Preimplantation Genetic Testing for Aneuploidy Improves Clinical, Gestational, and Neonatal Outcomes in Advanced Maternal Age Patients Without Compromising Cumulative Live-Birth Rate.

To assess the association between serum ovulation trigger progesterone (P) levels and the outcome of in vitro fertilization cycles. Design Setting: Real world single-center retrospective cohort study. Patient Intervention(s): All fresh cleavage and blastocyst-stage embryo transfers (ETs) performed from January 2012 to December 2016. Main outcome Measure(s): The impact of premature high serum P levels cycles in terms of clinical pregnancy rates (CPRs) and live birth rates (LBRs). Results: 8,034 ETs were performed: 7,597 cleavage-stage transfers and 437 blastocyst transfers. Serum P levels demonstrated to be inversely related to CPR (OR 0.72, p < 0.001) and LBR (OR 0.73, p < 0.001). The progressive decrease of LBR and CPR started when P levels were >1 ng/ml in a good prognosis cleavage ET subgroup, whereas in patients with worse prognosis only for P ≥ 1.75 ng/ml. In the blastocyst ET subgroup, the negative effect of P elevation was reported only if P was >1.75 ng/ml. CPR (OR 0.71 (0.62-0.80), p < 0.001) and LBR (OR 0.73 (0.63-0.84), p < 0.001) in thawed cycles resulted statistically significantly higher than in fresh cycles in the cleavage-stage subgroup. In the blastocyst group, no significant difference resulted between thawed and fresh cycles, independently of P levels [CPR OR 0. 37 (0.49-1.09), p = 0.123; LBR OR 0.71 (0.46-1.10), p = 0.126]. Conclusion: High P levels decrease CPR as well as LBR in both cleavage and blastocyst ET. In the cleavage group, for P levels below 1.75 ng/ml, our data suggest the possibility to wait until day 5 for ET, and if P level is ≥1.75 ng/ml, it should be considered to freeze all embryos and postpone the ET. Clinical Trial Registration: ClinicalTrials.gov, ID: NCT04253470.

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“…We also compared CPR and LBR with thawed cycles from the same period, excluding the ones deriving from PGTA (20).…”

Section: Methodsmentioning

confidence: 99%

The Role of hCG Triggering Progesterone Levels: A Real-World Retrospective Cohort Study of More Than 8000 IVF/ICSI Cycles

et al. 2020

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“…Sacchi et al [77], in an observational-cohort study with two years follow-up, including a total of 2538 couples, confirmed that PGT improves clinical outcomes in patients with AMA when compared to controls, as documented by higher LBR (40.3% vs. 11.0%), reduced pregnancy loss (3.6% vs. 22.6%), and multiple pregnancy rate (0% vs. 11.1%). Multivariate analysis showed no negative impact of PGT-A related interventions on the cumulative delivery rate and on neonatal outcomes.…”

Section: Advanced Maternal Agementioning

confidence: 83%

Preimplantation Genetic Testing: Where We Are Today

Greco

Litwicka

Minasi

et al. 2020

IJMS

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Background: Preimplantation genetic testing (PGT) is widely used today in in-vitro fertilization (IVF) centers over the world for selecting euploid embryos for transfer and to improve clinical outcomes in terms of embryo implantation, clinical pregnancy, and live birth rates. Methods: We report the current knowledge concerning these procedures and the results from different clinical indications in which PGT is commonly applied. Results: This paper illustrates different molecular techniques used for this purpose and the clinical significance of the different oocyte and embryo stage (polar bodies, cleavage embryo, and blastocyst) at which it is possible to perform sampling biopsies for PGT. Finally, genetic origin and clinical significance of embryo mosaicism are illustrated. Conclusions: The preimplantation genetic testing is a valid technique to evaluated embryo euploidy and mosaicism before transfer.

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“…The mean female age in that study was 39 years old. More recently, Sacchi et al published a prospective cohort study of women aged 38-44 years old with and without PGT-A that included up to 2 years of follow-up (Sacchi et al, 2019). They found that the CLBR per oocyte retrieval was not significantly different between groups (26.3% vs. 24.0%, p = NS).…”

Section: Methodsmentioning

confidence: 99%

Preimplantation genetic testing for aneuploidy: A Canadian Fertility and Andrology Society Guideline

Chan

Ryu

Zwingerman

2021

Reproductive BioMedicine Online

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Preimplantation Genetic Testing for Aneuploidy Improves Clinical, Gestational, and Neonatal Outcomes in Advanced Maternal Age Patients Without Compromising Cumulative Live-Birth Rate.

Cited by 77 publications

References 30 publications

The Role of hCG Triggering Progesterone Levels: A Real-World Retrospective Cohort Study of More Than 8000 IVF/ICSI Cycles

The Role of hCG Triggering Progesterone Levels: A Real-World Retrospective Cohort Study of More Than 8000 IVF/ICSI Cycles

Preimplantation Genetic Testing: Where We Are Today

Preimplantation genetic testing for aneuploidy: A Canadian Fertility and Andrology Society Guideline

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