West China Hospital, Sichuan University, and Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China ; and Thomas Jefferson University, Philadelphia, Pennsylvania.
Obstet Gynecol. 2022 Nov 1;140(5):769-777. doi: 10.1097/AOG.0000000000004962. Epub 2022 Oct 5.
To review the effect of comprehensive chromosome screening-based preimplantation genetic testing for aneuploidy (PGT-A) in women undergoing in vitro fertilization (IVF) treatment, we conducted this meta-analysis to compare pregnancy outcomes of women who did and did not undergo such testing.
We searched Medline, EMBASE, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov from their inception until February 28, 2022, for randomized controlled trials focusing on PGT-A treatment without any language restrictions.
Randomized controlled trials involving women undergoing IVF with or without PGT-A and comprehensive chromosome testing. Pooled relative risks (RRs) with 95% CIs were calculated for the primary outcome using a random-effects model with the Mantel-Haenszel method.
A total of nine trials with 3,334 participants were included. Overall, PGT-A was not associated with an increased live-birth rate (RR 1.13, 95% CI 0.96-1.34, I 2 =79%). However, PGT-A raised the live-birth rate in women of advanced maternal age (RR 1.34, 95% CI 1.02-1.77, I 2 =50%) but not in women of nonadvanced age (RR 0.94, 95% CI 0.89-0.99, I 2 =0%).
Preimplantation genetic testing for aneuploidy increases the live-birth rate in women of advanced maternal age.
PROSPERO, CRD42022311540.
为了评估在体外受精（IVF）治疗中进行基于综合染色体筛查的胚胎非整倍体检测（PGT-A）对妊娠结局的影响，我们进行了这项荟萃分析，以比较接受和未接受此类检测的女性的妊娠结局。
我们检索了 Medline、EMBASE、Cochrane 中央对照试验注册库和 ClinicalTrials.gov，检索时间截至 2022 年 2 月 28 日，检索对象为未设语言限制的聚焦于 PGT-A 治疗的随机对照试验。
纳入了涉及接受 IVF 联合或不联合 PGT-A 及综合染色体检测的女性的随机对照试验。使用 Mantel-Haenszel 方法的随机效应模型计算主要结局的合并相对风险（RR）及其 95%置信区间（CI）。
共有 9 项试验纳入 3334 名参与者。总体而言，PGT-A 并未增加活产率（RR 1.13，95%CI 0.96-1.34，I 2 =79%）。然而，PGT-A 提高了高龄产妇（RR 1.34，95%CI 1.02-1.77，I 2 =50%）而非非高龄产妇（RR 0.94，95%CI 0.89-0.99，I 2 =0%）的活产率。
胚胎非整倍体检测增加了高龄产妇的活产率。
PROSPERO，CRD42022311540。
