PGT-A: The biology and hidden failures of randomized control trials.
Prenat Diagn
; 42(9): 1211-1221, 2022 08.
Article
em En
| MEDLINE
| ID: mdl-35765263
ABSTRACT
OBJECTIVE:
Preimplantation Genetic Testing - Aneuploidy (PGT-A) for embryo selection has undergone significant advancements in the last 2 decades and yet many studies still fail to demonstrate any clinical benefits over traditional embryo morphology selection (Mo-S). To understand this conundrum, we performed a multi-center clinical study of PGT-A patients, where Mo-S and euploid selection (Eu-S) outcomes were directly compared.METHOD:
All suitable blastocysts were biopsied and analyzed for chromosome copy number. Outcomes (positive beta hCG, implantation, ongoing pregnancy, and live birth rates) for Eu-S were compared to Mo-S using single embryo transfers.RESULTS:
Compared to Eu-S embryos, Mo-S embryos resulted in significant reduction of outcomes for positive beta hCG (p = 0.0005), implantation (p = 0.0008), ongoing pregnancy (p = 0.0046), livebirth (p = 0.0112), babies per transfer (p = 0.0112), and babies per embryo transferred (p = 0.0112). Morphology selection resulted in patients of all age groups having non-euploid embryos chosen for transfer. Post-hoc evaluation of individual clinic performances showed variable transfer outcomes that could potentially confound the true benefits of PGT-A.CONCLUSION:
Embryo chromosome status is central to improved embryo transfer outcomes and sole reliance on current morphology-based selection practices, without Eu-S, will always compromise outcomes. Often overlooked but a major effector of successful PGT-A outcomes are individual clinic performances.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Testes Genéticos
/
Diagnóstico Pré-Implantação
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
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Prognostic_studies
Limite:
Female
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Humans
/
Pregnancy
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article