In vitro Fertilization with Single-nucleotide Polymorphism Microarray-based Preimplantation Genetic Testing for Aneuploidy Significantly Improves Clinical Outcomes in Infertile Women with Recurrent Pregnancy Loss: A Randomized Controlled Trial

• 作者: Chen Guo-Wu Fu Jing Lei Cai-Xia Li Lu Peng Xian-Dong Sui Yi-Lun Sun Xiao-Xi Ye Jiang-Feng Zhang Shuo Zhang Yue-Ping
• 来源期刊: 生殖与发育医学（英文）
• 关键词: Assisted Reproductive Treatment Clinical Outcomes Preimplantation Genetic Testing for Aneuploidy Recurrent Pregnancy Loss
• 年，卷（期）: 2020,（1）
• 所属期刊栏目: Original Article
• 页码范围: 32-41
• 页数: 10页
• 语种: 中文
• DOI: 10.4103/2096-2924.281852

摘要

Objective::To evaluate the effect of preimplantation genetic testing for aneuploidy (PGT-A) in infertile patients with recurrent pregnancy loss (RPL).Methods::A prospective randomized clinical trial was performed in a university-affiliated fertility center in Shanghai, China. Patients in the PGT-A group underwent blastocyst biopsy followed by single-nucleotide polymorphism microarray-based PGT-A and single euploid blastocyst transfer, whereas patients in the control group underwent routine in vitro fertilization/ICSI procedures and frozen embryo transfer of 1-2 embryos selected according to morphological standards. Results::Two hundred and seven infertile patients with RPL were included in this study and randomly assigned to either the control or the PGT-A group. Baseline variables and cycle characteristics were comparable between the two groups. The results showed that PGT-A significantly improved the ongoing pregnancy rate (55.34% vs. 29.81%) as well as the live birth rate (48.54% vs. 27.88%) and significantly reduced the miscarriage rate (0.00% vs. 14.42%) on a per-patient analysis. A significant increase in cumulative ongoing pregnancy rates over time was observed in the PGT-A group. Subgroup analysis showed that the significant benefit diminished for patients who attempted ≥2 PGT-A cycles.Conclusions::PGT-A significantly improved the ongoing pregnancy and live birth rate, while reduced miscarriage rate in infertile RPL patients. However, the significance diminished in patients attempting ≥2 cycles; thus, further studies are warranted to explore the most cost-effective number of attempts in these patients to avoid overuse.