ORIGINAL ARTICLES: ASSISTED REPRODUCTION

The nature of aneuploidy with

increasing age of the female partner:
a review of 15,169 consecutive
trophectoderm biopsies evaluated
with comprehensive
chromosomal screening
Jason M. Franasiak, M.D.,a Eric J. Forman, M.D.,a,b Kathleen H. Hong, M.D.,a,b Marie D. Werner, M.D.,a,b
Kathleen M. Upham, B.S.,b Nathan R. Treff, Ph.D.,a,b and Richard T. Scott Jr., M.D.a,b
a
Division of Reproductive Endocrinology, Department of Obstetrics, Gynecology and Reproductive Science, Robert Wood
Johnson Medical School, Rutgers University, New Brunswick, and b Reproductive Medicine Associates of New Jersey,
Morristown, New Jersey

Objective: To determine the relationship between the age of the female partner and the prevalence and nature of human embryonic
aneuploidy.
Design: Retrospective.
Setting: Academic.
Patient(s): Trophectoderm biopsies.
Intervention(s): Comprehensive chromosomal screening performed on patients with blastocysts available for biopsy.
Main Outcome Measure(s): Evaluation of the impact of maternal age on the prevalence of aneuploidy, the probability of having no
euploid embryos within a cohort, the complexity of aneuploidy as gauged by the number of aneuploid chromosomes, and the trisomy/
monosomy ratio.
Result(s): Aneuploidy increased predictably after 26 years of age. A slightly increased prevalence was noted at younger ages, with
>40% aneuploidy in women 23 years and under. The no euploid embryo rate was lowest (2% to 6%) in women aged 26 to 37, was
33% at age 42, and was 53% at age 44. Among the biopsies with aneuploidy, 64% involved a single chromosome, 20% two chromo-
somes, and 16% three chromosomes, with the proportion of more complex aneuploidy increasing with age. Finally, the trisomy/mono-
somy ratio approximated 1 and increased minimally with age.
Conclusion(s): The lowest risk for embryonic aneuploidy was between ages 26 and 30. Both younger and older age groups had higher
rates of aneuploidy and an increased risk for more complex aneuploidies. The overall risk did not
measurably change after age 43. Trisomies and monosomies are equally prevalent. (Fertil SterilÒ
2014;101:656–63. Ó2014 by American Society for Reproductive Medicine.) Use your smartphone
Key Words: Comprehensive chromosomal screening, embryonic aneuploidy, IVF, to scan this QR code
preimplantation genetic screening, trophectoderm biopsy and connect to the
discussion forum for
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A
dvances in clinical and labo-
Received August 24, 2013; revised October 31, 2013; accepted November 7, 2013; published online ratory practice have resulted
December 17, 2013.
J.M.F. has nothing to disclose. E.J.F. has nothing to disclose. K.H.H. has nothing to disclose. M.D.W. has
in steady improvements in in
nothing to disclose. K.M.U. has nothing to disclose. N.R.T. has nothing to disclose. R.T.S. has vitro fertilization (IVF) outcomes
nothing to disclose. over the last two decades. Although
Reprint requests: Jason M. Franasiak, M.D., RMA of New Jersey, 140 Allen Road, Basking Ridge, New
Jersey 07920 (E-mail: jfranasiak@rmanj.com). the enhanced outcomes are excellent
and provide infertile couples with
Fertility and Sterility® Vol. 101, No. 3, March 2014 0015-0282/$36.00
Copyright ©2014 American Society for Reproductive Medicine, Published by Elsevier Inc.
outstanding opportunities to build
http://dx.doi.org/10.1016/j.fertnstert.2013.11.004 their families, the reality is that IVF

656 VOL. 101 NO. 3 / MARCH 2014


remains an inefficient process. Evaluation of the most
recent Society for Assisted Reproductive Technologies
(SART)/U.S. Centers for Disease Control and Prevention
(CDC) data reveal that approximately 17% of fresh embryos
deemed of sufficient quality to merit transfer actually prog-
ress to clinical pregnancy (1).
The inefficiency in IVF may result from many factors,
but clearly one major issue is the age-related rate of aneu-
ploidy (2). Aneuploidy is associated with maternal age and
is only subtly related to the morphologic appearance of the
embryo (3). As such, a real percentage of even the ‘‘most
ideal’’ embryos selected for transfer are going to be aneu-
ploid and have little if any meaningful reproductive poten-
tial (4).
The development of validated testing platforms capable
of analyzing all 24 chromosomes has empowered clinicians,
laboratorians, and scientists to assess the ploidy status of
embryos before selection for transfer (5, 6). Accurate
diagnoses combined with the substantively enhanced safety
attained with trophectoderm biopsy (7) at the blastocyst
stage have resulted in meaningfully increased implantation
and delivery rates (4, 8).
These studies provide class I data for enhanced outcomes,
but they apply to well-defined populations, with data
condensed into relatively large age ranges. Clinical applica-
tion of these technologies requires specific counseling of in-
dividuals from the general IVF population. Although an
individuals' personal prognosis will be influenced by multiple
factors, data on comprehensive chromosomal screening (CCS)
results from the general population may be useful. Counseling
regarding CCS generally occurs in two settings: before elect-
ing to proceed with CCS and again after the results of the an-
alyses of their cohort are available.
Before initiating treatment, counseling typically includes
at least three general considerations. First is the safety of the
procedure itself. That issue has been addressed, and the safety
of trophectoderm biopsy is reasonably established. The other
two issues are what proportion of a patient's embryos are
likely to be aneuploid, and what is the probability that all of
her embryos will be aneuploid, leaving nothing available
for transfer? These answers may need to be adjusted for
each individual's circumstances, but age-specific data are
most helpful.
After the results of the CCS analysis are available, there
may be questions of whether those results are generally
consistent with those of a woman's age-controlled peers. In
addition to the overall rate of aneuploidy, it is possible to
consider the nature of the aneuploid errors that are identified.
This would include the complexity of the errors (i.e., did they
involve a single chromosome, two chromosomes, or three or
more chromosomes?). Also worthy of consideration is the
overall ratio of trisomies to monosomies. The prognostic
values of these factors for a single individual remain to be
examined in detail, but they do provide some insight into
the nature of the errors that that cohort of the embryo expe-
rienced. They may also be important for the clinician and
embryologist when evaluating the performance of the assay
being used for CCS across a larger number of embryos from
multiple patients within their laboratory.
VOL. 101 NO. 3 / MARCH 2014
Fertility and Sterility®
To date, there has not been a systematic report of CCS
results in a large number of embryos from a general IVF pop-
ulation. Our study determined the relationship between
maternal age and the aneuploidy rate, the no-euploid embryo
rate per cohort, the complexity of encountered aneuploid
errors, and the trisomy/monosomy ratio.
MATERIALS AND METHODS
Population
The embryos undergoing CCS of trophectoderm biopsies
that were submitted to the Reproductive Medicine Associ-
ates (RMA) genetics laboratory for analysis were selected
for the study. In our center, all patients are offered
aneuploidy screening as a means to increase pregnancy
rates, decrease loss rates, and decrease transfer order. All bi-
opsies were reviewed, and the following information was
collected: [1] the result of the genetic analysis, [2] the age
of the woman producing the oocyte that resulted in the
embryo being biopsied, and [3] the IVF program from which
the biopsy was submitted. There were no inclusion or exclu-
sion criteria beyond having those pieces of information
available. The indications for CCS were categorized as fam-
ily balancing, single-gene cases, recurrent pregnancy loss,
and routine infertility care. Expanded blastocysts, equiva-
lent to Gardner blastocele expansion score of 3 to 6, are bio-
psied for CCS.
Assays
The trophectoderm biopsy samples were placed into lysis
buffer using a previously established protocol and were
then submitted for evaluation. The samples were analyzed
via quantitative polymerase chain reaction (qPCR) or single-
nucleotide polymorphism (SNP) array using an established
24-chromosome assay that has been specifically validated
for trophectoderm biopsies (5, 6). The results of each biopsy
were initially categorized as being euploid or aneuploid.
Among those embryos that were aneuploid, they were
further categorized as having a single chromosome
involved, two chromosomes involved, or three or more
aneuploid chromosomes. Finally, the aneuploid result was
further characterized as being either monosomic or trisomic.
In the event that there were two or more abnormalities with
one chromosome being monosomic and another being
trisomic, the embryo was considered both monosomic and
trisomic.
Data Analysis
The initial analysis was simply to determine the percentage of
biopsy samples that were euploid and the number that were
aneuploid relative to the age of the woman producing the
oocyte. The data were stratified into single years of age. Sub-
sequently, the data were grouped into the age groups used for
reporting by SART, with the exception of the <35-years age
group. Given the large number of years within that age group,
the data were further divided into those oocytes where the
female was younger than 26 years, 26 to 30 years of age, or
31 to 34 years of age.
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The aneuploidy rates across age groups were compared
using contingency table analyses. Additionally, linear regres-
sion was used to examine the relationship between age and
the proportion of embryos that were aneuploid.
The relationship between age and the probability that no
euploid embryos would be available for transfer was exam-
ined by first calculating that probability for each year of
maternal age. The number of no-euploid cohorts was divided
by the total number of cohorts examined for each year of
age. The no-euploid rate was compared among age groups
by contingency table analyses, and the overall relationship
between age and risk for a no-euploid cohort was examined
by regression.
The results of all trophectoderm biopsies were then strat-
ified based on the number of errors that were documented in
the genetic analysis. The results were labeled as 0 (euploidy), 1
(single aneuploidy), 2 (double aneuploidy), or 3 or more (com-
plex aneuploidy). These results were stratified by individual
years and by age groups and then were compared with contin-
gency table and regression analyses.
Next, aneuploid results for each age were divided into
those which that found either a monosomy or a trisomy. These
were similarly compared with contingency table and regres-
sion analyses. Finally, the overall aneuploidy rate within
age groups was compared between the referring centers via
contingency table analyses.
In all cases, an alpha error >.05 was considered statisti-
cally significant. The retrospective analysis of data was
approved by the institutional review board.
RESULTS
Demographics
There were 15,169 CCS results obtained from 2,701 patients in
3,392 cycles. There were 9,001 euploid results and 6,168
aneuploid results from these samples. The difference in the
number of aneuploid chromosomes and the number of aneu-
ploid biopsy samples reflects the fact that some samples were
aneuploid for more than one chromosome (as will be
described). Ages of the female partners ranged from 22 to
49 years. The numbers of individuals at each age, the mean
and standard error for the number of oocytes retrieved, and
the number of euploid and aneuploid samples for each age
are presented in Table 1.
The no-result rate from embryo biopsies was 2.8%. The
mean, median, minimum, and maximum number of blasto-
cysts biopsied according to patient age is detailed in
Figure 1A. In nearly all age groups, the minimum number
biopsied was one blastocyst, and the median number ex-
ceeded five blastocysts in only patients aged 22, 24, 28,
and 30 years. Figure 1B further details the number of blasto-
cysts per individual case and correlates this with the

TABLE 1

Distribution of samples evaluated relative to the age of the female partner and the ensuing comprehensive chromosomal screening results.
Euploid Aneuploid
Oocytes retrieved Cohorts of embryos No. of biopsies Percentage Percentage
Age (y) (m ± SEM) evaluated (n) evaluated (n) n of total n of total
22 23.5
3.5 9 72 40 55.6 32 44.4
23 19.3
1.7 12 76 45 59.2 31 40.8
24 21.5
2.1 13 79 57 72.2 22 27.8
25 12.9
1.1 17 90 50 55.6 40 44.4
26 15.1
1.1 29 175 132 75.4 43 24.6
27 16.2 þ 0.6 36 240 175 72.9 65 27.1
28 13.0
0.7 57 335 259 77.3 76 22.7
29 13.9
0.4 106 585 464 79.3 121 20.7
30 12.9
0.4 126 802 616 76.8 186 23.2
31 13.9
0.3 164 862 595 69.0 267 31.0
32 11.1
0.2 193 1,023 705 68.9 318 31.1
33 13.9
0.4 231 1,324 913 69.0 411 31.0
34 13.7
0.4 221 1,156 794 68.7 362 31.3
35 11.6
0.3 226 1,222 800 65.5 422 34.5
36 12.8
0.3 267 1,284 828 64.5 456 35.5
37 10.1
0.3 257 1,153 662 57.4 491 42.6
38 8.7
0.2 280 1,123 585 52.1 538 47.9
39 10.5
0.2 272 1,008 475 47.1 533 52.9
40 11.2
0.3 249 953 398 41.8 555 58.2
41 9.2
0.3 234 750 233 31.1 517 68.9
42 8.7
0.2 150 453 113 24.9 340 75.1
43 6.0
0.3 79 217 36 16.6 181 83.4
44 5.7
0.2 41 85 10 11.8 75 88.2
45 8.0
0.4 22 39 4 15.7 35 84.3
46 11.8
0.5 4 43 12 27.9 31 72.1
47 6.3
0.3 4 17 0 0.0 17 100.0
48 2 1 1 0 0.0 1 100.0
49 4 1 2 0 0.0 2 100.0
Total 3,301 15,169 9,001 6,168
Franasiak. Aneuploidy versus age. Fertil Steril 2014.

658 VOL. 101 NO. 3 / MARCH 2014

 Fertility and Sterility®

FIGURE 1

Case demographics. (A) The mean, median, minimum, and maximum number of blastocysts biopsied according to patient age. In nearly all age
groups, the minimum number biopsied was one blastocyst, and the median number exceeded five blastocysts in only patients aged 22, 24, 28,
and 30 years. (B) The number of blastocysts per individual case. In 50% of the cases, there were three or fewer blastocysts available for biopsy,
and 20% of the patients had only a single blastocyst available for biopsy.
Franasiak. Aneuploidy versus age. Fertil Steril 2014.

proportion of cases that had that number of blastocysts
available for biopsy. Importantly for generalizability, 50%
of the cases had three or fewer blastocysts available for bi-
opsy. There were a number of low responders included in
the evaluation, with 20% of patients having only a single
blastocyst available for biopsy.
The indications for CCS are included in Supplemental
Figure 1 by age group and overall. In patients under age 26,
the most common indication was routine infertility care
(61.4%), followed by single-gene cases (36.4%) and recurrent
pregnancy loss (2.3%). For the remainder of the age groups,
general infertility represented nearly 80% or more of the
cases. Recurrent loss as an indication was highest in patients
43 years and older and represented 16.4% of cases. Family
balancing represented a minority of cases for all age groups
as did single-gene cases, with the exception of the younger
than age 26 patients (as indicated earlier). Overall, general
infertility care represented 85.0% of cases, followed by recur-
rent pregnancy loss at 11.0%, single-gene cases at 3.1%, and
family balancing at 0.9%.
Age Versus Aneuploidy
The prevalence of aneuploidy for each age is presented in
Figure 2A. As expected, the prevalence of aneuploidy rose
steadily with age (P<1*106). Although it is possible to

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ORIGINAL ARTICLE: ASSISTED REPRODUCTION

FIGURE 2

Prevalence of aneuploidy. (A) The prevalence of aneuploidy relative to the age of the female partner demonstrates the lowest risk in women from
their middle to late twenties, with significantly higher rates in embryos obtained from both younger and older women (P<1*106). The relationship
between age and the rate of aneuploidy is a best fit at the 5th degree polynomial (regression line shown). (B) The relationship between maternal age
and the probability that no euploid blastocysts will be available within a single cohort demonstrates a uniformly low risk between the maternal ages
of 26 and 37 years. Higher risks are present in younger and older patients (P<.0003 or less).
Franasiak. Aneuploidy versus age. Fertil Steril 2014.

compare all the age groups to each other, there are an enor-
mous number of possible comparisons; given the large sample
size, there are an enormous number of statistically significant
differences. More important is to the see the change in the prev-
alence of aneuploidy and to provide a point estimate for each
and every age. The relationship between aneuploidy and age
was best predicted by a fifth order polynomial: [Percent aneu-
ploid ¼ 1,965  278.9 * Age þ 16.41 * (Age)2  0.4922 *
(Age)3 þ 0.007451 * (Age)4  0.000044692 * (Age)5]. The rela-
tionship was statistically significant (P<1*106). This polyno-
mial regression line is superimposed on the graph of
aneuploidy vs. age in Figure 2A.
When combining the data into age ranges, the prevalence
of aneuploidy was lowest between the ages of 26 and 30. Sur-
prisingly, the prevalence was higher in women younger than
26 years of age, with a prevalence of over 40% in women 22

660 VOL. 101 NO. 3 / MARCH 2014


and 23 years of age compared with the rate of 20% to 27% in
women 26 to 30 years of age. The prevalence of aneuploidy
rose steadily from age 31 through age 43, then plateaued at
approximately 85%. Statistical analyses of these apparent
differences in age ranges were accomplished grouping the
data into age ranges as previously described. There were
statistically significant differences between age groups
(P<1*106).
Risk of Having No-euploid Embryos within a Single
Cohort
The no-euploid rate was lowest and equivalent in the embryos
obtained from women in the 26–30, 31–34, and 35–38 year
age groups (P¼ .92). These data are summarized in
Figure 2B. These age ranges are inclusive of the majority of
women undergoing IVF. Consistent with the increased risk
for aneuploidy, younger women in the 22–25 year old age
group also had an increased risk for having no-euploid
embryos within their cohort (P< .0005). There was also a sta-
tistically significant increase in the risk for having no-euploid
blastocysts with increasing age for each successive age group
(P< .0003 or less for all comparisons). The relationship be-
tween age and the probability of having no-euploid embryos
was best predicted by a sixth order polynomial: [No-euploid
rate ¼ 19,563 þ 3,837 Oocyte Age  307.5 Oocyte (Age)2
þ 12.92 Oocyte (Age)3  0.3007 Oocyte (Age)4 þ 0.003676
Oocyte (Age)5  1.8438E-005 Oocyte (Age)6]. Interestingly,
the risk for having no-euploid blastocysts was less than
one-third at 42 years of age, and it did not surpass 50% until
age 44.
Single, Dual, or Multiple Errors
Among the 6,168 aneuploid samples, errors involving a single
chromosome were most common (3,931, 63.7%; P<1*106).
There were 1,229 (19.9%) samples that were aneuploid for
two chromosomes, and 1,008 (16.3%) samples with complex
aneuploidy involving three or more chromosomes.
The impact of age on the complexity of the aneuploid
errors is presented in Figure 3A. Age clearly impacted the
complexity of the aneuploidy (P<1*106). The aneuploidy
errors found in women under 26 years of age were more likely
to involved either two chromosomes or three or more chromo-
somes than in the biopsies from women 26–30 years of age
(P<1*106). Over 71% of errors in embryos from women
between the ages of 26 and 30 involved a single chromosome.
This proportion decreased steadily with age with women aged
43 and older, having errors involving a single chromosome
accounting for only 32% of their aneuploidy. Ultimately,
the complexity of the errors rose with increasing age, and
statistically significant differences were present between all
age groups (P<1*106).
Ratio of Trisomies to Monosomies
Among the 9,889 aneuploidies identified, 4,513 were the
result of a monosomy, and 4,376 were the result of a trisomic
chromosome. This results in a trisomy/monosomy ratio of
0.97 for the two basic types of errors.
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Fertility and Sterility®
Evaluation of the relationship between maternal age and
the ratio of trisomic/monosomic errors demonstrated statisti-
cally significant differences, with a lower ratio (proportion-
ally more monosomies) in younger women and a higher
ratio (proportionally more trisomies) in older women
(P< .009) (Fig. 3B). A regression of age vs. trisomy/monosomy
ratios demonstrates that the increase is linear with increasing
age: Trisomy:monosomy ratio ¼ 0.4074 þ 0.01561 * Age
(P< .009) (Fig. 3B). The trisomy/monosomy ratio did vary
with age, but it remained within an extremely narrow range
across the age group (0.78 to 1.11).
DISCUSSION
These data represent the largest systematic report of CCS re-
sults in the general IVF population to date. Given that the
indication for CCS in this population was routine infertility
care in 85% of cases, we believe these results are generalizable
among patients who are able to make blastocysts for biopsy.
Moreover, normal and low responders were included, with
50% of the cases having three or fewer blastocysts available
for biopsy and 20% of patients having only a single blastocyst
available. Thus, the findings have wide-reaching implica-
tions, including for providing new information for patient
counseling, understanding the prevalence of aneuploidy
across age groups, gaining better insight into the biology of
aneuploidy in human reproduction, and evaluating new as-
says developed to detect aneuploidy.
There are two important issues relevant to counseling pa-
tients addressed by the data. First is the proportion of embryos
likely to be aneuploid. Age-specific data in both circum-
stances serve as the starting point for the discussion. We
find the lowest level of aneuploidy between the ages of 26
and 30 with a predictable and steady rise through age 43, at
which point the rate plateaus at approximately 85%, consis-
tent with previously published data (9). The polynomial
regression formula is not in itself a counseling tool, but the
fact that biologic rates increase in a mathematically predict-
able manner is of importance in counseling. These data can
assist in setting reasonable expectations of cycle outcomes
as well as guide discussions of the relative benefits of chromo-
some screening.
The second counseling issue addressed is the probability
that all embryos will be aneuploid, leaving no embryo for
transfer. Rates of no-euploid transfers have been reported to
be 25% in large reports, but these were not broken down by
age group (10). Interestingly, we found the rate of no-
euploid embryos to be lowest and equivalent for women in
age groups inclusive of age 26 to 38; this represents the
vast majority of women undergoing IVF, making it unlikely
in most circumstances that women undergoing CCS would
find themselves in the situation of having no embryo to trans-
fer. Again, the biologic rates fit a mathematically predictable
model. Perhaps the most important counseling fact is that the
risk of a no-euploid embryo was only one-third at age 42 and
surpassed one-half only after age 44. Discussing these data at
the outset will help set reasonable expectations and allow for
quick movement onto the next cycle or other forms of treat-
ment in the event of a no-euploid embryo cycle.
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ORIGINAL ARTICLE: ASSISTED REPRODUCTION

FIGURE 3

Nature of aneuploidy. (A) The complexity of the aneuploidies that occur (the number of aneuploid chromosomes in a given trophectoderm sample)
is impacted by maternal age (P<1*106). Increasing age results not only in an increase in the proportion of embryos that are aneuploid but also an
increase in the proportion of those aneuploid embryos that will have more than one aneuploid chromosome. (B) The ratio of trisomies to
monosomies approximates 1 throughout reproductive life, and absolute variation is low at all ages. Some variation does exist with younger
patients, who have disproportionally greater monosomies, and older patients, who have disproportionate trisomies (P<.009).
Franasiak. Aneuploidy versus age. Fertil Steril 2014.

When reviewing results of CCS for a patient, it is impor-
tant to evaluate the results in light of age-controlled peers.
Indeed, the evaluation of the prevalence across age groups
yielded both predictable and surprising data. Predictably,
both the aneuploid rate and the no-euploid embryo rate
rose in a mathematically predictable way with age. Surpris-
ingly, the exception to this in both cases was the patients
younger than 26 years of age. Indeed, the rates of aneuploidy
reached >40% at age 25, and the no-euploid embryo rate was
nearly one-third at age 22, nearly the same as for a patient 42
years of age. It should be noted that this patient population
was 36% single-gene cases and 61% part of routine care in
an effort to increase pregnancy rates, decrease loss rates,
and decrease transfer order. This information is not only

662 VOL. 101 NO. 3 / MARCH 2014


helpful in counseling but sheds some light on the biology of
aneuploidy in the reproductive system.
In addition to the bimodal distribution of aneuploidy, the
rates of single, dual, and multiple errors (11) as well as the
ratio of trisomy/monosomy also help create a clearer picture
of aneuploidy in human reproduction. The majority of aneu-
ploidy involves only one chromosome, but we found that
nearly 20% of cases involved two chromosomes and 16%
involved three or more. Again, a bimodal distribution was
seen in which patients younger than 26 years and older
than 34 years had a progressively higher likelihood of multi-
ple chromosomal abnormalities. Whether this is explained by
a higher likelihood of creation of chromosomal abnormalities
or a decreased ability to correct and/or prevent propagation of
errors is not clear. Finally, evaluation of the trisomy/mono-
somy ratios across ages showed an increase in monosomies
in younger women, with progressively increasing trisomies
in older age groups. This ratio demonstrated a mathematically
predictable rise across age groups.
These findings not only allow for better patient coun-
seling and understanding of the biology but also are a valu-
able tool as a reference standard as new assays are tested
for CCS. To date, there is not a large report of aneuploidy
across a large cohort of embryos. Additionally, in this patient
population, genetic screening is not reserved for specific indi-
cations beyond IVF as part of fertility treatment; the distribu-
tion of the number of embryos sampled by age is similar to
that seen in the general population of patients seeking fertility
care. Thus, these data serve as a reference and allow for com-
parisons going forward as new technology is evaluated.
We recognize the limitations of the retrospective nature
of our study. The patients included were those able to make
a blastocyst to have a biopsy and genetic testing. Addition-
ally, although they provide important information in terms
of patient counseling and describe the biology of overall
aneuploidy, our results do not provide direct answers to the
pathophysiologic questions raised. The biologic questions
regarding the nature of aneuploidy are more aptly addressed
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Fertility and Sterility®
by detailing the prevalence of aneuploidy across specific
chromosomes, which is an area of active study at our center.
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SUPPLEMENTAL FIGURE 1

Indications for comprehensive chromosomal screening. The indications were categorized as family balancing, general infertility care, recurrent
pregnancy loss, and single gene cases. Our center offers CCS as routine care, and thus this represented the overwhelming majority of cases in
each age group as well as overall. Single-gene cases were higher in patients under age 26 years. Otherwise, the other indications represent a
minority of cases, so these results are generalizable to the general IVF population.
Franasiak. Aneuploidy versus age. Fertil Steril 2014.

663.e1 VOL. 101 NO. 3 / MARCH 2014