Live birth with or without preimplantation genetic testing for aneuploidy

Junhao Yan, Yingying Qin, Han Zhao, Yun Sun, Fei Gong, Rong Li, Xiaoxi Sun, Xiufeng Ling, Hong Li, Cuifang Hao, Jichun Tan, Jing Yang, Yimin Zhu, Fenghua Liu, Dawei Chen, Daimin Wei, Juanjuan Lu, Tianxiang Ni, Wei Zhou, Keliang WuYuan Gao, Yuhua Shi, Yao Lu, Ting Zhang, Wei Wu, Xiang Ma, Hailan Ma, Jing Fu, Junqiang Zhang, Qingxia Meng, Heping Zhang, Richard S. Legro, Zi Jiang Chen

Research output: Contribution to journalArticlepeer-review

133 Scopus citations

Abstract

BACKGROUND Embryo selection with preimplantation genetic testing for aneuploidy (PGT-A) may improve pregnancy outcomes after initial embryo transfer. However, it remains uncertain whether PGT-A improves the cumulative live-birth rate as compared with conventional in vitro fertilization (IVF). METHODS In this multicenter, randomized, controlled trial, we randomly assigned subfertile women with three or more good-quality blastocysts to undergo either PGT-A or conventional IVF; all the women were between 20 and 37 years of age. Three blastocysts were screened by next-generation sequencing in the PGT-A group or were chosen by morphologic criteria in the conventional-IVF group and then were successively transferred one by one. The primary outcome was the cumulative live-birth rate after up to three embryo-transfer procedures within 1 year after randomization. We hypothesized that the use of PGT-A would result in a cumulative live-birth rate that was no more than 7 percentage points higher than the rate after conventional IVF, which would constitute the noninferiority margin for conventional IVF as compared with PGT-A. RESULTS A total of 1212 patients underwent randomization, and 606 were assigned to each trial group. Live births occurred in 468 women (77.2%) in the PGT-A group and in 496 (81.8%) in the conventional-IVF group (absolute difference, -4.6 percentage points; 95% confidence interval [CI], -9.2 to -0.0; P<0.001). The cumulative frequency of clinical pregnancy loss was 8.7% and 12.6%, respectively (absolute difference, -3.9 percentage points; 95% CI, -7.5 to -0.2). The incidences of obstetrical or neonatal complications and other adverse events were similar in the two groups. CONCLUSIONS Among women with three or more good-quality blastocysts, conventional IVF resulted in a cumulative live-birth rate that was noninferior to the rate with PGT-A.

Original languageEnglish (US)
Pages (from-to)2047-2058
Number of pages12
JournalNew England Journal of Medicine
Volume385
Issue number22
DOIs
StatePublished - Nov 25 2021

All Science Journal Classification (ASJC) codes

  • General Medicine

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