Commentary on two recently published formal guidelines on management of “mosaic” embryos after preimplantation genetic testing for aneuploidy (PGT-A)

• Main Authors: Norbert Gleicher, David H. Barad, Zion Ben-Rafael, Demian Glujovsky, Lyka Mochizuki, Deepak Modi, Maximillian Murtinger, Pasquale Patrizio, Raoul Orvieto, Shizuko Takahashi, Andrea Weghofer, Søren Ziebe, on behalf of the International Do No Harm Group in IVF (IDNHG-IVF)
• Format: Article
• Language: English
• Published: BMC 2021-02-01
• Series: Reproductive Biology and Endocrinology
• Subjects: Preimplantation genetic testing for aneuploidy (PGT-A); In vitro fertilization (IVF); Mosaicism; Guidelines; Professional organizations
• Online Access: https://doi.org/10.1186/s12958-021-00716-1

Abstract Two professional societies recently published opinions on the clinical management of “mosaic” results from preimplantation genetic testing for aneuploidy (PGT-A) in human blastocyst-stage embryos in associations with in vitro fertilization (IVF). We here point out three principal shortcomings: (i) Though a most recent societal opinion states that it should not be understood as an endorsement of the use of PGT-A, any discussion of how PGT-A should be clinically interpreted for all practical purposes does offer such an endorsement. (ii) The same guideline derived much of its opinion from a preceding guidance in favor of utilization of PGT-A that did not follow even minimal professional requirements for establishment of practice guidelines. (iii) Published guidelines on so-called “mosaic” embryos from both societies contradict basic biological characteristics of human preimplantation-stage embryos. They, furthermore, are clinically unvalidated and interpret results of a test, increasingly seen as harmful to IVF outcomes for many infertile women. Qualified professional organizations, therefore, should finally offer transparent guidelines about the utilization of PGT-A in association with IVF in general.