Preimplantation genetic testing for aneuploidy and subsequent blastocyst transfer improves pregnancy outcome in advanced maternal age patients

Abstract

Context: Advanced maternal age (AMA) is an important parameter that negatively influences the pregnancy rate in assisted reproductive technology because the rate of aneuploidy in the embryos increases with the patient age. Aims: The aim of this study is to evaluate whether the transfer of an euploid embryo selected by preimplantation genetic testing for aneuploidy (PGT-A) would improve the pregnancy outcome in AMA patients. Settings and Design: This was a retrospective controlled study. Materials and Methods: A total of 250 patients who had undergone frozen transfers of day 5/6 blastocysts were recruited. Patients who had morphologically selected euploid blastocyst transfer were grouped under PGT-A (n = 47) and patients who had only morphologically selected blastocyst transfer were grouped under non-PGT-A (n = 203). The patients were further grouped as test group (AMA patients, ≥35 years of age) and control group (young patients, <35 years of age) in PGT-A and non-PGT-A arm. The comparison was performed between all of the groups. The primary outcome measure was serum beta-human chorionic gonadotropin level for pregnancy confirmation after 14 days of embryo transfer. Statistical Analysis Used: The Chi-square test was used to analyze pregnancy outcomes. Results: Overall pregnancy rate was found to be significantly increased in the PGT-A group in comparison to the non-PGT-A group irrespective of the age (78.5% vs. 59.7%, P = 0.00001). No significant difference were observed in Young versus AMA group of PGT-A arm (79.2% vs. 77.8%, P = 0.62). Interestingly, the study showed a significant increase in the pregnancy outcome of the AMA patients of PGT-A group (77.8% vs. 57.8%, P = 0.002) as compared to the non-PGT-A group. Conclusions:> The present study demonstrates that the transfer of PGT-A-selected euploid embryo significantly improves the pregnancy outcome in AMA patients.