Dataset Information

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

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.

SUBMITTER: Ohishi S

PROVIDER: S-EPMC9840739 | biostudies-literature | 2023 Jan

REPOSITORIES: biostudies-literature

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Publications

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

Ohishi Sachiko S Otani Tetsuo T

Journal of assisted reproduction and genetics 20221212 1

<h4>Purpose</h4>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.<h4>Methods</h4>A total of 2113 females undergoing IVF with at least one blastocyst were reviewed. Patients in the PGT-A and non ...[more]

PMID: 36508033

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Project description:Study questionDo donor oocyte recipients benefit from preimplantation genetic testing for aneuploidy (PGT-A)?Summary answerPGT-A did not improve the likelihood of live birth for recipients of vitrified donor oocytes, but it did avoid embryo transfer in cycles with no euploid embryos.What is known alreadyRelative to slow freeze, oocyte vitrification has led to increased live birth from cryopreserved oocytes and has led to widespread use of this technology in donor egg IVF programs. However, oocyte cryopreservation has the potential to disrupt the meiotic spindle leading to abnormal segregation of chromosome during meiosis II and ultimately increased aneuploidy in resultant embryos. Therefore, PGT-A might have benefits in vitrified donor egg cycles. In contrast, embryos derived from young donor oocytes are expected to be predominantly euploid, and trophectoderm biopsy may have a negative effect relative to transfer without biopsy.Study design, size, durationThis is a paired cohort study analyzing donor oocyte-recipient cycles with or without PGT-A performed from 2012 to 2018 at 47 US IVF centers.Participants/materials, setting, methodsVitrified donor oocyte cycles were analyzed for live birth as the main outcome measure. Outcomes from donors whose oocytes were used by at least two separate recipient couples, one couple using PGT-A (study group) and one using embryos without PGT-A (control group), were compared. Generalized estimating equation models controlled for confounders and nested for individual donors contributing to both PGT-A and non-PGT-A cohorts, enabling a single donor to serve as her own control.Main results and the role of chanceIn total, 1291 initiated recipient cycles from 223 donors were analyzed, including 262 cycles with and 1029 without PGT-A. The median aneuploidy rate per recipient was 25%. Forty-three percent of PGT-A cycles had only euploid embryos, whereas only 12.7% of cycles had no euploid embryos. On average 1.09 embryos were transferred in the PGT-A group compared to 1.38 in the group without PGT-A (P < 0.01). Live birth occurred in 53.8% of cycles with PGT-A versus 55.8% without PGT-A (P = 0.44). Similar findings persisted in cumulative live birth from per recipient cycle.Limitations, reasons for cautionPooled clinical data from 47 IVF clinics introduced PGT-A heterogeneity as genetic testing were performed using different embryology laboratories, PGT-A companies and testing platforms.Wider implications of the findingsPGT-A testing in donor oocyte-recipient cycles does not improve the chance for live birth nor decrease the risk for miscarriage in the first transfer cycle but does increase cost and time for the patient. Further studies are required to test if our findings can be applied to the young infertility patient population using autologous oocytes.Study funding/competing interest(s)No external funding was used for this study. There are no conflicts of interest to declare.Trial registration numberN/A.

Dataset Information

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

Purpose

Methods

Results

Conclusion

Publications

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

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