated when infertility results from one or more causes having no other effective treatment and often be the best treatment for couples with multifactor infertility because it can address or overcome all contributing causes at the same time. Concurrent with an IVF cycle, it is possible to obtain a cellular biopsy from a developing embryo and genetically evaluate this sample such as preimplantation genetic screening (PGS). PGS is the practice to evaluate embryos for chromosomal aneuploidy. Mrs. BJP, a 38- year-old female, came to the hospital with recurrent IVF failure. She had a history of two attempts of intrauterine insemination (IUI) and a history of three IVF attempts but has not been impregnanted. Physical examination revealed BMI 20.4kg/m2 and gynecologic status within normal limit. Transvaginal ultrasound examination revealed that uterus position ante flexion, size and shape within normal limit, endometrium regular 9mm, both ovaries in normal size. Ovarian stimulation used total rFSH 3300 IU. Oocyte retrieval was performed and got 7 oocytes, 3 were fertilized, and then 2 embryos were frozen. We performed PGS to both embryos and the results were one embryo normal and one embryo aneuploidy. We performed single embryo transfer and patient succeeded in getting pregnant. Morphologically normal looking embryos can still harbor genetic or epigenetic defect. The objective of IVF is to place the single best embryo. It is important to consider the method of embryo selection.