The effect of female age on pregnancy outcomes in patients with pre-implantation testing for aneuploidy (PGT-A): a multicenter retrospective study

Abstract

Objective This study aimed to evaluate the effect of female age on pregnancy outcomes of couples with PGT-A treatment and to find potential correlations or trends.Methods A multicenter retrospective study was conducted among women with pre-implantation testing for aneuploidy (PGT-A) cycles from three reproductive centers in China. They were divided into four groups according to female age (Group A: <30 years old, Group B: 30–34, Group C: 35–39, and group D: ≥40). The primary outcome was the clinical pregnancy rate (CPR) and the live birth rate (LBR). secondary outcomes were the biochemical pregnancy rate (BPR), early miscarriage rate (EMR), and preterm birth rate (PBR).Results A total of 603 PGT-A cycles were included in the present study. There were 161, 256, 147, and 39 cycles in Group A, B, C, D, respectively. The CPR was 53.8% in Group D, which was decreased compared with Group A (60.2%), Group B (56.3%), and Group C (59.2%). The LBRs were 52.8%, 48.4%, 42.9%, and 41.0%, respectively. EMRs were 11.3%,9.7%,24.1%, 23.8%. And PBRs were 4.7%, 7.3%, 9.1%, and 25.0% in Group A, B, C, and D, respectively. The EMR and PBR showed significantly different among groups. Binary Logistic regression analysis indicated maternal age affects the live birth rate (OR 0.937, 95%CI 0.883–0.995), Early miscarriage rate (OR 1.148, 95%CI 1.033–1.275) and Preterm birth rate (OR 1.196, 95%CI 1.017–1.405).Conclusion As pregnancy outcomes tend to decrease with maternal age after euploid embryo transfer. The results indicated that endometrial receptivity, another key factor for embryo implantation, was affected by female age. During the ART treatment for women with advanced maternal age, we should not only pay attention to oocyte/embryos quality, but also emphasize endometrial receptivity.