The impact of preimplantation genetic testing for aneuploidy on time to live birth in in vitro fertilization.

OBJECTIVE

To determine whether using preimplantation genetic testing for aneuploidy (PGT-A) impacts time to pregnancy resulting in a live birth.

DESIGN

Retrospective cohort study.

SUBJECTS: Patients who underwent their first oocyte retrieval between January 1, 2014, and December 31, 2022, were included. Patients were categorized into a PGT-A group and a non-PGT-A group on the basis of the use of PGT-A at the time of the first oocyte retrieval. Patients were then stratified by age: women aged <38 years and women aged ≥38 years at the time of the first retrieval. Propensity score matching was performed using 9 criteria, matching 2,158 PGT-A patients to 2,158 non-PGT-A patients in the younger age group and 1,343 PGT-A patients to 1,343 non-PGT-A patients in the older age group.

EXPOSURE: Use of PGT-A.

MAIN OUTCOME MEASURES: The positive pregnancy rate leading to a live birth over a 1-year period after the initial egg retrieval. This was used as an indicator of time to successful pregnancy.

RESULTS

After the matching process, there were no statistically significant differences in the examined characteristics between PGT-A and non-PGT-A patients. The Kaplan-Meier curves showed that there was no significant difference in the probability of having a live birth in the younger group, with a live birth hazard ratio for the full year of 0.97 (95% confidence interval, 0.90-1.04) but was significantly shorter for PGT-A patients, with a live birth hazard ratio of 1.46 (95% confidence interval, 1.30-1.64) in the older group. Patients in the ≥38-year-old group who used PGT-A had a higher live birth rate over a 1-year period than non-PGT-A patients (51.2% vs. 36.4%). In contrast, PGT-A and non-PGT-A patients in the <38-year-old group had similar cumulative 1-year live birth rates (69.5% vs. 67.1%). In both age groups, the miscarriage rates and mean number of transfers were lower for PGT-A patients.

CONCLUSION

Preimplantation genetic testing for aneuploidy is associated with a shorter time to pregnancy resulting in a live birth for patients who are at least 38 years old but does not affect time to successful pregnancy in younger patients over a 1-year period.