Skip to main content
SpringerLink
Log in

PGT-A improved singleton live birth rate among all age groups of women who underwent elective single blastocyst transfer: a single-centre retrospective study

  • Assisted Reproduction Technologies
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

This study assessed the difference in singleton live birth rate (SLBR) between preimplantation genetic testing for aneuploidy (PGT-A) and non-PGT in patients undergoing elective single frozen blastocyst transfer (eSFBT).

Methods

This retrospective cohort study evaluated 10,701 cycles of eSFBT, including PGT-A (n = 3125) and non-PGT (n = 7576). Cycles were further stratified according to age at retrieval. The main outcome was SLBR; secondary outcomes were clinical pregnancy, conception rates, and multiple live birth rate. Confounders were adjusted using multivariable logistic regression models, and the trend test was performed using the general linear model.

Results

SLBR was negatively correlated with age in the non-PGT group (p-trend < 0.001) but not in PGT-A group (p-trend = 0.974). Stratified by the age, SLBR were significantly different between two groups except for the 20–24-year-old group: PGT-A vs non-PGT group in 20–24, 25–29, 30–34, 35–39 and ≥ 40-year-old subgroups were, 53.5% vs 53.2%, 53.5% vs 48.0%, 53.5% vs 43.1%, 53.3% vs 32.5%, and 42.9% vs 17.6%, respectively. In addition, after adjusting for potential confounders, SLBR still remained significantly different in all age groups except in the youngest quartile (PGT-A vs non-PGT group, 20–24: adjusted odds ratio (aOR), 1.33, 95% CI, 0.92–1.92, p = 0.129; 25–29: aOR, 1.32, 95% CI, 1.14–1.52, p < 0.001; 30–34: aOR, 1.91, 95% CI, 1.65–2.20, p < 0.001; 35–39: aOR, 2.50, 95% CI, 1.97–3.17, p < 0.001; ≥ 40: aOR, 3.54, 95% CI, 1.66–7.55, p = 0.001).

Conclusion

PGT-A might improve SLBR among all age groups and play an increasingly important role in SLBR in older patients who underwent eSFBT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Data availability

The datasets used or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Munne S, Kaplan B, Frattarelli JL, et al. Preimplantation genetic testing for aneuploidy versus morphology as selection criteria for single frozen-thawed embryo transfer in good-prognosis patients: a multicenter randomized clinical trial. Fertil Steril. 2019;112(1071–9): e7.

    Google Scholar 

  2. Li N, Guan Y, Ren B, et al. Effect of blastocyst morphology and developmental rate on euploidy and live birth rates in preimplantation genetic testing for aneuploidy cycles with single-embryo transfer. Front Endocrinol (Lausanne). 2022;13: 858042.

    Article  PubMed  Google Scholar 

  3. Steiner AZ, Jukic AM. Impact of female age and nulligravidity on fecundity in an older reproductive age cohort. Fertil Steril. 2016;105(1584–8): e1.

    Google Scholar 

  4. Minasi MG, Colasante A, Riccio T, et al. Correlation between aneuploidy, standard morphology evaluation and morphokinetic development in 1730 biopsied blastocysts: a consecutive case series study. Hum Reprod. 2016;31:2245–54.

    Article  PubMed  Google Scholar 

  5. Rubio C, Bellver J, Rodrigo L, et al. In vitro fertilization with preimplantation genetic diagnosis for aneuploidies in advanced maternal age: a randomized, controlled study. Fertil Steril. 2017;107:1122–9.

    Article  PubMed  Google Scholar 

  6. 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. 2019;36:2493–504.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Greco E, Litwicka K, Minasi MG, et al. Preimplantation genetic testing: where we are today. Int J Mol Sci 2020;21(12):4381.

  8. Sarkar P, Jindal S, New EP, et al. The role of preimplantation genetic testing for aneuploidy in a good prognosis IVF population across different age groups. Syst Biol Reprod Med. 2021;67:366–73.

    Article  CAS  PubMed  Google Scholar 

  9. Simopoulou M, Sfakianoudis K, Maziotis E, et al. PGT-A: who and when? Α systematic review and network meta-analysis of RCTs. J Assist Reprod Genet. 2021;38:1939–57.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Wang L, Wang X, Li M, et al. PGT-A: the biology and hidden failures of randomized control trials. Prenat Diagn 2022;42(9):1211–21.

  11. Scott RT Jr, Upham KM, Forman EJ, et al. Blastocyst biopsy with comprehensive chromosome screening and fresh embryo transfer significantly increases in vitro fertilization implantation and delivery rates: a randomized controlled trial. Fertil Steril. 2013;100:697–703.

    Article  PubMed  Google Scholar 

  12. Ubaldi FM, Capalbo A, Colamaria S, et al. Reduction of multiple pregnancies in the advanced maternal age population after implementation of an elective single embryo transfer policy coupled with enhanced embryo selection: pre- and post-intervention study. Hum Reprod. 2015;30:2097–106.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Practice Committees of the American Society for Reproductive M, the Society for Assisted Reproductive Technology. Electronic address Aao, Practice Committees of the American Society for Reproductive M, et al. The use of preimplantation genetic testing for aneuploidy (PGT-A): a committee opinion. Fertil Steril. 2018;109:429–36.

    Article  Google Scholar 

  14. Zhang WY, von Versen-Hoynck F, Kapphahn KI, et al. Maternal and neonatal outcomes associated with trophectoderm biopsy. Fertil Steril. 2019;112(283–90): e2.

    Google Scholar 

  15. Sciorio R, Dattilo M. PGT-A preimplantation genetic testing for aneuploidies and embryo selection in routine ART cycles: Time to step back? Clin Genet. 2020;98:107–15.

    Article  CAS  PubMed  Google Scholar 

  16. Gleicher N, Barad DH, Patrizio P, et al. We have reached a dead end for preimplantation genetic testing for aneuploidy. Hum Reprod. 2022; 37(12):2730–34.

  17. Gardner DK, Lane M, Stevens J, et al. Blastocyst score affects implantation and pregnancy outcome: towards a single blastocyst transfer. Fertil Steril. 2000;73:1155–8.

    Article  CAS  PubMed  Google Scholar 

  18. Chen D, Shen X, Wu C, et al. Eleven healthy live births: a result of simultaneous preimplantation genetic testing of α- and β-double thalassemia and aneuploidy screening. J Assist Reprod Genet. 2020;37:549–57.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Chen D, Xu Y, Ding C, et al. The inconsistency between two major aneuploidy-screening platforms-single-nucleotide polymorphism array and next-generation sequencing-in the detection of embryo mosaicism. BMC Genomics. 2022;23:62.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Lu MM, Wen YX, Liu YL, et al. Trophectoderm biopsy reduces the level of serum beta-human chorionic gonadotropin in early pregnancy. Fertil Steril. 2020;114:801–8.

    Article  CAS  PubMed  Google Scholar 

  21. Mackens S, Santos-Ribeiro S, van de Vijver A, et al. Frozen embryo transfer: a review on the optimal endometrial preparation and timing. Hum Reprod. 2017;32:2234–42.

    Article  CAS  PubMed  Google Scholar 

  22. Lee JC, Badell ML, Kawwass JF. The impact of endometrial preparation for frozen embryo transfer on maternal and neonatal outcomes: a review. Reprod Biol Endocrinol. 2022;20:40.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Franasiak JM, Forman EJ, Hong KH, et al. The nature of aneuploidy with increasing age of the female partner: a review of 15,169 consecutive trophectoderm biopsies evaluated with comprehensive chromosomal screening. Fertil Steril. 2014;101(656–63): e1.

    Google Scholar 

  24. Hassold T, Hunt P. To err (meiotically) is human: the genesis of human aneuploidy. Nat Rev Genet. 2001;2:280–91.

    Article  CAS  PubMed  Google Scholar 

  25. Irani M, Zaninovic N, Rosenwaks Z, et al. Does maternal age at retrieval influence the implantation potential of euploid blastocysts? Am J Obstet Gynecol. 2019;220(379):e1–7.

    Google Scholar 

  26. Reig A, Franasiak J, Scott RT Jr, et al. The impact of age beyond ploidy: outcome data from 8175 euploid single embryo transfers. J Assist Reprod Genet. 2020;37:595–602.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Zhang WY, Johal JK, Gardner RM, et al. The impact of euploid blastocyst morphology and maternal age on pregnancy and neonatal outcomes in natural cycle frozen embryo transfers. J Assist Reprod Genet. 2022;39:647–54.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Capalbo A, Poli M, Rienzi L, et al. Mosaic human preimplantation embryos and their developmental potential in a prospective, non-selection clinical trial. Am J Hum Genet. 2021;108:2238–47.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Scriven PN. Elucidating the PGT-A paradox: marginalising the detriment relegates the benefit. J Assist Reprod Genet. 2022;39(11):2475–81.

  30. Yang ZH, Liu JE, Collins GS, et al. Selection of single blastocysts for fresh transfer via standard morphology assessment alone and with array CGH for good prognosis IVF patients: results from a randomized pilot study. Mol Cytogenet 2012;5(1):24.

  31. Ozgur K, Berkkanoglu M, Bulut H, et al. Single best euploid versus single best unknown-ploidy blastocyst frozen embryo transfers: a randomized controlled trial. J Assist Reprod Genet. 2019;36:629–36.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Yan J, Qin Y, Zhao H, et al. Live birth with or without preimplantation genetic testing for aneuploidy. N Engl J Med. 2021;385:2047–58.

    Article  CAS  PubMed  Google Scholar 

  33. Forman EJ, Hong KH, Ferry KM, et al. In vitro fertilization with single euploid blastocyst transfer: a randomized controlled trial. Fertil Steril. 2013;100(100–7): e1.

    Google Scholar 

  34. Forman EJ, Upham KM, Cheng M, et al. Comprehensive chromosome screening alters traditional morphology-based embryo selection: a prospective study of 100 consecutive cycles of planned fresh euploid blastocyst transfer. Fertil Steril. 2013;100:718–24.

    Article  PubMed  Google Scholar 

  35. Pagliardini L, Vigano P, Alteri A, et al. Shooting STAR: reinterpreting the data from the “Single Embryo TrAnsfeR of Euploid Embryo” randomized clinical trial. Reprod Biomed Online. 2020;40:475–8.

    Article  CAS  PubMed  Google Scholar 

  36. Alfarawati S, Fragouli E, Colls P, et al. The relationship between blastocyst morphology, chromosomal abnormality, and embryo gender. Fertil Steril. 2011;95:520–4.

    Article  PubMed  Google Scholar 

  37. Capalbo A, Rienzi L, Cimadomo D, et al. Correlation between standard blastocyst morphology, euploidy and implantation: an observational study in two centers involving 956 screened blastocysts. Hum Reprod. 2014;29:1173–81.

    Article  PubMed  Google Scholar 

  38. Majumdar G, Majumdar A, Verma IC, et al. Relationship Between Morphology, Euploidy and Implantation Potential of Cleavage and Blastocyst Stage Embryos. J Hum Reprod Sci. 2017;10:49–57.

    CAS  PubMed  PubMed Central  Google Scholar 

  39. Shi W, Zhou H, Chen L, et al. Live birth rate following frozen-thawed blastocyst transfer is higher in high-grade day 6 blastocysts than in low-grade day 5 blastocysts. Front Endocrinol (Lausanne). 2022;13:1066757.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This work was supported by the Natural Science Foundation of Guangdong Province (2021A1515010559) and Guangdong Provincial Key Laboratory of Reproductive Medicine (2020B1212060029).

Funding

This study was funded by the Natural Science Foundation of Guangdong Province (2021A1515010559) and Guangdong Provincial Key Laboratory of Reproductive Medicine (2020B1212060029).

Author information

Authors and Affiliations

  1. Reproductive Medicine Center, The First Affiliated Hospital of Sun Yat-Sen University, Zhoushan 2 Road, Guangzhou, Guangdong, People’s Republic of China

    Zetong Zheng, Jifan Tan, Lin Chen, Simin Liu, Canquan Zhou & Yubin Li

  2. Guangdong Provincial Key Laboratory of Reproductive Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Zhoushan 2 Road, Guangzhou, Guangdong, People’s Republic of China

    Zetong Zheng, Jifan Tan, Lin Chen, Simin Liu, Canquan Zhou & Yubin Li

Authors
  1. Zetong Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jifan Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lin Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Simin Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Canquan Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yubin Li
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Zetong Zheng, Canquan Zhou, and Yubin Li contributed to the study design. Zetong Zheng and Jifan Tan contributed to manuscript writing. Data acquisition and analysis were carried out by Lin Chen and Simin Liu. Zetong Zheng and Jifan Tan carried out the statistical analyses. Canquan Zhou and Yubin Li critically reviewed the paper. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Canquan Zhou or Yubin Li.

Ethics declarations

Ethics approval and consent to participate

The present study received approval from the Institutional Review Board of the First Affiliated Hospital of Sun Yat-sen University on 16 Aug 2021 (No. [2021]538).

Declaration of interest

The authors have no relevant financial or non-financial interests to disclose.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Zetong Zheng and Jifan Tan have contributed equally to this work and shared the first authorship.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 23 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zheng, Z., Tan, J., Chen, L. et al. PGT-A improved singleton live birth rate among all age groups of women who underwent elective single blastocyst transfer: a single-centre retrospective study. J Assist Reprod Genet 40, 1417–1427 (2023). https://doi.org/10.1007/s10815-023-02775-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10815-023-02775-2

Keywords

Search

Navigation