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Journal of Assisted Reproduction and Genetics

, Volume 36, Issue 12, pp 2493–2504 | Cite as

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

  • Laura Sacchi
  • Elena Albani
  • Amalia Cesana
  • Antonella Smeraldi
  • Valentina Parini
  • Marco Fabiani
  • Maurizio Poli
  • Antonio Capalbo
  • Paolo Emanuele Levi-SettiEmail author
Assisted Reproduction Technologies

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.

Keywords

Preimplantation genetic testing Advanced maternal age Clinical outcome Miscarriage Aneuploidy 

Notes

Supplementary material

10815_2019_1609_MOESM1_ESM.docx (51 kb)
ESM 1 (DOCX 51 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Laura Sacchi
    • 1
  • Elena Albani
    • 1
  • Amalia Cesana
    • 1
  • Antonella Smeraldi
    • 1
  • Valentina Parini
    • 1
  • Marco Fabiani
    • 2
  • Maurizio Poli
    • 2
  • Antonio Capalbo
    • 2
  • Paolo Emanuele Levi-Setti
    • 1
    Email author
  1. 1.Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility CenterHumanitas Clinical and Research InstituteRozzanoItaly
  2. 2.Igenomix ItalyMarosticaItaly

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