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

Abstract

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.