Moini Ashraf, Najafpour Narges, Kashani Ladan, Farid-Mojtahedi Maryam, Maleki-Hajiagha Arezoo, Tehranian Afsaneh, Karimi Rana
Department of Obstetrics and Gynecology, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
Clin Exp Reprod Med. 2024 Sep;51(3):268-275. doi: 10.5653/cerm.2023.06352. Epub 2024 Mar 25.
The purpose of this study was to evaluate the impact of preimplantation genetic testing for aneuploidy (PGT-A) on clinical outcomes among high-risk patients.
This retrospective study involved 1,368 patients and the same number of cycles, including 520 cycles with PGT-A and 848 cycles without PGT-A. The study participants comprised women of advanced maternal age (AMA) and those affected by recurrent implantation failure (RIF), recurrent pregnancy loss (RPL), or severe male factor infertility (SMF).
PGT-A was associated with significant improvements in the implantation rate (IR) and the ongoing pregnancy rate/live birth rate (OPR/LBR) per embryo transfer cycle in the AMA (39.3% vs. 16.2% [p<0.001] and 42.0% vs. 21.8% [p<0.001], respectively), RIF (41.7% vs. 22.0% [p<0.001] and 47.0% vs. 28.6% [p<0.001], respectively), and RPL (45.6% vs. 19.5% [p<0.001] and 49.1% vs. 24.2% [p<0.001], respectively) groups, as well as the IR in the SMF group (43.3% vs. 26.5%, p=0.011). Additionally, PGT-A was associated with lower overall incidence rates of pregnancy loss in the AMA (16.7% vs. 34.3%, p=0.001) and RPL (16.7% vs. 50.0%, p<0.001) groups. However, the OPR/LBR per total cycle across all PGT-A groups did not significantly exceed that for the control groups.
PGT-A demonstrated beneficial effects in high-risk patients. However, our findings indicate that these benefits are more pronounced in carefully selected candidates than in the entire high-risk patient population.
本研究旨在评估非整倍体胚胎植入前遗传学检测（PGT-A）对高危患者临床结局的影响。
这项回顾性研究纳入了1368例患者及相同数量的周期，其中包括520个PGT-A周期和848个非PGT-A周期。研究参与者包括高龄产妇（AMA）以及受反复植入失败（RIF）、反复流产（RPL）或严重男性因素不育（SMF）影响的女性。
PGT-A与AMA组（分别为39.3%对16.2% [p<0.001]和42.0%对21.8% [p<0.001]）、RIF组（分别为41.7%对22.0% [p<0.001]和47.0%对28.6% [p<0.001]）以及RPL组（分别为45.6%对19.5% [p<0.001]和49.1%对24.2% [p<0.001]）每个胚胎移植周期的着床率（IR）和持续妊娠率/活产率（OPR/LBR）的显著提高相关，也与SMF组的IR提高相关（43.3%对26.5%，p=0.011）。此外，PGT-A与AMA组（16.7%对34.3%，p=0.001）和RPL组（16.7%对50.0%，p<0.001）较低的总体流产发生率相关。然而，所有PGT-A组每个总周期的OPR/LBR并未显著超过对照组。
PGT-A在高危患者中显示出有益效果。然而，我们的研究结果表明，这些益处在精心挑选的候选者中比在整个高危患者群体中更为明显。
