Assessing the impact of both preimplantation genetic testing for aneuploidy with blastocyst morphologic grade on live birth rates in frozen embryo transfers from fresh and frozen donor oocytes.

PURPOSE: To evaluate the live birth rate (LBR) following donor frozen embryo transfer (dFET) of preimplantation genetic testing for aneuploidy (PGT-A) versus untested donor embryos, stratified by blastocyst morphologic grade (MG).

METHODS

This was a retrospective cohort study of 146 patients undergoing dFET of a single euploid blastocyst from fresh or frozen oocytes using PGT-A compared to age-matched controls (1:1 ratio) who did not use PGT-A. Primary outcome was LBR. LBR was compared among cohorts, with further stratification by (1) high/low MG and (2) fresh/frozen oocyte status. Secondary outcomes included perinatal outcomes.

RESULT(S): Median age in both groups was 44.5 years (p = 0.98). LBR was similar among the two cohorts (PGT-A: 57.5% vs. untested: 50.0%, p = 0.20). There was similar LBR in fresh (PGT-A: 59.2% vs. untested: 50.0%, p = 0.20) and frozen (PGT-A: 47.6% vs. untested: 50.0%, p = 0.85) oocyte subgroups. When stratified by MG, we appreciated similar LBR among high-quality blastocysts (PGT-A-high: 56.5% vs. untested-high: 52.3%, p = 0.49) among the whole cohort, as well as in fresh (fresh-PGT-A-high: 58.3% vs. fresh-untested-high: 52.9%, p = 0.46) and frozen (frozen-PGT-A-high: 44.4% vs. frozen-untested-high: 51.7%, p = 0.59) subgroups. Similarly, we appreciated no difference in LBR among low-quality blastocysts (PGT-A-low: 75.0% vs. untested-low: 31.2%, p = 0.08) among the whole cohort, as well as in the fresh (fresh-PGT-A-low: 80.0% vs. fresh-untested-low: 16.1%, p = 0.08) or frozen (frozen-PGT-A-low: 66.7% vs. frozen-untested-low: 40.0%, p = 0.56) subgroups. Gestational age (37.8 weeks, p = 1.0) and infant birth weight (PGT-A: 3128.0 g vs. untested: 3150.2 g, p = 0.60) were similar.

CONCLUSION(S): Though limited by the small number of MG blastocysts, overall PGT-A did not improve LBR regardless of blastocyst quality from fresh and previously frozen donor oocytes.

CAPSULE: Use of PGT-A did not improve live birth rate regardless of blastocyst quality from both fresh and previously frozen donor oocytes.