Live birth with or without preimplantation genetic testing for aneuploidy

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.

From New England Journal of Medicine, , Live Birth with or without Preimplantation Genetic Testing for Aneuploidy, 385, 2047-2058. Copyright © 2021 Massachusetts Medical Society. Reprinted with permission.

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Work Title Live birth with or without preimplantation genetic testing for aneuploidy
Access
Open Access
Creators
  1. Junhao Yan
  2. Yingying Qin
  3. Han Zhao
  4. Yun Sun
  5. Fei Gong
  6. Rong Li
  7. Xiaoxi Sun
  8. Xiufeng Ling
  9. Hong Li
  10. Cuifang Hao
  11. Jichun Tan
  12. Jing Yang
  13. Yimin Zhu
  14. Fenghua Liu
  15. Dawei Chen
  16. Daimin Wei
  17. Juanjuan Lu
  18. Tianxiang Ni
  19. Wei Zhou
  20. Keliang Wu
  21. Yuan Gao
  22. Yuhua Shi
  23. Yao Lu
  24. Ting Zhang
  25. Wei Wu
  26. Xiang Ma
  27. Hailan Ma
  28. Jing Fu
  29. Junqiang Zhang
  30. Qingxia Meng
  31. Heping Zhang
  32. Richard S. Legro
  33. Zi Jiang Chen
License In Copyright (Rights Reserved)
Work Type Article
Publisher
  1. New England Journal of Medicine
Publication Date November 25, 2021
Publisher Identifier (DOI)
  1. https://doi.org/10.1056/NEJMoa2103613
Deposited April 27, 2023

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