Assessing the impact of both preimplantation genetic testing for aneuploidy with blastocyst morphologic grade on live birth rates in frozen embryo transfers from fresh and frozen donor oocytes

IF 2.5 3区医学 Q2 OBSTETRICS & GYNECOLOGY Archives of Gynecology and Obstetrics Pub Date : 2025-02-13 DOI:10.1007/s00404-024-07876-6

Alyson Dennis, Nirali Jain, Emily Auran Clarke, Jennifer K. Blakemore

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Abstract

Purpose

To evaluate the live birth rate (LBR) following donor frozen embryo transfer (dFET) of preimplantation genetic testing for aneuploidy (PGT-A) versus untested donor embryos, stratified by blastocyst morphologic grade (MG).

Methods

This was a retrospective cohort study of 146 patients undergoing dFET of a single euploid blastocyst from fresh or frozen oocytes using PGT-A compared to age-matched controls (1:1 ratio) who did not use PGT-A. Primary outcome was LBR. LBR was compared among cohorts, with further stratification by (1) high/low MG and (2) fresh/frozen oocyte status. Secondary outcomes included perinatal outcomes.

Result(s)

Median age in both groups was 44.5 years (p = 0.98). LBR was similar among the two cohorts (PGT-A: 57.5% vs. untested: 50.0%, p = 0.20). There was similar LBR in fresh (PGT-A: 59.2% vs. untested: 50.0%, p = 0.20) and frozen (PGT-A: 47.6% vs. untested: 50.0%, p = 0.85) oocyte subgroups. When stratified by MG, we appreciated similar LBR among high-quality blastocysts (PGT-A-high: 56.5% vs. untested-high: 52.3%, p = 0.49) among the whole cohort, as well as in fresh (fresh-PGT-A-high: 58.3% vs. fresh-untested-high: 52.9%, p = 0.46) and frozen (frozen-PGT-A-high: 44.4% vs. frozen-untested-high: 51.7%, p = 0.59) subgroups. Similarly, we appreciated no difference in LBR among low-quality blastocysts (PGT-A-low: 75.0% vs. untested-low: 31.2%, p = 0.08) among the whole cohort, as well as in the fresh (fresh-PGT-A-low: 80.0% vs. fresh-untested-low: 16.1%, p = 0.08) or frozen (frozen-PGT-A-low: 66.7% vs. frozen-untested-low: 40.0%, p = 0.56) subgroups. Gestational age (37.8 weeks, p = 1.0) and infant birth weight (PGT-A: 3128.0 g vs. untested: 3150.2 g, p = 0.60) were similar.

Conclusion(s)

Though limited by the small number of MG blastocysts, overall PGT-A did not improve LBR regardless of blastocyst quality from fresh and previously frozen donor oocytes.

Capsule

Use of PGT-A did not improve live birth rate regardless of blastocyst quality from both fresh and previously frozen donor oocytes.

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评估胚泡形态分级的非整倍体着床前基因检测对新鲜和冷冻供体卵母细胞冷冻胚胎移植的活产率的影响。

目的：通过囊胚形态分级（MG）对非整倍体（PGT-A）和未检测的供体胚胎进行着床前基因检测，评估供体冷冻胚胎移植（dFET）后的活产率（LBR）。方法：这是一项回顾性队列研究，146例患者使用PGT-A对新鲜或冷冻卵母细胞中的单个整倍体囊胚进行dFET，与不使用PGT-A的年龄匹配对照组（1:1比例）进行比较。主要终点为LBR。比较各组间的LBR，并根据(1)高/低MG和(2)新鲜/冷冻卵母细胞状态进一步分层。结果：两组患者的中位年龄均为44.5岁（p = 0.98）。两个队列的LBR相似（PGT-A: 57.5% vs.未检测：50.0%,p = 0.20）。新鲜卵母细胞亚组（PGT-A: 59.2% vs.未检测：50.0%,p = 0.20）和冷冻卵母细胞亚组（PGT-A: 47.6% vs.未检测：50.0%,p = 0.85）的LBR相似。当按MG分层时，我们发现整个队列中高质量囊胚（pgt - a高：56.5% vs.未经测试：52.3%,p = 0.49）以及新鲜（新鲜pgt - a高：58.3% vs.新鲜未经测试：52.9%,p = 0.46）和冷冻（冷冻pgt - a高：44.4% vs.冷冻未经测试：51.7%,p = 0.59）亚组的LBR相似。同样，我们发现在整个队列中，低质量囊胚（PGT-A-low: 75.0% vs.未经测试的低：31.2%,p = 0.08）以及新鲜（新鲜-PGT-A-low: 80.0% vs.新鲜-未经测试的低：16.1%,p = 0.08）或冷冻（冷冻-PGT-A-low: 66.7% vs.冷冻-未经测试的低：40.0%,p = 0.56）亚组的LBR没有差异。胎龄（37.8周，p = 1.0）和婴儿出生体重（PGT-A: 3128.0 g vs.未测试：3150.2 g, p = 0.60）相似。结论：尽管受MG囊胚数量的限制，无论新鲜和先前冷冻供体卵母细胞的囊胚质量如何，PGT-A总体上没有改善LBR。胶囊：无论新鲜和先前冷冻的供体卵母细胞的囊胚质量如何，使用PGT-A都不能提高活产率。

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来源期刊

Archives of Gynecology and Obstetrics 医学-妇产科学

CiteScore

4.70

自引率

15.40%

发文量

493

审稿时长

1 months

期刊介绍： Founded in 1870 as "Archiv für Gynaekologie", Archives of Gynecology and Obstetrics has a long and outstanding tradition. Since 1922 the journal has been the Organ of the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe. "The Archives of Gynecology and Obstetrics" is circulated in over 40 countries world wide and is indexed in "PubMed/Medline" and "Science Citation Index Expanded/Journal Citation Report". The journal publishes invited and submitted reviews; peer-reviewed original articles about clinical topics and basic research as well as news and views and guidelines and position statements from all sub-specialties in gynecology and obstetrics.