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Preimplantation genetic testing for aneuploidy in poor ovarian responders with four or fewer oocytes retrieved

  • Assisted Reproduction Technologies
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Abstract

Purpose

To assess whether preimplantation genetic testing for aneuploidies (PGT-A) at the blastocyst stage improves clinical outcomes compared with transfer of embryos without PGT-A in poor ovarian response (POR) patients.

Methods

Retrospective cohort study of IVF cycles from 2016 to 2019 at a single academic fertility center. IVF cycles with POR and four or fewer oocytes retrieved were stratified into PGT-A (n = 241) and non-PGT (n = 112) groups. In PGT-A cycles, trophectoderm biopsy, next-generation sequencing with 24-chromosome screening, and single euploid frozen embryo transfer were performed. In non-PGT cycles, fresh or frozen transfer of untested embryos on day 3 or 5 was performed. Main outcomes included live birth rate and miscarriage rate per retrieval.

Result(s)

Patients who underwent PGT-A cycles were significantly less likely to reach embryo transfer compared with those who underwent non-PGT cycles (13.7% vs 70.6%). The live birth rate per retrieval did not differ between the PGT-A and non-PGT groups (6.6% vs 5.4%). Overall, the miscarriage rate was low. The PGT-A group demonstrated a significantly lower miscarriage rate per retrieval (0.4% vs 3.6%) as well as per pregnancy (5.9% vs 40.0%) compared with the non-PGT group. The number needed to treat to avoid one clinical miscarriage was 31 PGT-A cycles.

Conclusion(s)

PGT-A did not improve live birth rate per retrieval in POR patients with four or fewer oocytes retrieved. PGT-A was associated with a lower miscarriage rate; however, a fairly large number of PGT-A cycles were needed to prevent one miscarriage.

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Data availability

The material contained in the manuscript has not been published, has not been submitted, or is not being submitted elsewhere for publication.

Code availability

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Authors and Affiliations

Authors

Contributions

J.D. performed study design, execution, statistical analysis, and wrote the manuscript. H.H., Q.Z., A.N., and S.A. coordinated data collection and statistical analysis. B.B. and R.L. contributed interpretation of the data and edit of the manuscript. We thank Stephanie A. Leonard for assistance in statistics. All authors reviewed the manuscript and provided critical feedback and discussion.

Corresponding author

Correspondence to Jie Deng.

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The authors declare that they do not have conflicts of interest.

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This research is approved by IRB at Stanford University.

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The work was done in Stanford Medicine Fertility and Reproductive Health Services.

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Deng, J., Hong, H.Y., Zhao, Q. et al. Preimplantation genetic testing for aneuploidy in poor ovarian responders with four or fewer oocytes retrieved. J Assist Reprod Genet 37, 1147–1154 (2020). https://doi.org/10.1007/s10815-020-01765-y

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