Assisted reproductive technology ( ART ART ) cumulative live birth rates following preimplantation genetic diagnosis for aneuploidy ( PGD PGD ‐A) or morphological assessment of embryos: A cohort analysis

摘要

Background Preimplantation genetic diagnosis for aneuploidy ( PGD ‐A) for all 24 chromosomes improves implantation and clinical pregnancy rates per single assisted reproductive technology ( ART ) cycle. However, there is limited data on the live‐birth rate of PGD ‐A over repeated cycles. Aim To assess the cumulative live‐birth rates ( CLBR ) of PGD ‐A compared with morphological assessment of embryos of up to three ‘complete ART cycles’ (fresh plus frozen/thaw cycles) in women aged 37?years or older. Materials and Methods A retrospective cohort study of ART treatments undertaken by ART ‐na?ve women at a large Australian fertility clinic between 2011 and 2014. Cohorts were assigned based on the embryo selection method used in their first fresh cycle [ PGD ‐A, n ?=?110 women ( PGD ‐A group); morphological assessment of embryos, n ?=?1983 women (control group)]. CLBR , time to clinical pregnancy and cycles needed to achieve a live birth were measured over multiple cycles. Results Compared to the control group, the PGD ‐A group achieved a higher per cycle live‐birth rate (14.47% vs 9.12%, P ??0.01), took a shorter mean time to reach a clinical pregnancy leading to a live‐birth (104.8?days vs 140.6?days, P ??0.05) and required fewer cycles to achieve a live‐birth (6.91 cycles vs 10.96 cycles, P ??0.01). However, after three ‘complete ART cycles’, the CLBR was comparable for the two groups (30.90% vs 26.77%, P ?=?0.34). Conclusion This is the first study to assess the effectiveness of PGD ‐A over multiple ART cycles. These real‐world findings suggest that PGD ‐A leads to better outcomes than using morphological assessment alone in women of advanced maternal age.