Preimplantation genetic testing for aneuploidy in patients with low embryo numbers: benefit or harm?

J Assist Reprod Genet. 2022 Sep;39(9):2027-2033. doi: 10.1007/s10815-022-02588-9. Epub 2022 Aug 17.

Abstract

Purpose: We sought to explore the utility of preimplantation genetic testing for aneuploidy (PGT-A) in a poor prognosis group of women with few embryos available for transfer.

Methods: This was a retrospective matched cohort study examining records for first or second-cycle IVF patients with 1 to 3 blastocysts. The study group comprised 130 patients who underwent PGT-A on all embryos. The control group included 130 patients matched by age, BMI, and blastocyst number and quality who did not undergo PGT-A during the same time period.

Results: The live birth rate (LBR) per embryo transfer (ET) were similar in the PGT-A and control groups, and the spontaneous abortion (SAB) rate was the same (23%). However, we found a significantly higher LBR per oocyte retrieval in the control group vs the PGT-A group (43% vs 20%, respectively) likely due to the many no-euploid cycles in the PGT-A group. In a subgroup analysis for age, the similar LBR per ET persisted in women < 38. However, in older women, there was a trend to a higher LBR per ET in the PGT-A group (43%) vs the control group (22%) but a higher LBR per oocyte retrieval in the control group (31%) vs the PGT-A group (13%).

Conclusions: Overall, we observed a significant increase in LBR per oocyte retrieval in women in the control group compared to women undergoing PGT-A, and no difference in SAB rate. Our data suggests that PGT-A has no benefit in a subpopulation of women with few embryos and may cause harm.

Keywords: In vitro fertilization; Low ovarian reserve; Pregnancy; Preimplantation genetic testing.

MeSH terms

  • Abortion, Spontaneous* / genetics
  • Aneuploidy
  • Blastocyst
  • Cohort Studies
  • Female
  • Fertilization in Vitro
  • Genetic Testing
  • Humans
  • Pregnancy
  • Preimplantation Diagnosis*
  • Retrospective Studies