THE UTILITY OF PREIMPLANTATION GENETIC TESTING FOR ANEUPLOIDY DURING IVF IN PATIENTS WITH DIFFERENT INFERTILITY DIAGNOSES

Based on limited evidence, preimplantation genetic testing for aneuploidy (PGT-A) is suggested to be beneficial to patients with advanced maternal age, recurrent implantation failure, and severe male factor. Although PGT-A is now being offered to most patients undergoing an IVF cycle, its utility in patients with various infertility diagnoses has not been clearly established. The goal of this study was to evaluate transfer outcomes in women with or without PGT-A, based on etiology of infertility. All autologous IVF cycles with or without PGT-A followed by a subsequent single frozen embryo transfer (FET) performed at SG Fertility centers between January 2017 to July 2020. Live birth rates/ongoing pregnancy rates (LBR/OPR), clinical pregnancy rates (CPR), and miscarriage rates were compared between PGT-A tested and untested cycles in patients with endometriosis, diminished ovarian reserve (DOR), and ovulatory disorder (PCOS). Generalized estimating equation (GEE) was used to analyze the correlation between PGT-A testing and selected outcomes. Autologous IVF cycles having an FET without PGT-A (n=1,940) and with PGT-A (n=2,462) were included. In the non PGT-A vs PGT-A group, the percentage of patients with endometriosis was 14.6% vs 9.4%, DOR was 20.3% vs 42.4%, and PCOS was 65% vs 47.5%, respectively. The transfer of a PGT-A tested embryo in patients with DOR was associated with higher CPR and LBR/OPR as well as lower miscarriage rates compared to those that transferred a non PGT-A tested embryo. However, in patients with endometriosis and PCOS, no difference in CPR and LBR/OPR between the transfer of a PGT-A and non PGT-A tested embryo was detected (see table). Patients with endometriosis had a lower miscarriage rate when PGT-A tested embryos were transferred. In patients undergoing IVF treatment with the diagnosis of DOR, the transfer of an euploid embryo leads to improved pregnancy outcomes. PGT-A did not show a beneficial effect when primary diagnosis was endometriosis or PCOS, except lower miscarriage rate in patients with endometriosis.