Comparison of 1-year cumulative live birth and perinatal outcomes following single blastocyst transfer with or without preimplantation genetic testing for aneuploidy: a propensity score-matched study

J Assist Reprod Genet. 2023 Nov;40(11):2669-2680. doi: 10.1007/s10815-023-02926-5. Epub 2023 Sep 4.

Abstract

Purpose: We evaluated whether preimplantation genetic testing for aneuploidy (PGT-A) could increase the cumulative live birth rate (CLBR) in patients with recurrent implantation failure (RIF) and recurrent pregnancy loss (RPL).

Methods: The clinical records of 7,668 patients who underwent oocyte retrieval (OR) with or without PGT-A were reviewed for 365 days and retrospectively analyzed. Using propensity score matching, 579 patients in the PGT-A group were matched one-to-one with 7,089 patients in the non-PGT-A (control) group. Their pregnancy and perinatal outcomes and CLBRs were statistically compared.

Results: The live birth rate per single vitrified-warmed blastocyst transfers (SVBTs) significantly improved in the PGT-A group in all age groups (P < 0.0002, all). Obstetric and perinatal outcomes were comparable between both groups regarding both RIF and RPL cases. Cox regression analysis demonstrated that in the RIF cases, the risk ratio per OR was significantly lower in the PGT-A group than in the control group (P = 0.0480), particularly in women aged < 40 years (P = 0.0364). However, the ratio was comparable between the groups in RPL cases. The risk ratio per treatment period was improved in the PGT-A group in both RIF and RPL cases only in women aged 40-42 years (P = 0.0234 and P = 0.0084, respectively).

Conclusion: Increased CLBR per treatment period was detected only in women aged 40-42 years in both RIF and RPL cases, suggesting that PGT-A is inappropriate to improve CLBR per treatment period in all RIF and RPL cases.

Keywords: Cumulative live birth rate; Perinatal outcome; Preimplantation genetic testing for aneuploidy; Propensity score matching; Recurrent implantation failure; Recurrent pregnancy loss.

MeSH terms

  • Abortion, Habitual*
  • Aneuploidy
  • Blastocyst
  • Embryo Transfer
  • Female
  • Fertilization in Vitro
  • Genetic Testing
  • Humans
  • Live Birth
  • Pregnancy
  • Pregnancy Rate
  • Preimplantation Diagnosis*
  • Propensity Score
  • Retrospective Studies