Preimplantation genetic testing practices in the Nordic countries

Hreinsson J¹, Iwarsson E², Hanson CJ³, Grøndahl ML⁴, Løssl K⁵, Hydén-Granskog C⁶, Ingerslev HJ⁷ PGT study group*.

Acta Obstetricia et Gynecologica Scandinavica, 2020, Volume 99, pages 707-715.

¹Mount Sinai Fertility, Toronto, ON, Canada

²Department of Molecular Medicine and Surgery, Karolinska Institutet and Clinical Genetics, Karolinska University Laboratory, Karolinska University Hospital, Stockholm, Sweden

³Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden

⁴Department of Obstetrics and Gynecology, Department of Reproductive Medicine, Copenhagen University Hospital Herlev, Herlev, Denmark

⁵The Fertility Clinic – Section 4071, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark

⁶Department of Culture and Learning, Aalborg University, Aalborg, Denmark

⁷Reproductive Medicine Unit, Helsinki University Hospital, Helsinki, Finland

⁸Fertility Unit and Center for Preimplantation Genetic Testing, Aalborg University Hospital, Aalborg, Denmark

DOI: 10.1111/aogs.13821

PMID: 32034767

Abstract:

Introduction:

Preimplantation genetic testing (PGT) is growing in importance and volume internationally. International societies such as the European Society for Human Reproduction and Embryology compile international results and these data are published in scientific journals. We present the first compilation of practices, quality measuress and outcome data from Nordic clinics performing PGT. Material

Materials and Methods:

We conducted a structured online survey of PGT practices in the Nordic countries to compare clinical and laboratory techniques, outcomes and quality measures applied in Nordic clinics. The survey was designed by the authors and answered by the authors and members of the study group. The outcome data represents results from 2018. Results and details were clarified through iteration with responding clinics while maintaining anonymity. Response rate in the study was 80%, with 8 of 10 clinics performing PGT responding.

Results:

Most of the PGT cycles in the Nordic countries are funded through the public healthcare system with University Hospitals performing the majority of treatments, 716/848, or 84.4%, of oocyte retrievals in this dataset. The genetic analyses are in five cases performed by the affiliated local genetic laboratory, and the remaining three consult with large international private enterprise laboratories. Genetic coun- seling is widely used. Results in the Nordic clinics compare well with international data. Systematic quality control procedures are in place and the larger clinics and laborato- ries utilize ISO certification or accreditation in the quality management. Automatic wit- nessing with detailed electronic documentation of laboratory processes is not utilized in the responding clinics, although a majority uses manual witnessing procedures in the laboratory. The outcome after PGT in terms of clinical pregnancy per transfer is around 40% per embryo transfer and compares well with international data.

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*The PGT study group: Morten Rønn Petersen: The IVF Laboratory at The Fertility Clinic, Rigshospitalet – Section 4071, University Hospital of Copenhagen, Copenhagen, Denmark; Peter Bredbacka: Ovumia Fertinova, Tampere, Finland; Bugge Nøhr: Department of Obstetrics and Gynecology, Department of Reproductive Medicine, Copenhagen University Hospital Herlev, Herlev, Denmark; Linda Savolainen: Reproductive Medicine Karolinska, Karolinska University Hospital, Stockholm, Sweden; Christina Hnida: Fertility Unit and Center for Preimplantation Genetic Diagnosis, Aalborg University Hospital, Aalborg, Denmark; Christian Liebst Frisk Toft: Department of Molecular Diagnostics, Aalborg University Hospital, Aalborg, Denmark; Johnny Hindkjær: Aagaard Fertility Clinic, Aarhus N, Denmark; Jørn Aagaard: Aagaard Fertility Clinic, Aarhus N, Denmark; Kersti Lundin: Reproductive Medicine, Sahlgrenska University Hospital, Göteborg, Sweden; Laura Kirstine Sønderberg Roos: Department of Clinical Genetics, Copenhagen University Hospital Rigshospitalet, København Ø, Denmark.