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Preimplantation Genetic Testing for Aneuploidy Improves Clinical, Gestational, and Neonatal Outcomes in Advanced Maternal Age Patients Without Compromising Cumulative Live-Birth Rate.

  • Assisted Reproduction Technologies
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Abstract

Purpose

To report the effects of blastocyst stage aneuploidy testing on clinical, gestational, and neonatal outcomes for patients of advanced maternal age undergoing IVF.

Methods

This is a single-center observational-cohort study with 2 years follow-up. The study includes a total of 2538 couples undergoing 2905 egg collections (control group), 308 (PGT-A), and 106 (drop-out group, consenting for PGT-A but withdrawing due to poor embryological outcome)

Results

Compared with control group, PGT-A showed improved clinical outcomes (live-birth rate per transferred embryo, LBR 40.3% vs 11.0%) and reduced multiple pregnancy rate (MPR, 0% vs 11.1%) and pregnancy loss (PL, 3.6% vs 22.6%). Drop-out group showed the worst clinical outcomes suggesting that abandoning PGT-A due to poor response to ovarian stimulation is not a favorable option. Cytogenetic analysis of product of conceptions and CVS/amniocentesis showed higher aneuploid pregnancy rates for control group regardless of embryo transfer strategy (0%, 17.9%, and 19.9%, for PGT-A, control day 5 and day 3, respectively). Multivariate analysis showed no negative impact of PGT-A-related interventions on cumulative delivery rate (26.3%, 95% CI 21.5–31.6 vs 24.0%, 95% CI 22.5–25.6 for PGT-A and control, respectively) and on neonatal outcomes.

Conclusion

PGT-A improves clinical outcomes, particularly by reducing pregnancy loss and chromosomally abnormal pregnancy for patients of advanced maternal age, with no major impact on cumulative live-birth rate (CLBR) per egg retrieval.

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Authors and Affiliations

  1. Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, Humanitas Clinical and Research Institute, via Manzoni 56, 20085, Rozzano, MI, Italy

    Laura Sacchi, Elena Albani, Amalia Cesana, Antonella Smeraldi, Valentina Parini & Paolo Emanuele Levi-Setti

  2. Igenomix Italy, via E.Fermi 1, 36063, Marostica, VI, Italy

    Marco Fabiani, Maurizio Poli & Antonio Capalbo

Authors
  1. Laura Sacchi
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  2. Elena Albani
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  3. Amalia Cesana
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  4. Antonella Smeraldi
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  5. Valentina Parini
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  6. Marco Fabiani
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  7. Maurizio Poli
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  8. Antonio Capalbo
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  9. Paolo Emanuele Levi-Setti
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Correspondence to Paolo Emanuele Levi-Setti.

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Sacchi, L., Albani, E., Cesana, A. et al. Preimplantation Genetic Testing for Aneuploidy Improves Clinical, Gestational, and Neonatal Outcomes in Advanced Maternal Age Patients Without Compromising Cumulative Live-Birth Rate.. J Assist Reprod Genet 36, 2493–2504 (2019). https://doi.org/10.1007/s10815-019-01609-4

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  • DOI: https://doi.org/10.1007/s10815-019-01609-4

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