Recurrent Implantation Failure – Role of PGT and Era to Optimize Reproductive Outcomes?

Abstract

recipients who performed fresh transfer (179) were excluded. Static analysis was performed with t-student test.RESULTS: In group A, the average age of recipients was 42 (32-50 years old), average oocytes allocated 13.93, average blastocysts per patient was 5.88 with a blastulation rate of 57%. In group B, the average age was 42 (30-49 years old), average oocytes allocated 11.45, average blastocysts per patient 4.81 with a blastulation rate of 58%. The average time in months to achieve pregnancy from the moment of oocyte allocation was five and a half months (M¼5.57; SD¼0.42) in group A and four and a half months (M¼4.58; SD¼0.17) in group B, this difference was not significant; t (1.29), p>0.05. The total of embryo transfers in group A was 1 to 4 and in group B 1 to 5. The average number of transfers until pregnancy was obtained in group A was 1.6 (M¼1.58; SD¼0.01) versus 1.73 (M¼1.73; SD¼0.01) in group B, this difference was not significant; t (1.27), p>0.05.CONCLUSIONS: Although PGTa is a tool to select euploid embryos, and thus seek to shorten the time to pregnancy and the number of transfers necessary to achieve it, in the case of an egg donation program, we did not find such benefit for either of the two parameters analyzed. The main limitation of this study was its retrospective design based on data from a single center which may be subject of bias. Further large prospective studies are required to make meaningful comparisons.IMPACT STATEMENT: While PGTa is a tool for selecting euploid embryos, it has no benefit in shortening the time to pregnancy in an egg donation program and it could increase treatment costs. Prospective randomized studies are needed to confirm the hypothesis and a cost-effectiveness analysis to determine its applicability.

Preimplantation genetic testing for aneuploidy optimizes reproductive outcomes in recurrent reproductive failure: a systematic review

“…Fodina et al’s ( 28 ) retrospective study reported that PGT-A group showed statistically significant higher chance in achieving both biochemical (17.9 vs. 5.6%, p = 0 0.01) and clinical pregnancy (49.3 vs. 44.4%, p = 0.049), as compared to those who did not undergo PGT-A ( n = 72 vs. 22) in RIF sufferers. In the same year, Rao’s ( 31 ) retrospective study also reported that IR was higher in the PGT-A group ( n = 54) than the control group ( n = 189) (47 vs. 42%), although the difference was not significant. In 2022, Gu et al ( 33 ) conducted a retrospective analysis which revealed that the positive serum human chorionic gonadotropin (56.9 vs. 33.9%, p < 0.01), clinical pregnancy (49.5 vs. 31.2%, p < 0.01), live birth (43.1 vs. 25.7%, p < 0.01), and fetal heart rates (50.0 vs. 29.8%, p < 0.01) per transfer were significantly higher in the RIF-PGT-A group ( n = 209) than the RIF-non-PGT-A group ( n = 257).…”

Does endometrial receptivity array improve reproductive outcomes in euploid embryo transfer cycles? a systematic review

“…The authors concluded that the reproductive outcomes did not differ between those who underwent ERA and those who did not. In 2021, Rao ( 14 ) retrospectively reviewed the reproductive outcomes of patients with RIF (n=322), who were divided into three groups: group I, ERA, PGT (n=79); group II, PGT, no ERA (n=54); and group III, no PGT, no ERA (n=189). Similarly, there was no difference in the implantation rate among the three groups (53% vs. 47% vs. 42%).…”