Preimplantation genetic testing for aneuploidy: helpful but not a first choice

J Assist Reprod Genet. 2023 Jan;40(1):161-168. doi: 10.1007/s10815-022-02683-x. Epub 2022 Dec 12.

Abstract

Purpose: This retrospective cohort study aimed to assess and compare the outcomes between cumulative live birth of patients with and without PGT-A and also between prior unsuccessful IVF cycles and PGT-A cycles among patients who experienced IVF but without live birth delivery, and to clarify the effective usage of PGT-A as an in vitro fertilization (IVF) add-on.

Methods: A total of 2113 females undergoing IVF with at least one blastocyst were reviewed. Patients in the PGT-A and non-PGT-A groups were further categorized into first-time IVF and prior unsuccessful IVF groups (previous IVF experience but without live birth delivery).

Results: In the PGT-A group, there were additional oocyte retrieval cycles, fewer transfer cycles per patient, higher clinical pregnancy rates per embryo transfer, and lower miscarriage rates per clinical pregnancy as compared to the non-PGT-A group, all showing significant differences. However, the first-time IVF group with PGT-A had a significantly longer duration from the first oocyte retrieval to the first live birth delivery (LBD) and a significantly lower LBD rate per patient than the non-PGT-A group. The cumulative probability for a first LBD with PGT-A was inferior in the first-time IVF group for women < 35 years, marginally superior in the prior unsuccessful IVF group of women aged 38-40 years, and similar for other groups.

Conclusion: PGT-A should not be recommended to all patients; however, if the first IVF treatment failed, PGT-A may reduce the patient's burden regardless of age.

Keywords: Cumulative probability of live birth delivery (LBD); Effectiveness of PGT-A; In vitro fertilization (IVF); Preimplantation genetic testing for aneuploidy (PGT-A); Prior unsuccessful IVF.

MeSH terms

  • Aneuploidy
  • Female
  • Fertilization in Vitro
  • Genetic Testing
  • Humans
  • Pregnancy
  • Pregnancy Rate
  • Preimplantation Diagnosis*
  • Retrospective Studies