Perinatal outcomes of singleton live births after preimplantation genetic testing during single frozen-thawed blastocyst transfer cycles: a propensity score-matched study

Wei, Zheng; Yang, Shu Heng; Yang, Chen; Ren, Bo; Sun, Si Min; Liu, Yan Li; Yang, Ru Jing; Lou, Hua; Zhang, Lin Lin; Guan, Yi Chun

doi:10.1016/j.fertnstert.2021.12.020

Cited by 9 publications

(11 citation statements)

References 46 publications

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“…In this study, the proportion of boys born in the unbiopsied group was 51.4% (that is, 106 boys were born for every 100 girls), which was in the internationally recognized range of 102 ~ 107 but slightly lower than that reported in an earlier domestic multicenter study 30 . Although the percentage of female infants in the biopsied group was high, after correcting for confounding factors, this difference was no longer signi cant, which is consistent with previous research 34,35 .…”

Section: Discussionsupporting

confidence: 90%

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Adverse maternal and neonatal outcomes of preimplantation genetic testing with trophectoderm biopsy: A retrospective cohort study of 3373 intracytoplasmic sperm injection single frozen-thawed blastocyst transfer cycles

Sun

Fang

Jiao

et al. 2022

Preprint

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Trophectoderm biopsy is the most widely used biopsy method at present, its effectiveness and safety have always been a concern. Notably, various factors associated with the assisted reproductive technology (ART) process may be related to adverse maternal and neonatal outcomes. After taking potential factors into account, this study was designed to investigate whether trophectoderm biopsy increases the risk of adverse maternal and neonatal outcomes. This respective cohort study enrolled 3373 ICSI (Intracytoplasmic sperm injection) single frozen-thawed blastocyst transfer cycles with and without trophectoderm biopsy in the Reproductive Medical Center of the First Affiliated Hospital of Zhengzhou University in China from January 2015 to June 2020. Statistical methods including univariate logistic regression analysis, multivariate logistic regression analysis and stratified analysis were performed to analyze pregnancy and neonatal outcomes. We found that PGT (Preimplantation genetic testing) with trophectoderm biopsy does not increase the risk of adverse maternal and neonatal outcomes in ICSI single frozen-thawed blastocyst transfer cycles, and PGT can reduce the rate of birth defects. In addition, whether trophectoderm biopsy is performed or not, endometrial preparation by natural cycle and transplantation of Day 5 blastocysts and high-quality blastocysts may be conducive to better pregnancy outcomes, including higher rates of clinical pregnancy and live birth, as well as lower abortion rate.

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Section: Discussionsupporting

confidence: 90%

“…With increasing female age, the embryo ploidy rate gradually decreases 36 . In addition, the spontaneous abortion rate increases 35 . Chen, L., et al have proven that the development days and quality of biopsied blastocysts affect the abortion rate 37 .…”

Section: Discussionmentioning

confidence: 99%

Adverse maternal and neonatal outcomes of preimplantation genetic testing with trophectoderm biopsy: A retrospective cohort study of 3373 intracytoplasmic sperm injection single frozen-thawed blastocyst transfer cycles

Sun

Fang

Jiao

et al. 2022

Preprint

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“…However, it is a technology that must be used wisely. The results from Zheng et al (2) further bolster evidence that embryo biopsy may increase the risk of HDP. However, it also highlights the need for a well-designed RCT to evaluate the safety of PGT and fully evaluate the risk of HDP with PGT.…”

mentioning

confidence: 80%

“…Only the births from live singletons were analyzed. The primary finding of the study was that singleton pregnancy with PGT was associated with a higher risk of gestational hypertension (adjusted odds ratio of 2.58) (2).…”

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confidence: 98%

Preimplantation genetic testing and hypertensive disorders of pregnancy: Is the risk real?

Bedrick

Christianson

2022

Fertility and Sterility

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“…A systematic review and meta-analysis by Hou et al [ 5 ] found inconsistent results; PGT after blastocyst biopsy and FBT did not increase the risk of HDP. Additionally, several retrospective studies have found higher risks of gestational hypertension [ 6 ] and preeclampsia [ 7 ] after transferring biopsied blastocysts. Nevertheless, some authors discovered that embryo biopsy does not increase adverse events related to placentation or obstetric conditions [ 8 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

Trophectoderm biopsy is associated with adverse obstetric outcomes rather than neonatal outcomes

Zhang²,

Zhou³

et al. 2023

BMC Pregnancy Childbirth

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Background With the wide application of preimplantation genetic testing (PGT) with trophectoderm (TE) biopsy, the safety of PGT has always been a concern. Since TE subsequently forms the placenta, it is speculated that the removal of these cells was associated with adverse obstetrical or neonatal outcomes after single frozen-thawed blastocyst transfer (FBT). Previous studies report contradictory findings with respect to TE biopsy and obstetric and neonatal outcomes. Methods We conducted a retrospective cohort study including 720 patients with singleton pregnancies from single FBT cycles who delivered at the same university-affiliated hospital between January 2019 and March 2022. The cohorts were divided into two groups: the PGT group (blastocysts with TE biopsy, n = 223) and the control group (blastocysts without biopsy, n = 497). The PGT group was matched with the control group by propensity score matching (PSM) analysis at a ratio of 1:2. The enrolled sample sizes in the two groups were 215 and 385, respectively. Results Patient demographic characteristics were comparable between the groups after PSM except for the proportion of recurrent pregnancy loss, which was significantly higher in the PGT cohort (31.2 vs. 4.2%, P < 0.001). Patients in the PGT group had significantly higher rates of gestational hypertension (6.0 vs. 2.6%, adjusted odds ratio (aOR) 2.91, 95% confidence interval (CI) 1.18–7.18, P = 0.020) and abnormal umbilical cord (13.0 vs. 7.8%, aOR 1.94, 95% CI 1.08–3.48, P = 0.026). However, the occurrence of premature rupture of membranes (PROM) (12.1 vs. 19.7%, aOR 0.59, 95% CI 0.35–0.99, P = 0.047) was significantly lower in biopsied blastocysts than in unbiopsied embryos. There were no significant differences in regard to other obstetric and neonatal outcomes between the two groups. Conclusions Trophectoderm biopsy is a safe approach, as the neonatal outcomes from biopsied and unbiopsied embryos were comparable. Furthermore, PGT is associated with higher risks of gestational hypertension and abnormal umbilical cord but may have a protective effect on PROM.

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Perinatal outcomes of singleton live births after preimplantation genetic testing during single frozen-thawed blastocyst transfer cycles: a propensity score-matched study

Cited by 9 publications

References 46 publications

Adverse maternal and neonatal outcomes of preimplantation genetic testing with trophectoderm biopsy: A retrospective cohort study of 3373 intracytoplasmic sperm injection single frozen-thawed blastocyst transfer cycles

Adverse maternal and neonatal outcomes of preimplantation genetic testing with trophectoderm biopsy: A retrospective cohort study of 3373 intracytoplasmic sperm injection single frozen-thawed blastocyst transfer cycles

Preimplantation genetic testing and hypertensive disorders of pregnancy: Is the risk real?

Trophectoderm biopsy is associated with adverse obstetric outcomes rather than neonatal outcomes

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