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

• Published in: Journal of assisted reproduction and genetics 2021-12, Vol.38 (12), p.3277-3285
• Main Authors: Sanders, Kathryn D., Silvestri, Giuseppe, Gordon, Tony, Griffin, Darren K.
• Format: Article
• Language: English
• Subjects: Adult; Age; Aneuploidy; Birth Rate; Blastocyst - physiology; Data collection; Embryo transfer; Embryology; Embryos; Female; Fertilization; Fertilization - physiology; Fertilization in Vitro - statistics & numerical data; Genetic screening; Genetic Testing - methods; Genetics; Gynecology; Human Genetics; Humans; Live Birth; Maternal Age; Medicine; Medicine & Public Health; Pregnancy; Pregnancy Rate; Preimplantation Diagnosis - methods; Reproductive Medicine; Retrospective Studies; Statistical analysis; United Kingdom
• ISSN: 1058-0468; 1573-7330
• DOI: 10.1007/s10815-021-02349-0

Purpose To examine the live birth and other outcomes reported with and without preimplantation genetic testing for aneuploidy (PGT-A) in the United Kingdom (UK) Human Embryology and Fertilization Authority (HFEA) data collection. Methods A retrospective cohort analysis was conducted following freedom of information (FoI) requests to the HFEA for the PGT-A and non-PGT-A cycle outcomes for 2016–2018. Statistical analysis of differences between PGT-A and non-PGT-A cycles was performed. Other than grouping by maternal age, no further confounders were controlled for; fresh and frozen transfers were included. Results Outcomes collected between 2016 and 2018 included total number of cycles, cycles with no embryo transfer, total number of embryos transferred, live birth rate (LBR) per embryo transferred and live birth rate per treatment cycle. Data was available for 2464 PGT-A out of a total 190,010 cycles. LBR per embryo transferred and LBR per treatment cycle (including cycles with no transfer) were significantly higher for all PGT-A vs non-PGT-A age groups (including under 35), with nearly all single embryo transfers (SET) after PGT-A (significantly more in non-PGT-A) and a reduced number of transfers per live birth particularly for cycles with maternal age over 40 years. Conclusion The retrospective study provides strong evidence for the benefits of PGT-A in terms of live births per embryo transferred and per cycle started but is limited in terms of matching PGT-A and non-PGT-A cohorts (e.g. in future studies, other confounders could be controlled for). This data challenges the HFEA “red traffic light” guidance that states there is “no evidence that PGT-A is effective or safe” and hence suggests the statement be revisited in the light of this and other new data.