Comparative analysis of cumulative live birth rates in patients with recurrent pregnancy loss undergoing preimplantation genetic testing for aneuploidy versus conventional in vitro fertilisation/intracytoplasmic sperm injection: a retrospective study.

IF 4.2 3区医学 Q1 REPRODUCTIVE BIOLOGY

Journal of Ovarian Research Pub Date : 2025-07-03 DOI:10.1186/s13048-025-01721-3

Pei Xin Li, Jing Yi Han, Wei Zheng, Ran Shen, Nan Meng, Bing Nan Ren, Yi Xuan Yan, Yue Yang, Man Yu Hu, Yi Chun Guan

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引用次数: 0

Abstract

Background: Recurrent pregnancy loss (RPL) affects 1-2% of women worldwide and poses diagnostic and therapeutic challenges due to its multifactorial causes. Preimplantation genetic testing for aneuploidy (PGT-A) aims to improve outcomes by selecting euploid embryos, but its benefits in RPL patients remain uncertain. This study compared the effectiveness of PGT-A versus conventional in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) in improving cumulative live birth rates (CLBRs) and explored the effects of maternal age and miscarriage frequency on treatment efficacy.

Methods: This study included RPL patients who underwent their first oocyte retrieval and at least one single-blastocyst transfer between June 2016 and June 2022. Patients were divided into an IVF/ICSI group (n = 156) and a PGT-A group (n = 198). Primary outcomes included the CLBR, live birth rate, miscarriage rate, time to live birth, and perinatal outcomes.

Results: After three single-blastocyst transfer cycles, no significant difference was observed in the conservative CLBR between the PGT-A and IVF/ICSI groups (Cycle 1: adjusted odds ratio [aOR] = 0.78, 95% confidence interval [CI]: 0.49-1.23; Cycle 2: aOR = 0.81, 95% CI: 0.51-1.29; Cycle 3: aOR = 0.96, 95% CI: 0.60-1.53; all P > 0.05). Similarly, the optimal CLBR after three transfer cycles showed no significant difference between the two groups (P > 0.05). However, the time to live birth was significantly longer in the PGT-A group than in the IVF/ICSI group (adjusted hazard ratio = 0.56, 95% CI: 0.42-0.75, P < 0.05). Other outcomes were comparable between the two groups.

Conclusion: PGT-A did not significantly improve the CLBR or shorten the time to live birth in RPL patients. Further research is needed to elucidate its role and identify potential subgroups within the RPL population that may benefit from PGT-A.

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非整倍体植入前基因检测与常规体外受精/胞浆内单精子注射的复发性流产患者累积活产率的比较分析：一项回顾性研究。

背景：复发性妊娠丢失（RPL）影响全世界1-2%的妇女，由于其多因素原因，给诊断和治疗带来了挑战。非整倍体植入前基因检测（PGT-A）旨在通过选择整倍体胚胎来改善结果，但其在RPL患者中的益处仍不确定。本研究比较了PGT-A与传统体外受精/胞浆内单精子注射（IVF/ICSI）在提高累积活产率（clbr）方面的有效性，并探讨了产妇年龄和流产频率对治疗效果的影响。方法：本研究纳入了2016年6月至2022年6月期间接受第一次卵母细胞提取和至少一次单囊胚移植的RPL患者。患者分为IVF/ICSI组（156例）和PGT-A组（198例）。主要结局包括CLBR、活产率、流产率、活产时间和围产期结局。结果：在3个单囊胚移植周期后，PGT-A组和IVF/ICSI组的保守CLBR无显著差异(第1周期：调整优势比[aOR] = 0.78, 95%可信区间[CI]: 0.49-1.23；周期2:aOR = 0.81, 95% CI: 0.51-1.29；周期3:aOR = 0.96, 95% CI: 0.60-1.53；P < 0.05)。同样，3个转移周期后的最佳CLBR在两组间无显著差异（P < 0.05）。然而，PGT-A组的活产时间明显长于IVF/ICSI组（校正风险比= 0.56,95% CI: 0.42-0.75， P）。结论：PGT-A并未显著改善RPL患者的CLBR或缩短活产时间。需要进一步的研究来阐明其作用，并确定RPL人群中可能受益于PGT-A的潜在亚群。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Ovarian Research REPRODUCTIVE BIOLOGY-

CiteScore

6.20

自引率

2.50%

发文量

125

审稿时长

>12 weeks

期刊介绍： Journal of Ovarian Research is an open access, peer reviewed, online journal that aims to provide a forum for high-quality basic and clinical research on ovarian function, abnormalities, and cancer. The journal focuses on research that provides new insights into ovarian functions as well as prevention and treatment of diseases afflicting the organ. Topical areas include, but are not restricted to: Ovary development, hormone secretion and regulation Follicle growth and ovulation Infertility and Polycystic ovarian syndrome Regulation of pituitary and other biological functions by ovarian hormones Ovarian cancer, its prevention, diagnosis and treatment Drug development and screening Role of stem cells in ovary development and function.