Effect of Preimplantation Genetic Testing for Aneuploidy on Live Birth Rate in Young Women With Recurrent Implantation Failure: A Secondary Analysis of a Multicentre Randomised Trial

优势比 医学 活产 置信区间 胚胎移植 非整倍体 产科 怀孕 倾向得分匹配 流产 逻辑回归 人口 妇科 高龄产妇 内科学 生物 胎儿 遗传学 基因 染色体 环境卫生
作者
Hengyu Guan,Yaqiong He,Yao Lu,Jiaan Huang,Yuan Wang,Qinling Zhu,Jia Qi,Wen‐Chin Lin,Steven R. Lindheim,Zhe Wei,Ying Ding,Yun Sun
出处
标识
DOI:10.1111/1471-0528.18027
摘要

ABSTRACT Objective To investigate the benefit of preimplantation genetic testing for aneuploidy (PGT‐A) in recurrent implantation failure (RIF). Design Secondary analysis of a multicentre, randomised, double‐blind, placebo‐controlled clinical trial. Setting Eight academic fertility centres in China, 2018–2020. Population Overall, 485 infertile women aged < 38 years were evaluated. They had a history of two or more unsuccessful embryo transfer cycles with at least three good‐quality embryos that had been transferred cumulatively and underwent a single blastocyst transfer with or without PGT‐A. Those with thin endometrium or recurrent pregnancy loss were excluded. Methods Patients were categorised into PGT‐A and non‐PGT‐A groups. All pregnancies were followed to delivery. Pregnancy and neonatal outcomes were obtained from obstetric and neonatal medical records. Propensity score matching (PSM) and multivariate logistic regression models were applied to adjust for potential confounding factors. Main Outcome Measures LBR per embryo transfer. Result(s) There was no significant difference in LBR between the PGT‐A and non‐PGT‐A groups both before (39.1% vs. 41.5%, p = 0.760) and after (39.1% vs. 40.6%, p = 0.862) PSM. Unadjusted and adjusted logistic regression models revealed no beneficial effect of PGT‐A on LBR per embryo transfer (crude odds ratio: 0.91, 95% confidence interval: 0.49–1.69; adjusted odds ratio: 1.04, 95% confidence interval: 0.53–2.03). The incidence of maternal and neonatal complications was not significantly different between the groups. Conclusions Patients with RIF aged < 38 years do not benefit from PGT‐A. Thus, factors other than genetic abnormalities may contribute to this clinical conundrum.
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