PGT-A: who and when? Α systematic review and network meta-analysis of RCTs.

Autor: Simopoulou, Mara, Sfakianoudis, Konstantinos, Maziotis, Evangelos, Tsioulou, Petroula, Grigoriadis, Sokratis, Rapani, Anna, Giannelou, Polina, Asimakopoulou, Marilena, Kokkali, Georgia, Pantou, Amelia, Nikolettos, Konstantinos, Vlahos, Nikolaos, Pantos, Konstantinos
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Zdroj: Journal of Assisted Reproduction & Genetics; Aug2021, Vol. 38 Issue 8, p1939-1957, 19p
Abstrakt: Purpose: Wide controversy is still ongoing regarding efficiency of preimplantation genetic testing for aneuploidy (PGT-A). This systematic review and meta-analysis, aims to identify the patient age group that benefits from PGT-A and the best day to biopsy. Methods: A systematic search of the literature was performed on MEDLINE/PubMed, Embase and Cochrane Central Library up to May 2020. Eleven randomized controlled trials employing PGT-A with comprehensive chromosomal screening (CCS) on Day-3 or Day-5 were eligible. Results: PGT-A did not improve live-birth rates (LBR) per patient in the general population (RR:1.11; 95%CI:0.87-1.42; n=1513; I2=75%). However, PGT-A lowered miscarriage rate in the general population (RR:0.45; 95%CI:0.25-0.80; n=912; I2=49%). Interestingly, the cumulative LBR per patient was improved by PGT-A (RR:1.36; 95%CI:1.13-1.64; n=580; I2=12%). When performing an age-subgroup analysis PGT-A improved LBR in women over the age of 35 (RR:1.29; 95%CI:1.05-1.60; n=692; I2=0%), whereas it appeared to be ineffective in younger women (RR:0.92; 95%CI:0.62-1.39; n=666; I2=75%). Regarding optimal timing, only day-5 biopsy practice presented with improved LBR per ET (RR: 1.37; 95% CI: 1.03-1.82; I2=72%). Conclusion: PGT-A did not improve clinical outcomes for the general population, however PGT-A improved live-birth rates strictly when performed on blastocyst stage embryos of women over the 35-year-old mark. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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