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Different Strategies of Preimplantation Genetic Testing for Aneuploidies in Women of Advanced Maternal Age: A Systematic Review and Meta-Analysis. | LitMetric

AI Article Synopsis

  • Preimplantation genetic testing for aneuploidies (PGT-A) is often used by older women trying to conceive, but its effectiveness is still debated.
  • A literature review analyzed randomized controlled trials comparing IVF outcomes with and without PGT-A in women aged 35 and older, focusing on live birth rates.
  • The study found that comprehensive chromosomal screening improved live birth rates compared to FISH, especially when using blastocyst biopsy techniques.

Article Abstract

Background: Preimplantation genetic testing for aneuploidies (PGT-A) is widely used in women of advanced maternal age (AMA). However, the effectiveness remains controversial.

Method: We conducted a comprehensive literature review comparing outcomes of IVF with or without PGT-A in women of AMA in PubMed, Embase, and the Cochrane Central Register of Controlled Trials in January 2021. All included trials met the criteria that constituted a randomized controlled trial for PGT-A involving women of AMA (≥35 years). Reviews, conference abstracts, and observational studies were excluded. The primary outcome was the live birth rate in included random control trials (RCTs).

Results: Nine randomized controlled trials met our inclusion criteria. For techniques of genetic analysis, three trials (270 events) performed with comprehensive chromosomal screening showed that the live birth rate was significantly higher in the women randomized to IVF/ICSI with PGT-A (RR = 1.30, 95% CI 1.03-1.65), which was not observed in six trials used with FISH as well as all nine trials. For different stages of embryo biopsy, only the subgroup of blastocyst biopsy showed a higher live birth rate in women with PGT-A (RR = 1.36, 95% CI 1.04-1.79).

Conclusion: The application of comprehensive chromosome screening showed a beneficial effect of PGT-A in women of AMA compared with FISH. Moreover, blastocyst biopsy seemed to be associated with a better outcome than polar body biopsy and cleavage-stage biopsy.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8432243PMC
http://dx.doi.org/10.3390/jcm10173895DOI Listing

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