Preimplantation Genetic Testing for Aneuploidy for Recurrent Pregnancy Loss and Recurrent Implantation Failure in Minimal Ovarian Stimulation Cycle for Women Aged 35–42 Years: Live Birth Rate, Developmental Follow-up of Children, and Embryo Ranking

• Published in: Reproductive sciences (Thousand Oaks, Calif.) Calif.), 2023-03, Vol.30 (3), p.974-983
• Main Authors: Kato, Keiichi, Kuroda, Tomoko, Yamadera-Egawa, Rie, Ezoe, Kenji, Aoyama, Naoki, Usami, Akemi, Miki, Tetsuya, Yamamoto, Toshiyuki, Takeshita, Toshiyuki
• Format: Article
• Language: English
• Subjects: Abortion, Habitual - diagnosis; Abortion, Habitual - genetics; Abortion, Habitual - therapy; Aneuploidy; Birth Rate; Child; Embryology; Female; Fertilization in Vitro - methods; Follow-Up Studies; Genetic Testing - methods; Genetics: Original Article; Humans; Live Birth; Medicine; Medicine & Public Health; Obstetrics/Perinatology/Midwifery; Ovulation Induction; Pregnancy; Pregnancy Rate; Preimplantation Diagnosis - methods; Reproductive Medicine; Retrospective Studies
• ISSN: 1933-7191; 1933-7205
• DOI: 10.1007/s43032-022-01073-z

This study was aimed at exploring the benefits of preimplantation genetic testing for aneuploidy (PGT-A) in ensuring a successful pregnancy in patients with recurrent pregnancy loss (RPL) caused by an abnormal number of chromosomes in the embryo and recurrent implantation failure (RIF). Thirty-two patients who underwent PGT-A (18 in the RIF protocol and 14 in the RPL protocol) were enrolled in the study, and 2556 patients who did not undergo PGT-A during the same in vitro fertilization (IVF) treatment period were enrolled as controls. All patients underwent minimal stimulation cycle IVF. In the RPL protocol, the live birth rate per embryo transfer (ET) and that per patient were higher with PGT-A (80.0% each) than without it (0% each; P = 0.0050), and the rate of miscarriages was lower with PGT-A than without it (20.0% vs. 100.0%, P = 0.0098). In the RIF protocol, there were no significant differences in the live birth rate per ET and in the rate of miscarriages between groups with and without PGT-A—90.0% vs. 69.2% ( P = 0.2313) and 0% vs. 10.0% ( P = 0.3297), respectively. None of the children whose mothers underwent PGT-A presented adverse findings at a 1.5-year developmental check-up. In conclusion, PGT-A in RPL is advantageous for improving the live birth rate per ET and that per patient in minimal stimulation cycle IVF; it reduces the rate of miscarriages. In addition, PGT-A might be more beneficial for embryo selection than the existing morphological grades of blastocysts, resulting in earlier conception.