PGD reduces the live birth rates when used with IVF. It entails undeniable manipulation of embryos, which if avoided is ethically favourable.
There is no doubt that a medical and ethical objective is to improve the effectiveness of in vitro fertilisation (IVF), i.e. improve pregnancy rates, but there appears to have been a failure to achieve this for now (see HERE), since these rates have remained very stable for some time (see latest data HERE).
In an attempt to improve the effectiveness of IVF, preimplantation genetic diagnosis (PGD) has been proposed to try to select the best quality embryos for transfer, especially to avoid the transfer of aneuploid embryos (embryos in which the number of chromosomes is not a multiple of 23).
However, randomised prospective studies show that the live birth rate does not seem to be improved if PGD is previously used.
To try to evaluate whether or not to use PGD, a large study was conducted (see HERE) that analysed the results of 5,471 ovarian stimulation cycles in which PGD was used and 97,069 cycles in which it was not. The results show that the embryo transfer rate is virtually the same when PGD is used (64.2%) and when it is not (62.3%).
However, the birth rate per cycle start was slightly lower (25.2%) when PGD was used compared to non-PGD cycles (28.8%), which was also confirmed when the pregnancy rate was calculated from the number of embryo transfers (39.3% versus 46.2%). The number of miscarriages was practically similar in both groups (13.7% versus 13.9%).
The authors concluded that the use of PGD reduces the live birth rates when used with IVF. These findings have an unquestionable bioethical connotation, since PGD entails undeniable manipulation of embryos, which if avoided is ethically favourable.