PGT-A is associated with reduced cumulative live birth rate in first reported IVF stimulation cycles age ≤ 40: an analysis of 133,494 autologous cycles reported to SART CORS

Does PGT-A affect cumulative live birth rate?

“…These same studies that observe an increase in LBR or CLBR in women of advanced reproductive age also note that there are slight decreases in CLBR observed when populations less than 30 years or less than 35 years old are studied [11 ▪ ,29 ▪ ,30 ▪ ]. This may be because of the nonselection of possible mosaic embryos, which is dependent on the subjectivity of the selected laboratory for chromosomal analysis, as is discussed following.…”

“…When looking per embryo transfer, the positive benefits become clearer. For ages 38–40, the CLBR was 69.6 vs. 53.5% (SS), for ages 41–42 59.9 vs. 29.7 (SS) and for greater than 42, the CLBR was 51.2 vs. 11.7% (SS) [11 ▪ ].…”

“…Retrospective studies analyzing SART outcomes from retrieval cycles performed between 2014 and 2015 demonstrated that the CLBR per transfer when employing PGT-A only becomes beneficial once looking at women of advanced reproductive age [11 ▪ ,14 ▪ ]. SART defines cumulative live birth as up to one live birth per retrieval cycle and transfer cycles linked to that retrieval [4].…”

“…Although many of the RCTs for PGT-A do include fresh blastocyst transfers (with rapid chromosome analysis) [7,10,16,18–21], numerous retrospective studies, including those using SART data, compare pregnancy outcomes in PGT-A versus morphology-only that include fresh blastocyst transfer only within the morphology-only group [11 ▪ ,14 ▪ ]. Although extensive research has demonstrated that frozen transfer rates are comparable to that of fresh when comparing rates between embryos from donor eggs as well as autologous [22,23], there is the risk of thaw nonsurvival as well as other laboratory risks, albeit a small percentage [24].…”

“…IVF outcome studies tend to vary on whether they report LBR or CLBR; however, the majority of prior studies demonstrate that PGT-A does not increase the CLBR when looking at all ages, although it demonstrates an increase in the per-transfer LBR in women of advanced reproductive age [11 ▪ ].…”