Amelia Pantou1,2, Anastasios Mitrakos3,4, Georgia Kokkali5, Konstantina Petroutsou5, Georgia Tounta1, Leandros Lazaros1, Alexandros Dimopoulos6,7, Konstantinos Sfakianoudis5, Konstantinos Pantos5, Michael Koutsilieris8, Ariadni Mavrou1, Emmanuel Kanavakis1, Maria Tzetis2. 1. Genesis Genoma Lab, Genetic Diagnosis, Clinical Genetics and Research, Athens, Greece. 2. Laboratory of Medical Genetics, Medical School, National and Kapodistrian University of Athens, Athens, Greece. 3. Genesis Genoma Lab, Genetic Diagnosis, Clinical Genetics and Research, Athens, Greece. amitrakos@med.uoa.gr. 4. Laboratory of Medical Genetics, Medical School, National and Kapodistrian University of Athens, Athens, Greece. amitrakos@med.uoa.gr. 5. Genesis Athens IVF Clinic, Athens, Greece. 6. Biomedical Sciences Research Center "Alexander Fleming", Athens, Greece. 7. Hellenic Naval Academy, Piraeus, Greece. 8. Experimental Physiology Laboratory, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Abstract
PURPOSE: To investigate whether preimplantation genetic testing for aneuploidy (PGT-A) improves the clinical outcome in patients with advanced maternal age (AMA), recurrent miscarriages (RM), and recurrent implantation failure (RIF). METHODS: Retrospective cohort study from a single IVF center and a single genetics laboratory. One hundred seventy-six patients undergoing PGT-A were assigned to three groups: an AMA group, an RM group, and a RIF group. Two hundred seventy-nine patients that did not undergo PGT-A were used as controls and subgrouped similarly to the PGT-A cohort. For the PGT-A groups, trophectoderm biopsy was performed and array comparative genomic hybridization was used for PGT-A. Clinical outcomes were compared with the control groups. RESULTS: In the RM group, we observed a significant decrease of early pregnancy loss rates in the PGT-A group (18.1% vs 75%) and a significant increase in live birth rate per transfer (50% vs 12.5%) and live birth rate per patient (36% vs 12.5%). In the RIF group, a statistically significant increase in the implantation rate per transfer (69.5% vs 33.3%) as well as the live birth rate per embryo transfer (47.8% vs 19%) was observed. In the AMA group, a statistically significant reduction in biochemical pregnancy loss was observed (3.7% vs 31.5%); however, live birth rates per embryo transfer and per patient were not significantly higher than the control group. CONCLUSION: Our results agree with recently published studies, which suggest caution in the universal application of PGT-A in women with infertility. Instead, a more personalized approach by choosing the right candidates for PGT-A intervention should be followed.
PURPOSE: To investigate whether preimplantation genetic testing for aneuploidy (PGT-A) improves the clinical outcome in patients with advanced maternal age (AMA), recurrent miscarriages (RM), and recurrent implantation failure (RIF). METHODS: Retrospective cohort study from a single IVF center and a single genetics laboratory. One hundred seventy-six patients undergoing PGT-A were assigned to three groups: an AMA group, an RM group, and a RIF group. Two hundred seventy-nine patients that did not undergo PGT-A were used as controls and subgrouped similarly to the PGT-A cohort. For the PGT-A groups, trophectoderm biopsy was performed and array comparative genomic hybridization was used for PGT-A. Clinical outcomes were compared with the control groups. RESULTS: In the RM group, we observed a significant decrease of early pregnancy loss rates in the PGT-A group (18.1% vs 75%) and a significant increase in live birth rate per transfer (50% vs 12.5%) and live birth rate per patient (36% vs 12.5%). In the RIF group, a statistically significant increase in the implantation rate per transfer (69.5% vs 33.3%) as well as the live birth rate per embryo transfer (47.8% vs 19%) was observed. In the AMA group, a statistically significant reduction in biochemical pregnancy loss was observed (3.7% vs 31.5%); however, live birth rates per embryo transfer and per patient were not significantly higher than the control group. CONCLUSION: Our results agree with recently published studies, which suggest caution in the universal application of PGT-A in women with infertility. Instead, a more personalized approach by choosing the right candidates for PGT-A intervention should be followed.
Authors: Gayathree Murugappan; Lora K Shahine; Candice O Perfetto; Lee R Hickok; Ruth B Lathi Journal: Hum Reprod Date: 2016-06-07 Impact factor: 6.918
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