PDF(Pubmed)
Abstract：
OBJECTIVE: The purpose of this study was to evaluate the impact of preimplantation genetic testing for aneuploidy (PGT-A) on clinical outcomes among high-risk patients.
METHODS: This retrospective study involved 1,368 patients and the same number of cycles, including 520 cycles with PGT-A and 848 cycles without PGT-A. The study participants comprised women of advanced maternal age (AMA) and those affected by recurrent implantation failure (RIF), recurrent pregnancy loss (RPL), or severe male factor infertility (SMF).
RESULTS: PGT-A was associated with significant improvements in the implantation rate (IR) and the ongoing pregnancy rate/live birth rate (OPR/LBR) per embryo transfer cycle in the AMA (39.3% vs. 16.2% [p<0.001] and 42.0% vs. 21.8% [p<0.001], respectively), RIF (41.7% vs. 22.0% [p<0.001] and 47.0% vs. 28.6% [p<0.001], respectively), and RPL (45.6% vs. 19.5% [p<0.001] and 49.1% vs. 24.2% [p<0.001], respectively) groups, as well as the IR in the SMF group (43.3% vs. 26.5%, p=0.011). Additionally, PGT-A was associated with lower overall incidence rates of pregnancy loss in the AMA (16.7% vs. 34.3%, p=0.001) and RPL (16.7% vs. 50.0%, p<0.001) groups. However, the OPR/LBR per total cycle across all PGT-A groups did not significantly exceed that for the control groups.
CONCLUSIONS: PGT-A demonstrated beneficial effects in high-risk patients. However, our findings indicate that these benefits are more pronounced in carefully selected candidates than in the entire high-risk patient population.
METHODS: This retrospective study involved 1,368 patients and the same number of cycles, including 520 cycles with PGT-A and 848 cycles without PGT-A. The study participants comprised women of advanced maternal age (AMA) and those affected by recurrent implantation failure (RIF), recurrent pregnancy loss (RPL), or severe male factor infertility (SMF).
RESULTS: PGT-A was associated with significant improvements in the implantation rate (IR) and the ongoing pregnancy rate/live birth rate (OPR/LBR) per embryo transfer cycle in the AMA (39.3% vs. 16.2% [p<0.001] and 42.0% vs. 21.8% [p<0.001], respectively), RIF (41.7% vs. 22.0% [p<0.001] and 47.0% vs. 28.6% [p<0.001], respectively), and RPL (45.6% vs. 19.5% [p<0.001] and 49.1% vs. 24.2% [p<0.001], respectively) groups, as well as the IR in the SMF group (43.3% vs. 26.5%, p=0.011). Additionally, PGT-A was associated with lower overall incidence rates of pregnancy loss in the AMA (16.7% vs. 34.3%, p=0.001) and RPL (16.7% vs. 50.0%, p<0.001) groups. However, the OPR/LBR per total cycle across all PGT-A groups did not significantly exceed that for the control groups.
CONCLUSIONS: PGT-A demonstrated beneficial effects in high-risk patients. However, our findings indicate that these benefits are more pronounced in carefully selected candidates than in the entire high-risk patient population.
摘要：
目的：本研究的目的是评估植入前基因检测（PGT-A）对高危患者临床结局的影响。
方法：这项回顾性研究包括1,368例患者和相同的周期数，包括520个带有PGT-A的循环和848个不带PGT-A的循环。研究参与者包括高龄妇女（AMA）和反复植入失败（RIF）。复发性妊娠丢失（RPL），或严重男性因素不育症（SMF）。
结果：PGT-A与AMA中每个胚胎移植周期的着床率（IR）和持续妊娠率/活产率（OPR/LBR）的显着改善有关（39.3％vs.16.2%[p<0.001]和42.0%vs.21.8%[p<0.001]，分别)，RIF（41.7%与22.0%[p<0.001]和47.0%与28.6%[p<0.001]，分别)，和RPL（45.6%与19.5%[p<0.001]和49.1%24.2%[p<0.001]，分别)组，以及SMF组中的IR(43.3%vs.26.5%,p=0.011)。此外,PGT-A与AMA中妊娠丢失的总体发生率较低相关(16.7%vs.34.3%,p=0.001）和RPL（16.7%与50.0%,p<0.001)组。然而,所有PGT-A组每个总周期的OPR/LBR均未显著超过对照组.
结论：PGT-A在高危患者中显示出有益效果。然而,我们的研究结果表明,与整个高危患者人群相比,这些获益在精心挑选的候选人中更为明显.
方法：这项回顾性研究包括1,368例患者和相同的周期数，包括520个带有PGT-A的循环和848个不带PGT-A的循环。研究参与者包括高龄妇女（AMA）和反复植入失败（RIF）。复发性妊娠丢失（RPL），或严重男性因素不育症（SMF）。
结果：PGT-A与AMA中每个胚胎移植周期的着床率（IR）和持续妊娠率/活产率（OPR/LBR）的显着改善有关（39.3％vs.16.2%[p<0.001]和42.0%vs.21.8%[p<0.001]，分别)，RIF（41.7%与22.0%[p<0.001]和47.0%与28.6%[p<0.001]，分别)，和RPL（45.6%与19.5%[p<0.001]和49.1%24.2%[p<0.001]，分别)组，以及SMF组中的IR(43.3%vs.26.5%,p=0.011)。此外,PGT-A与AMA中妊娠丢失的总体发生率较低相关(16.7%vs.34.3%,p=0.001）和RPL（16.7%与50.0%,p<0.001)组。然而,所有PGT-A组每个总周期的OPR/LBR均未显著超过对照组.
结论：PGT-A在高危患者中显示出有益效果。然而,我们的研究结果表明,与整个高危患者人群相比,这些获益在精心挑选的候选人中更为明显.
