ABSTRACT
Objective:
To compare neonatal outcomes in
pregnancies resulting from
embryos that have undergone preimplantation
genetic testing (PGT)
biopsy compared with no
biopsy in both fresh and frozen
embryo transfers (ETs) and determine whether findings are mediated by
multiple births.
Design:
Retrospective
cohort study.
Setting:
Society of
Assisted Reproductive Technologies-Clinical Outcomes
Reporting System data, 2014-2015.
Patients Autologous in vitro
fertilization treatment cycles using fresh or frozen
blastocyst ET, with or without PGT
biopsy.
Interventions:
Not applicable. Main Outcome
Measures:
Large for
gestational age (LGA), small for
gestational age, and preterm delivery.
Secondary outcomes included high
birthweight, low
birthweight, and clinical
pregnancy measures. Outcomes were evaluated using log-binomial regression models with repeated
measures. Models were used to estimate the controlled direct effects of
biopsy on
birth outcomes that were not mediated by multiple gestations.
Results:
In fresh ET,
biopsy was associated with an increase in LGA (
relative risk [RR] 1.45,
confidence interval [CI] 1.04-2.02) that persisted in the model mediated for multiple
gestation (RR 1.36, 95% CI 1.01-1.83) but was not present in an
analysis restricted to elective single ET (RR 0.99, 95% CI 0.91-1.09). In frozen ET, there were no differences in any of the primary outcomes after
accounting for multiple gestations.
Conclusions:
In a large multicenter database, there were no differences in neonatal outcomes after PGT
biopsy in frozen ET cycles, and an increase in LGA was noted in fresh transfers that persisted even after
accounting for multiple gestations but was not present in
analysis restricted to elective single ET.
