Preimplantation genetic testing for aneuploidy could not improve cumulative live birth rate among 1,003 couples with recurrent pregnancy loss

Abstract

Abstract Background PGT-A has been widely used for RPL couples to help improve pregnancy outcomes by selecting euploid embryos. However, there is still insufficient evidence to determine the effectiveness of PGT-A in RPL couples, especially on the cumulative live birth rate. This study aims to investigate whether preimplantation genetic testing for aneuploidy (PGT-A) could improve the cumulative live birth rate in patients with recurrent pregnancy loss (RPL). Methods A retrospective large cohort study with 1003 RPL couples (799 in the PGT-A group, and 204 in the conventional IVF/ICSI group) was conducted in a university-affiliated reproductive center. Stratified analysis was performed according to female age (< 35 years and ≥ 35 years). The associations between embryo selection with PGT-A and cumulative pregnancy outcomes were further analyzed by a binary logistic regression model. Results The cumulative live birth rates were similar between the PGT-A group and the conventional IVF/ICSI group both in women under 35 years old [53.32% vs. 61.97%, adjusted OR (95%CI): 0.853(0.547–1.330), P = 0.483] and in women aged ≥ 35 years [28.75% vs. 30.65%, adjusted OR (95%CI): 1.314(0.671–2.574), P = 0.426]. Whereas, a significantly lower cumulative rates of biochemical pregnancy loss (10.13% vs. 32.56%, P < 0.05) and clinical pregnancy loss [20.89% vs. 37.21%, adjusted OR (95%CI): 0.408(0.173–0.966), P = 0.042] were found in the PGT-A group compared with the control group, only among women aged ≥ 35 years. The numbers of embryo transfers were significant less in PGT-A women with < 35 years old [1(1;2) vs. 1(1;2), P < 0.05] and with ≥ 35 years old [1(1;1) vs. 1(1;2), P < 0.05]. Conclusions PGT-A could not improve cumulative live birth rate in RPL couples regardless maternal age.