Role of preimplantation genetic testing of embryos for aneuploidy in assisted reproductive technology outcomes in different groups of patients

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Abstract

Objective: To investigate the effect of preimplantation genetic testing (PGT-A) on the outcomes of assisted reproductive technology (ART) in different patient groups.

Materials and methods: This observational study analyzed 800 IVF cycles involving embryo cryopreservation followed by cryopreserved embryo transfer. The patients were divided into four groups based on their clinical and medical history. Group I included older reproductive age women, Group II included patients with recurrent miscarriages, Group III included women with repeat implantation failure, and Group IV consisted of married couples with severe pathozoospermia. Each of the four groups was divided into two subgroups: subgroup "a" included IVF programs with PGT-A and subgroup "b" (controls) included IVF programs without PGT-A.

Results: Clinical pregnancy rate in older reproductive age women was statistically significantly higher in subgroup Ia, compared with that in subgroup Ib (p=0.002; RR (95% CI) =3.18 (1.45; 6.97)). In women with recurrent miscarriages, there was no statistically significant difference in clinical pregnancy rates between subgroups IIa and IIb. However, there was a statistically significant reduction in the incidence of reproductive loss in subgroup IIa, compared with subgroup IIb (p=0.031; RR (95% CI)=0.39 (0.16; 0.96)). Patients with repeat implantation failures showed a statistically significant increase in clinical pregnancy rates in subgroup IIIa, compared with subgroup IIIb (p=0.008; RR (95% CI)=1.98 (1.19; 3.28)). The live birth and early reproductive loss rates were not significantly different between subgroups IIIa and IIIb. There were no statistically significant differences in the clinical pregnancy rates between subgroups IVa and IVb and in the rates of early reproductive loss and live birth in the group of patients with severe pathozoospermia.

Conclusion: This study demonstrated improved outcomes in older reproductive age women; an almost threefold reduction in the rate of early reproductive loss in women with recurrent miscarriages and an increase in the rate of clinical pregnancy in patients with repeat implantation failures. However, there were no statistically significant improvements in ART outcomes in the patients with severe pathozoospermia. These results suggest that PGT-A is feasible in selected patient groups. However, multicenter randomized controlled trials with a qualitative design will provide more comprehensive information on the role of PGT-A in ART outcomes.

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About the authors

Svetlana G. Perminova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: perisvet@list.ru

Dr. Med. Sci., Leading Researcher at Reproductology Department

Russian Federation, Moscow

Guzel V. Savostina

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Author for correspondence.
Email: savostina2324@gmail.com

PhD Student

Russian Federation, Moscow

Alexey N. Ekimov

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: a_ekimov@oparina4.ru

Laboratory Geneticist at the Laboratory of Molecular Genetics

Russian Federation, Moscow

Irina S. Belova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: irsenb@inbox.ru

PhD Student

Russian Federation, Moscow

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