Comparative analysis of pregnancy outcomes in preimplantation genetic testing for aneuploidy and conventional in vitro fertilization and embryo transfer: a stratified examination on the basis of the quantity of oocytes and blastocysts from a multicenter randomized controlled trial

ABSTRACT

Objective

Live birth rate of assisted reproductive technology is influenced by the quantity of oocytes and blastocysts retrieved. Our previous study indicated comparable cumulative live birth rates between conventional in vitro fertilization and embryo transfer (IVF-ET) and preimplantation genetic testing for aneuploidies (PGT-A). The objective of this study is to investigate variations in pregnancy outcomes between PGT-A and conventional IVF-ET across distinct groups categorized by oocyte and blastocyst counts.

Design

A post hoc exploratory secondary analysis of data from a multicenter randomized controlled trial compared the cumulative live birth rates between conventional IVF-ET vs. PGT-A.

Setting

Academic fertility centers.

Subjects

A total of 1,212 infertile women with a good prognosis for a live birth after PGT-A or conventional IVF-ET were included.

Intervention

women underwent PGT-A or conventional IVF-ET

Main Outcome Measures

cumulative live birth rate, cumulative clinical pregnancy loss rate and good birth outcome.

Results

In the study, all participants were divided into four groups based on quartiles of the number of oocytes retrieved or blastocysts. There was an interaction between whether to perform PGT-A and oocytes numbers category on cumulative clinical pregnancy loss and biochemical pregnancy loss. Chi-square analysis revealed that the PGT-A group showed a lower cumulative frequency of clinical pregnancy loss compared to the IVF-ET group (PGT-A vs IVF-ET: 5.9% vs 13.7%; P=0.003; RR=0.430; 95%CI, 0.243-0.763) when the number of oocytes retrieved was <15. Although no interaction on CLBR, when the retrieved oocyte count ranged from 19 to 23 (19≤ oocytes <23) the PGT-A group exhibited a lower CLBR than the conventional IVF-ET group (PGT-A vs IVF-ET: 75.6% vs 87.1%; P=0.013; RR=0.868; 95%CI, 0.774-0.973), and the average body weight of newborns from the PGT-A group was approximately 142 g lower than that of the conventional IVF-ET group (PGT-A vs IVF-ET: 3334±479g vs 3476±473g; P=0.028). However, no statistically significant difference in the CLBR was observed between the PGT-A and IVF-ET groups in the other oocyte or blastocyst groups.

Conclusion

When the number of retrieved eggs was <15, the PGT-A group exhibited a lower cumulative clinical pregnancy loss rate but no higher CLBR than the conventional IVF-ET group.