scholarly journals 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

2021 ◽  
Author(s):  
Kathryn D. Sanders ◽  
Giuseppe Silvestri ◽  
Tony Gordon ◽  
Darren K. Griffin
Keyword(s):  
Genetic Testing ◽  
Data Collection ◽  
Live Birth ◽  
Maternal Age ◽  
Birth Rate ◽  
Treatment Cycle ◽  
Cohort Analysis ◽  
Live Birth Rate ◽  
Traffic Light ◽  
Preimplantation Genetic Testing

Abstract 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.

scholarly journals Different Strategies of Preimplantation Genetic Testing for Aneuploidies in Women of Advanced Maternal Age: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (17) ◽  
pp. 3895
Author(s):  
Wei-Hui Shi ◽  
Zi-Ru Jiang ◽  
Zhi-Yang Zhou ◽  
Mu-Jin Ye ◽  
Ning-Xin Qin ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Live Birth ◽  
Maternal Age ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Advanced Maternal Age ◽  
Controlled Trials ◽  
Preimplantation Genetic Testing ◽  
Randomized Controlled ◽  
Blastocyst Biopsy

Background: Preimplantation genetic testing for aneuploidies (PGT-A) is widely used in women of advanced maternal age (AMA). However, the effectiveness remains controversial. Method: We conducted a comprehensive literature review comparing outcomes of IVF with or without PGT-A in women of AMA in PubMed, Embase, and the Cochrane Central Register of Controlled Trials in January 2021. All included trials met the criteria that constituted a randomized controlled trial for PGT-A involving women of AMA (≥35 years). Reviews, conference abstracts, and observational studies were excluded. The primary outcome was the live birth rate in included random control trials (RCTs). Results: Nine randomized controlled trials met our inclusion criteria. For techniques of genetic analysis, three trials (270 events) performed with comprehensive chromosomal screening showed that the live birth rate was significantly higher in the women randomized to IVF/ICSI with PGT-A (RR = 1.30, 95% CI 1.03–1.65), which was not observed in six trials used with FISH as well as all nine trials. For different stages of embryo biopsy, only the subgroup of blastocyst biopsy showed a higher live birth rate in women with PGT-A (RR = 1.36, 95% CI 1.04–1.79). Conclusion: The application of comprehensive chromosome screening showed a beneficial effect of PGT-A in women of AMA compared with FISH. Moreover, blastocyst biopsy seemed to be associated with a better outcome than polar body biopsy and cleavage-stage biopsy.

scholarly journals CUMULATIVE LIVE BIRTH RATE IN WOMEN 37 YEARS OF AGE OR LESS WHO UTILIZE PREIMPLANTATION GENETIC TESTING-ANEUPLOIDY (PGT-A) VERSUS UNTESTED EMBRYOS

2020 ◽  
Vol 114 (3) ◽  
pp. e417-e418
Author(s):  
Rachel B. Mejia ◽  
Karen M. Summers ◽  
Abigail C. Mancuso ◽  
Emily A. Capper ◽  
Patrick Ten Eyck ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Cumulative Live Birth Rate ◽  
Preimplantation Genetic Testing ◽  
Cumulative Live Birth

scholarly journals The Pregnancy Outcome of Mosaic Embryo Transfer: A Prospective Multicenter Study and Meta-Analysis

Genes ◽  
2020 ◽  
Vol 11 (9) ◽  
pp. 973
Author(s):  
Ying Xin Zhang ◽  
Jang Jih Chen ◽  
Sunanta Nabu ◽  
Queenie Sum Yee Yeung ◽  
Ying Li ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Pregnancy Outcome ◽  
Live Birth ◽  
Birth Rate ◽  
Meta Analysis ◽  
Live Birth Rate ◽  
Miscarriage Rate ◽  
Prenatal Genetic Testing ◽  
Preimplantation Genetic Testing ◽  
Mosaic Embryo

Chromosomal mosaicism is at high occurrence in early developmental-stage embryos, but much lower in those at prenatal stage. Recent studies provided evidence on the viability of mosaic embryos by reporting pregnancy outcomes. Expanded research is warranted to evaluate its clinical significance. This is a multi-center prospective cohort study on 137 mosaic, 476 euploid and 835 non-preimplantation genetic testing (non-PGT) embryos from three in vitro fertilization (IVF) providers of three countries in Asia, applying the same preimplantation genetic testing for aneuploidies (PGT-A) reporting criteria. Mosaic embryo transfers (METs) resulted in a significantly lower clinical pregnancy rate (40.1% versus 59.0% versus 48.4%), lower ongoing/live birth rate (27.1% versus 47.0% versus 35.1%) and higher miscarriage rate (33.3% versus 20.5% versus 27.4%) than euploid and non-PGT transfers, respectively. Pregnancy losses after METs were different between embryos carrying numerical and segmental chromosomal abnormalities (p = 0.04). Our meta-analysis concluded that METs gave rise to pregnancies but were associated with a reduced ongoing/live birth rate and a higher miscarriage rate. All 37 MET live births were confirmed viable, among which 8 completed prenatal genetic testing with normal results. Longitudinal investigation on one MET pregnancy evidenced the aneuploidy depletion hypothesis. This is the first multi-center prospective study reporting a full MET pregnancy outcome with complementary information from prenatal genetic testing as compared to euploid and non-PGT cohorts.

scholarly journals Preimplantation Genetic Testing for Aneuploidies Improve the Clinical Pregnancy Outcome of Patients With AZFc Microdeletion

2021 ◽  
Author(s):  
xiliang wang ◽  
Yankun Wang ◽  
kaibo hou ◽  
dongmei hao ◽  
jinyan zhang ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Pregnancy Rate ◽  
Live Birth ◽  
Intracytoplasmic Sperm Injection ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Preimplantation Genetic Testing ◽  
Morphological Criteria

Abstract BackgroundMicrodeletions of AZF are the most common factor causing male infertility except Klinefelter syndrome. AZF patients are able to father babies through intracytoplasmic sperm injection (ICSI) and in vitro fertilization (IVF), and the ICSI embryos for IVF can be scored based on morphological criteria. However, the clinical pregnancy rate and the live birth rate are unsatisfactory.ResultsHere, we investigated the outcomes of using preimplantation genetic testing for aneuploidies (PGT-A) in families with AZFc microdeletions. A total of 26 intracytoplasmic sperm injection (ICSI) cycles were performed in 22 families, 25 ICSI cycles were performed, and 81 embryos underwent PGT-A. Among them, 48 were euploid embryos (23 females and 25 males), 30 were aneuploid embryos, and three embryos did not meet the quality control standards. Thirteen ICSI cycles with female euploid embryos and one ICSI cycle with male euploid embryos entered the stage of embryo implantation. Finally, the clinical pregnancy rate was 100% (14/14), and the live birth rate was 85.7% (12/14).ConclusionCompared with other published results, PGT-A increased the chance of fertility in AZFc microdeletion patients.

Reduced spontaneous abortion and increased live birth rate after PGD for advanced maternal age

2007 ◽  
Vol 88 ◽  
pp. S85-S86 ◽  
Author(s):  
S. Munne ◽  
J. Garrisi ◽  
F. Barnes ◽  
L. Werlin ◽  
W. Schoolcraft ◽  
...  
Keyword(s):  
Spontaneous Abortion ◽  
Live Birth ◽  
Maternal Age ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Advanced Maternal Age

scholarly journals Does Blastocyst Morphology Influence Live Birth Rate after Frozen-thawed Single Euploid Embryo Transfer?

2021 ◽  
Author(s):  
Na Li ◽  
Yichun Guan ◽  
Bingnan Ren ◽  
Yuchao Zhang ◽  
Yulin Du ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Inner Cell Mass ◽  
Medical Center ◽  
Cohort Analysis ◽  
Cell Mass ◽  
Live Birth Rate ◽  
Poor Quality ◽  
Blastocyst Quality

Abstract Objective To investigate whether the morphologic parameters of euploid blastocyst influence the live birth rate (LBR) following single frozen-thawed embryo transfer (FET) cycles? Methods A retrospective cohort analysis involving autologous single FET cycles after preimplantation genetic testing for aneuploidy (PGT-A) through next generation sequencing (NGS) by a university-based reproductive medical center that was performed from June 2017 to September 2019.Women were divided into three age groups (< 30, 30–34 and ≥ 35 years). The primary outcome measure was LBR. Outcomes were compared to determine the association between different blastocyst quality (Good, Average and Poor), inner cell mass (ICM) grade (A and B), and trophectoderm (TE) grade (A, B and C) and LBR. Results We included 232 single FET cycles for analysis, the total LBR was 48.48%. In the youngest group (< 30 years, n = 86), LBR were compared between cycles with various blastocyst quality (72.22% for good quality, 54.55% for average quality and 34.78% for poor quality; P = 0.019), ICM grade (70.59% for grade A and 42.03% for grade B; P = 0.035) and TE grade (85.71% for grade A,57.58% for grade B and 34.78 for grade C; P = 0.015). Similarly, in the 30–34 years group, LBR ranged from 50.00% for good quality to 45.45% for poor quality (P = 0.870), from 35.29% for ICM grade A to 51.22% for ICM grade B (P = 0.291), from 60.00% for TE grade A to 45.45% for TE grade C (P = 0.634). Likewise, in the oldest group (≥ 35years, n = 47), LBR were also comparable between these subgroups, but no significant differences were seen in blastocyst morphologic parameters and LBR (P > 0.05). Conclusion After single FET cycles, the LBR was associated with morphologic parameters of euploid blastocysts, especially in women < 30 years old. However, these differences were not found in women older than 30 years. We suggested that for older women whose embryos undergoing PGT-A with NGS to be euploid have the same development potential regardless of their blastocyst morphology.

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