Evidence-based management of preimplantation chromosomal mosaicism: lessons from the clinic

Andria G. Besser, M.S., Emily L. Mounts, M.S., and James A. Grifo, M.D., Ph.D.

Fertility and Sterility, 2021

https://doi.org/10.1016/j.fertnstert.2021.07.1182

Abstract

Mosaic results obtained through preimplantation genetic testing for aneuploidy pose ongoing challenges to clinical practice. Thorough genetic counseling for patients considering mosaic embryo transfer is consistently recommended by many best-practice statements, and providers are charged with the task of assessing and explaining potential prenatal, neonatal, and long-term risks. However, an increasing amount of outcome data from transferred embryos with mosaic results do not show any evidence of increased risk to ongoing pregnancies or newborns. This article examines how to reconcile these data with the current practices for patient education about preimplantation genetic testing for aneuploidy and mosaic embryo risk assessment, through an evidence-based lens.

Keywords: Preimplantation genetic testing; PGT-A; mosaicism; genetic counseling; vitrification