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

A cohort analysis

Evelyn Lee*, Georgina Mary Chambers, Lyndon Hale, Peter Illingworth, Leeanda Wilton

*Corresponding author for this work

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

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-naïve 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.

Original languageEnglish
Pages (from-to)525-532
Number of pages8
JournalAustralian and New Zealand Journal of Obstetrics and Gynaecology
Volume58
Issue number5
DOIs
Publication statusPublished - 1 Oct 2018
Externally publishedYes

Keywords

  • aneuploidy
  • assisted reproductive technologies
  • cumulative live-birth rates
  • embryo selection based on morphological assessment
  • preimplantation genetic diagnosis

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