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

Overview

Journal J Assist Reprod Genet

Publisher Springer

Specialties Genetics
Reproductive Medicine

Date 2023 Sep 3

PMID 37661208

Authors

Keiichi Kato

Kenji Ezoe

Sachie Onogi

Shiho Ito

Rie Egawa

Naoki Aoyama

Tomoko Kuroda

Akira Kuwahara

Takeshi Iwasa

Toshiyuki Takeshita

Minoru Irahara

Affiliations

Soon will be listed here.

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.

Citing Articles

Fatty acid supplementation during warming improves pregnancy outcomes after frozen blastocyst transfers: a propensity score-matched study.

Sawado A, Ezoe K, Miki T, Ohata K, Amagai A, Shimazaki K Sci Rep. 2024; 14(1):9343.

PMID: 38653766 PMC: 11039611. DOI: 10.1038/s41598-024-60136-0.

References

Katagiri Y, Jwa S, Kuwahara A, Iwasa T, Ono M, Kato K . Assisted reproductive technology in Japan: A summary report for 2020 by the ethics Committee of the Japan Society of obstetrics and gynecology. Reprod Med Biol. 2023; 22(1):e12494. PMC: 9811980. DOI: 10.1002/rmb2.12494. View

Gleicher N, Orvieto R . Is the hypothesis of preimplantation genetic screening (PGS) still supportable? A review. J Ovarian Res. 2017; 10(1):21. PMC: 5368937. DOI: 10.1186/s13048-017-0318-3. View

Haviland M, Murphy L, Modest A, Fox M, Wise L, Nillni Y . Comparison of pregnancy outcomes following preimplantation genetic testing for aneuploidy using a matched propensity score design. Hum Reprod. 2020; 35(10):2356-2364. DOI: 10.1093/humrep/deaa161. View

Forman E, Hong K, Ferry K, Tao X, Taylor D, Levy B . In vitro fertilization with single euploid blastocyst transfer: a randomized controlled trial. Fertil Steril. 2013; 100(1):100-7.e1. DOI: 10.1016/j.fertnstert.2013.02.056. View

Scott Jr R, Upham K, Forman E, Hong K, Scott K, Taylor D . Blastocyst biopsy with comprehensive chromosome screening and fresh embryo transfer significantly increases in vitro fertilization implantation and delivery rates: a randomized controlled trial. Fertil Steril. 2013; 100(3):697-703. DOI: 10.1016/j.fertnstert.2013.04.035. View

Sanders K, Silvestri G, Gordon T, Griffin D . Analysis of IVF live birth outcomes with and without preimplantation genetic testing for aneuploidy (PGT-A): UK Human Fertilisation and Embryology Authority data collection 2016-2018. J Assist Reprod Genet. 2021; 38(12):3277-3285. PMC: 8666405. DOI: 10.1007/s10815-021-02349-0. View

Bhatt S, Marchetto N, Roy J, Morelli S, McGovern P . Pregnancy outcomes following in vitro fertilization frozen embryo transfer (IVF-FET) with or without preimplantation genetic testing for aneuploidy (PGT-A) in women with recurrent pregnancy loss (RPL): a SART-CORS study. Hum Reprod. 2021; 36(8):2339-2344. DOI: 10.1093/humrep/deab117. View

Pantou A, Mitrakos A, Kokkali G, Petroutsou K, Tounta G, Lazaros L . The impact of preimplantation genetic testing for aneuploidies (PGT-A) on clinical outcomes in high risk patients. J Assist Reprod Genet. 2022; 39(6):1341-1349. PMC: 9174385. DOI: 10.1007/s10815-022-02461-9. View

Kucherov A, Fazzari M, Lieman H, Ball G, Doody K, Jindal S . PGT-A is associated with reduced cumulative live birth rate in first reported IVF stimulation cycles age ≤ 40: an analysis of 133,494 autologous cycles reported to SART CORS. J Assist Reprod Genet. 2022; 40(1):137-149. PMC: 9840738. DOI: 10.1007/s10815-022-02667-x. View

10.

Mejia R, Capper E, Summers K, Mancuso A, Sparks A, Van Voorhis B . Cumulative live birth rate in women aged ≤37 years after in vitro fertilization with or without preimplantation genetic testing for aneuploidy: a Society for Assisted Reproductive Technology Clinic Outcome Reporting System retrospective analysis. F S Rep. 2022; 3(3):184-191. PMC: 9532873. DOI: 10.1016/j.xfre.2022.05.004. View

11.

Alteri A, Cermisoni G, Pozzoni M, Gaeta G, Cavoretto P, Vigano P . Obstetric, neonatal, and child health outcomes following embryo biopsy for preimplantation genetic testing. Hum Reprod Update. 2023; 29(3):291-306. PMC: 10152168. DOI: 10.1093/humupd/dmad001. View

12.

Brookhart M, Wyss R, Layton J, Sturmer T . Propensity score methods for confounding control in nonexperimental research. Circ Cardiovasc Qual Outcomes. 2013; 6(5):604-11. PMC: 4032088. DOI: 10.1161/CIRCOUTCOMES.113.000359. View

13.

Glynn R, Schneeweiss S, Sturmer T . Indications for propensity scores and review of their use in pharmacoepidemiology. Basic Clin Pharmacol Toxicol. 2006; 98(3):253-9. PMC: 1790968. DOI: 10.1111/j.1742-7843.2006.pto_293.x. View

15.

Iwasa T, Kuwahara A, Takeshita T, Taniguchi Y, Mikami M, Irahara M . Preimplantation genetic testing for aneuploidy and chromosomal structural rearrangement: A summary of a nationwide study by the Japan Society of Obstetrics and Gynecology. Reprod Med Biol. 2023; 22(1):e12518. PMC: 10233076. DOI: 10.1002/rmb2.12518. View

16.

Sato T, Sugiura-Ogasawara M, Ozawa F, Yamamoto T, Kato T, Kurahashi H . Preimplantation genetic testing for aneuploidy: a comparison of live birth rates in patients with recurrent pregnancy loss due to embryonic aneuploidy or recurrent implantation failure. Hum Reprod. 2019; 34(12):2340-2348. DOI: 10.1093/humrep/dez229. View

17.

Ezoe K, Fukuda J, Takeshima K, Shinohara K, Kato K . Letrozole-induced endometrial preparation improved the pregnancy outcomes after frozen blastocyst transfer compared to the natural cycle: a retrospective cohort study. BMC Pregnancy Childbirth. 2022; 22(1):824. PMC: 9639274. DOI: 10.1186/s12884-022-05174-0. View

18.

Karakida S, Ezoe K, Fukuda J, Yabuuchi A, Kobayashi T, Kato K . Effects of gonadotropin administration on clinical outcomes in clomiphene citrate-based minimal stimulation cycle IVF. Reprod Med Biol. 2020; 19(2):128-134. PMC: 7138936. DOI: 10.1002/rmb2.12310. View

19.

Kato K, Ezoe K, Yabuuchi A, Fukuda J, Kuroda T, Ueno S . Comparison of pregnancy outcomes following fresh and electively frozen single blastocyst transfer in natural cycle and clomiphene-stimulated IVF cycles. Hum Reprod Open. 2019; 2018(3):hoy006. PMC: 6276691. DOI: 10.1093/hropen/hoy006. View

20.

Ezoe K, Coticchio G, Takenouchi H, Taoda S, Namerikawa S, Honda K . Spatiotemporal perturbations of pronuclear breakdown preceding syngamy affect early human embryo development: a retrospective observational study. J Assist Reprod Genet. 2021; 39(1):75-84. PMC: 8866620. DOI: 10.1007/s10815-021-02335-6. View

21.

Ezoe K, Miki T, Akaike H, Shimazaki K, Takahashi T, Tanimura Y . Maternal age affects pronuclear and chromatin dynamics, morula compaction and cell polarity, and blastulation of human embryos. Hum Reprod. 2023; 38(3):387-399. DOI: 10.1093/humrep/dead001. View