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Comprehensive analysis of the associations between previous pregnancy failures and blastocyst aneuploidy as well as pregnancy outcomes after PGT-A

  • Assisted Reproduction Technologies
  • Published:
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Abstract

Purpose

To investigate the associations of previous pregnancy failures, including implantation failures (IFs), biochemical pregnancy losses (BPLs), and early (EMs) and late miscarriages (LMs), with blastocyst aneuploidy and pregnancy outcomes after PGT-A.

Methods

This study included 792 couples who underwent PGT-A after multiple pregnancy failures. Subgroup analyses were used to compare the blastocyst aneuploidy rate (BAR), implantation rate (IR), early miscarriage rate (EMR), and live birth rate (LBR). Multiple linear and logistic regression models were used to evaluate the associations. The control group comprised couples with ≤ 2 IFs, ≤ 1 BPL, ≤ 1 EM, and no LM.

Results

Notably, a history of ≥ 4 IFs was significantly associated with an increase in aneuploid blastocysts (42.86% vs. 33.05%, P = 0.044, B = 10.23 for 4 IFs; 48.80% vs. 33.05%, P = 0.002, B = 14.43 for ≥ 5 IFs). Women with ≥ 4 prior EMs also harbored more aneuploid blastocysts (41.00% vs. 33.05%, P = 0.048; B = 9.23). Compared with the control group, women with ≥ 4 prior EMs had a significantly higher EMR (6.58% vs. 31.11%, P < 0.001, OR = 6.49) and a lower LBR (53.49% vs. 34.18%, P = 0.007, OR = 0.56) after euploid transfer. Moreover, a history of LM(s) was associated with adverse pregnancy outcomes after PGT-A (OR for EM = 3.16; OR for live birth = 0.48). However, previous BPLs and 2 EMs were not associated significantly with blastocyst aneuploidy and pregnancy outcomes after PGT-A.

Conclusion

A history of high-order IFs or EMs and existence of LM(s) were significantly associated with blastocyst aneuploidy and adverse pregnancy outcomes after PGT-A, whereas no such associations were observed with BPLs or 2 EMs.

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Acknowledgments

The authors would like to thank Jingfu Yang for his invaluable help during data collection. The authors are indebted to every member from the IVF and PGT laboratory for their tremendous contributions to laboratory procedures.

Funding

The study was funded by the National Key Research and Development Program of China (2016YFC1000202, 2018YFC1002804) and the National Natural Science Foundation of China (81671522).

Author information

Authors and Affiliations

  1. Center for Reproductive Medicine, Shandong University, 157 Jingliu Road, Jinan, 250001, China

    Tianxiang Ni, Qianqian Wu, Yueting Zhu, Wenjie Jiang, Qian Zhang, Yan Li, Junhao Yan & Zi-Jiang Chen

  2. National Research Center for Assisted Reproductive Technology and Reproductive Genetics, 157 Jingliu Road, Jinan, 250001, China

    Tianxiang Ni, Qianqian Wu, Yueting Zhu, Wenjie Jiang, Qian Zhang, Yan Li, Junhao Yan & Zi-Jiang Chen

  3. Shandong Provincial Key Laboratory of Reproductive Medicine, 157 Jingliu Road, Jinan, 250001, China

    Tianxiang Ni, Qianqian Wu, Yueting Zhu, Wenjie Jiang, Qian Zhang, Yan Li, Junhao Yan & Zi-Jiang Chen

  4. Shandong Provincial Clinical Medicine Research Center for Reproductive Health, 157 Jingliu Road, Jinan, 250001, China

    Tianxiang Ni, Qianqian Wu, Yueting Zhu, Wenjie Jiang, Qian Zhang, Yan Li, Junhao Yan & Zi-Jiang Chen

  5. Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, 845 Lingshan Road, Shanghai, 200000, China

    Zi-Jiang Chen

Authors
  1. Tianxiang Ni
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  2. Qianqian Wu
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  3. Yueting Zhu
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  4. Wenjie Jiang
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  5. Qian Zhang
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  6. Yan Li
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  7. Junhao Yan
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  8. Zi-Jiang Chen
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Contributions

All authors contributed to the study conception and design. Junhao Yan and Zi-Jiang Chen conceived and designed the study. Tianxiang Ni analyzed the data and drafted the manuscript. Qianqian Wu, Yueting Zhu and Wenjie Jiang collected and verified the data; Qian Zhang and Yan Li revised the manuscript. All authors were involved in interpreting the data and approved the final manuscript.

Corresponding author

Correspondence to Junhao Yan.

Ethics declarations

Ethical approval for the use and analysis of information and data from patients who underwent PGT was obtained from the Ethics Committee of Reproductive Medicine Center of Shandong University. Informed consent was obtained from all of the patients included in the study.

Conflict of interest

The authors declare that they have no conflict of interest.

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Ni, T., Wu, Q., Zhu, Y. et al. Comprehensive analysis of the associations between previous pregnancy failures and blastocyst aneuploidy as well as pregnancy outcomes after PGT-A. J Assist Reprod Genet 37, 579–588 (2020). https://doi.org/10.1007/s10815-020-01722-9

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  • DOI: https://doi.org/10.1007/s10815-020-01722-9

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