Clinical research of preimplantation genetic testing for aneuploidies in patients with recurrent implantation failure
10.3760/cma.j.cn101441-20210927-00435
- VernacularTitle:植入前遗传学非整倍体筛查对反复种植失败患者疗效的观察
- Author:
Hong CHEN
1
;
Jinxia ZHENG
;
Zili SUN
;
Yuanyuan WU
;
Zhiqin CHEN
Author Information
1. 同济大学附属第一妇婴保健院生殖医学科，上海 201204
- Publication Type:Journal Article
- Keywords:
Reproductive technology, assisted;
Preimplantation genetic testing for aneuploidies;
Fertilization, in vitro;
Recurrent implantation failure;
Embryo
- From:
Chinese Journal of Reproduction and Contraception
2022;42(6):557-565
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of preimplantation genetic testing for aneuploidies (PGT-A) based on next-generation sequencing technology (NGS) on the clinical outcomes of patients with recurrent implantation failure (RIF).Methods:A retrospective cohort study was conducted and the outcomes of patients with a history of RIF were analyzed, of which 63 women underwent PGT-A strategy (study group) and 179 women who underwent conventional in vitro fertilization (IVF) treatment (control group) at the Centre of Assisted Reproduction in Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine from December 2018 to January 2020. Propensity score matching (PSM) was conducted by female age. Baseline characteristics, stimulation characteristics and pregnancy outcomes were analyzed between the two groups. Logistic regression model was used to evaluate the relative prognostic significance of independent variables in relation to the live birth rate (LBR) and cumulative live birth rate (CLBR). Results:Totally 203 patients including 61 patients in study group and 142 patients in control group remained in each group after PSM, there were no significant differences in female age, body mass index, cause of infertility, duration of infertility, number of previous embryo transfer failures, basal follicle-stimulating hormone (bFSH), antral follicle count and ovarian stimulation protocols after matching (all P>0.05). More patients had unavailable embryos in study group than in control group [45.90% (28/61) vs. 13.38% (19/142), P<0.001], while the number of transferable embryos was significantly lower than that in control group [1(0, 2) vs. 2(1, 4), P<0.001]. The implantation rate [61.54% (24/39)], the clinical pregnancy rate [61.54% (24/39)], the ongoing pregnancy rate [61.54% (24/39)] and the live birth rate [61.54% (24/39)] per embryo transfer cycle in study group were significantly higher than those in control group [27.47% (75/273), P<0.001; 41.51% (66/159), P=0.024; 37.11% (59/159), P=0.006 and 37.11% (59/159), P=0.006, respectively]. However, there was no significant difference in CLBR between the two groups [39.34% (24/61) vs. 41.55% (59/142), P=0.770]. Logistic regression revealed that women used PGT was 2.71 times more likely to achieve live birth per transfer cycle compared with those women used non-PGT [ OR (95% CI) =2.71(1.32-5.58), P=0.007], however, the use of PGT was not associated with CLBR [ OR (95% CI)=2.49(0.87-7.13), P=0.089]. Conclusion:Compared with conventional IVF treatment, NGS-PGT strategy can improve the live birth rate per embryo transfer cycle, but cannot improve the cumulative live birth rate in RIF patients. Therefore, the clinical value of NGS-PGT strategy in RIF patients is still debatable.
