Success rates with preimplantation genetic testing for aneuploidy in good prognosis patients are dependent on age.

Autor:	Harris BS; Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Duke University Health System, Morrisville, North Carolina; Department of Obstetrics and Gynecology, Shady Grove Fertility - Jones Institute, Eastern Virginia Medical School, Norfolk, Virginia. Electronic address: bharris17@gmail.com., Acharya KS; Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Duke University Health System, Morrisville, North Carolina., Unnithan S; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina., Neal SA; Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Duke University Health System, Morrisville, North Carolina., Mebane S; Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Duke University Health System, Morrisville, North Carolina., Truong T; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina., Muasher SJ; Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Duke University Health System, Morrisville, North Carolina.
Jazyk:	angličtina
Zdroj:	Fertility and sterility [Fertil Steril] 2024 Sep 29. Date of Electronic Publication: 2024 Sep 29.
DOI:	10.1016/j.fertnstert.2024.09.043
Abstrakt:	Objective: To evaluate cumulative live birth after preimplantation genetic testing for aneuploidy (PGT-A) with next generation sequencing (NGS) compared with morphology alone among patients aged 21-40 years undergoing single blastocyst transfer. Design: Retrospective cohort study. Setting: Society for Assisted Reproductive Technology (SART) clinics. Patient(s): Patients aged 21-40 years undergoing first autologous retrieval cycles resulting in ≥5 fertilized oocytes, with subsequent single blastocyst transfer in Society for Assisted Reproductive Technology clinics from 2016-2019. Intervention: PGT-A using NGS. Main Outcome Measure(s): The primary outcome was cumulative live birth per retrieval. Secondary outcomes included clinical pregnancy, miscarriage, and live birth per transfer. Result(s): A total of 56,469 retrieval cycles were included in the analysis. Retrieval cycles were stratified based on age (<35, 35-37, and 38-40 years) and exposure to PGT-A with NGS. Modified Poisson regression modeling was used to evaluate the association between PGT-A and cumulative live birth per retrieval while controlling for covariates. In this cohort, most cycles did not use PGT-A (n = 49,608; 88%). After adjusting for covariates, the use of PGT-A was associated with a slightly lower cumulative live birth in individuals aged <35 years (risk ratio [RR]: 0.96; 95% CI: 0.93-0.99) compared with no PGT, but higher cumulative live birth in ages 35-37 years (RR: 1.04; 95% CI: 1.00-1.08), and 38-40 years (RR: 1.14; 95% CI: 1.07-1.20). A subgroup analysis limited to freeze-all cycles (n = 29,041) showed that PGT-A was associated with higher cumulative live birth in individuals aged ≥35 years and was similar to no PGT in individuals aged <35 years. Miscarriage was significantly less likely in individuals aged ≥35 years using PGT-A compared with no PGT-A. Conclusion(s): In this large national database study, success rates in cycles using PGT-A were dependent on age. Cumulative live birth was observed to be significantly less likely in PGT-A cycles among individuals aged <35 years and more likely among individuals aged 38-40 years, compared with no PGT-A. In individuals with no fresh transfer, results were similar. Moreover, miscarriage was significantly less likely with PGT-A among individuals aged 35-40 years in a subgroup analysis of freeze-all cycles. Competing Interests: Declaration of Interests B.S.H. has nothing to disclose. K.S.A reports travel support from Duke Health (employer); Duke Health Gynecology Peer Review Committee outside the submitted work. S.U. has nothing to disclose. S.A.N. has nothing to disclose. S.M. has nothing to disclose. T.T. has nothing to disclose. S.J.M. has nothing to disclose. (Copyright © 2024 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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