Maternal and perinatal outcomes after preimplantation genetic testing for aneuploidies using blastocyst biopsy for women of advanced age
10.3760/cma.j.cn101441-20220424-00179
- VernacularTitle:基于囊胚期活检的胚胎植入前非整倍体遗传学检测对高龄女性母婴结局的影响
- Author:
Yongxiu HAO
1
;
Wei CHEN
1
;
Zhiqiang YAN
1
;
Fei KONG
1
;
Yuanyuan WANG
1
;
Xiaohui ZHU
1
;
Liying YAN
1
;
Ping LIU
1
;
Rong LI
1
;
Jie QIAO
1
Author Information
1. 北京大学第三医院妇产科生殖医学中心，国家妇产疾病临床医学研究中心，辅助生殖教育部重点实验室，北京市生殖内分泌与辅助生殖技术重点实验室，北京 100191
- Publication Type:Journal Article
- Keywords:
Preimplantation genetic testing for aneuploidies;
Blastocyst biopsy;
Advanced age;
Maternal outcomes;
Perinatal outcomes
- From:
Chinese Journal of Reproduction and Contraception
2022;42(11):1098-1106
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To examine the effects of preimplantation genetic testing for aneuploidies (PGT-A) using blastocyst biopsy on maternal and perinatal outcomes for women of advanced age.Methods:A retrospective cohort study was conducted during January 2016 to December 2018 at Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital. Women who were aged ≥35 years, underwent intracytoplasmic sperm injection (ICSI, control group) or PGT-A after ICSI (PGT-A group) with single frozen-thawed blastocyst transferred were eligible in this study. They were further divided into 35-37 years old subgroup and ≥38 years old subgroup according to age. The primary outcome was live birth, and the secondary outcomes were human chorionic gonadotropin (hCG) positivity, clinical pregnancy, pregnancy loss, hypertension in pregnancy, gestational diabetes mellitus, gestational age, preterm birth, caesarean section, low birth weight, small gestational age, and large gestational age.Results:For women aged ≥35 years, the live birth rate in PGT-A group was significantly higher than that in control group [38.0% (89/234) vs. 26.8% (237/885), OR(95% CI)=1.49(1.13-1.97), P=0.047], the miscarriage rate was significantly lower than that in control group [17.6% (19/108) vs. 29.0% (116/443), OR(95% CI)=0.45(0.24-0.85), P=0.013]. We found that for women who aged ≥38 years, the live birth rate [ OR(95% CI)=3.01(1.67-5.44), P<0.001], hCG positivity rate [ OR(95% CI)=2.08(1.25-3.47), P=0.005], clinical pregnancy rate [ OR(95% CI)=2.39(1.40-4.07), P=0.001] in PGT-A group were significantly higher than those in control group, and the miscarriage rate in PGT-A group was significantly lower than that in control group [ OR(95% CI)=0.34(0.13-0.85), P=0.022]; for women aged 35-37 years, there were no statistically significant differences in pregnancy outcomes between the two groups (all P>0.05). Moreover, there were no statistically significant differences in the rates of obstetric complications and perinatal outcomes for women aged ≥35 years between PGT-A group and control group (all P>0.05), and similar results were found in the subgroup analyses for women who aged 35-37 years or ≥38 years. Conclusion:PGT-A using blastocyst stage biopsy strategy in single blastocyst thaw transferred cycles could significantly improve the rates of hCG positivity, clinical pregnancy, and live birth, and significantly reduce the miscarriage rate for women aged ≥38 years, but could not improve the pregnancy outcomes for women aged 35-37 years. In addition, the use of PGT-A does not increase the risk of obstetric complications and perinatal outcomes for women of advanced age.
