Selecting euploid embryo for transfer by preimplantation genetic testing for aneuploidy improved clinical outcomes in patients with advanced maternal age

Abstract

Objectives: This study aimed to investigate whether selecting euploid embryos by preimplantation genetic testing for aneuploidy (PGT-A) can improve the clinical outcomes in patients with advanced maternal age. Hence, it provides evidence about the role of PGT-A in the treatment for patients with advanced maternal age in Vietnam.

Methods: This is a retrospective cohort study, conducted at IVFMD, My Duc Hospital, Vietnam, from March 2017 to March 2019. There were 244 patients taking preimplantation genetic testing for aneuploidy (PGT-A group). Biopsy was performed at the blastocyst stage. On the day of biopsy, about 5-6 trophectoderm cells were collected and sent to analysis, while the remaining was individually vitrified to be used for embryo transfer to the patient. When patients had PGT-A, the clinician consulted and indicated the euploid embryo for frozen embryo transfer cycle. The ongoing pregnancy rate was compared with the group of patients who only performed blastocyst transfer (non-PGT-A group). Other outcomes, such as the average number of transferred embryos, clinical pregnancy rate, implantation rate, miscarriage rate and multiple pregnancy rate, were also compared between the two groups.

Results: In the total of 493 patients fulfilled the inclusion criteria, there were 244 patients in PGT-A group and 249 patients in non-PGT-A group. The patient characteristics of the two groups were similar (p > 0.05). A total of 816 blastocysts were biopsied and 315 (38.6%) of these were aneuploidy. The ongoing pregnancy rate of PGT-A group was significantly higher than non-PGT-A group (43.9% vs. 32.1%, p = 0.01). Moreover, mean number of transferred embryos and multiple pregnancy rate of PGT-A group was lower than non-PGT-A group (1.3 vs. 2, p < 0.001; 5.7% vs. 12%, p < 0.001, respectively).

Conclusions: In patients with advanced maternal age, the transfer of euploidy embryos selected by PGT-A improved the ongoing pregnancy rate and reduced the number of transferred embryos and multiple pregnancy rate. Therefore, this group of patients may benefit from PGT-A.