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PGT-A is associated with reduced cumulative live birth rate in first reported IVF stimulation cycles age ≤ 40: an analysis of 133,494 autologous cycles reported to SART CORS

  • Assisted Reproduction Technologies
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Abstract

Purpose

To evaluate the impact of preimplantation genetic testing for aneuploidy (PGT-A) on cumulative live birth rate (CLBR) in IVF cycles.

Methods

Retrospective cohort study of the SART CORS database, comparing CLBR for patients using autologous oocytes, with or without PGT-A. The first reported autologous ovarian stimulation cycle per patient between January 1, 2014, and December 31, 2015, and all linked embryo transfer cycles between January 1, 2014, and December 31, 2016, were included in the study. Exclusion criteria were donor oocyte cycles, donor embryo cycles, gestational carrier cycles, cycles which included both a fresh embryo transfer (ET) combined with a thawed embryo previously frozen (ET plus FET), or cycles with a fresh ET after PGT-A.

Results

A total of 133,494 autologous IVF cycles were analyzed. Amongst patients who had blastocysts available for either ET or PGT-A, including those without transferrable embryos, decreased CLBR was noted in the PGT-A group at all ages, except ages > 40 (p < 0.01). A subgroup analysis of only those patients who had PGT-A and a subsequent FET, excluding those without transferrable embryos, demonstrated a very high CLBR, ranging from 71.2% at age < 35 to 50.2% at age > 42. Rates of multiple gestations, preterm birth, early pregnancy loss, and low birth weight were all greater in the non-PGT-A group.

Conclusions

PGT-A was associated with decreased CLBR amongst all patients who had blastocysts available for ET or PGT-A, except those aged > 40. The negative association of PGT-A use and CLBR per cycle start was especially pronounced at age < 35.

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Acknowledgements

SART wishes to thank all of its members for providing clinical information to the SART CORS database for use by patients and researchers. Without the efforts of our members, this research would not have been possible.

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Authors and Affiliations

  1. Illume Fertility, 761 Main Ave, Suite #200, Norwalk, CT, 06531, USA

    Alexander Kucherov

  2. Department of Epidemiology & Population Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA

    Melissa Fazzari

  3. Department of Obstetrics & Gynecology and Women’s Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA

    Harry Lieman & Sangita Jindal

  4. Montefiore’s Institute for Reproductive Medicine and Health, Hartsdale, NY, USA

    Harry Lieman & Sangita Jindal

  5. Reproductive Medicine and Infertility Associates, Woodbury, MN, USA

    G. David Ball

  6. Center for Assisted Reproduction, Bedford, TX, USA

    Kevin Doody

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  1. Alexander Kucherov
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Kucherov, A., Fazzari, M., Lieman, H. et al. PGT-A is associated with reduced cumulative live birth rate in first reported IVF stimulation cycles age ≤ 40: an analysis of 133,494 autologous cycles reported to SART CORS. J Assist Reprod Genet 40, 137–149 (2023). https://doi.org/10.1007/s10815-022-02667-x

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