Preimplantation genetic testing for aneuploidy helps to achieve a live birth with fewer transfer cycles for the blastocyst FET patients with unexplained recurrent implantation failure

Abstract

Abstract Purpose: This retrospective cohort study aimed to investigate the value of preimplantation genetic testing for aneuploidy (PGT-A) as a screening test for patients suffered from unexplained recurrent implantation failure (RIF). Methods: After screening patients in one reproductive medicine center, twenty-nine, eighty-seven and thirty-eight women (<40-year-old) who had suffered unexplained RIF with PGT-A, or RIF without PGT-A, or no RIF with PGT-A were included. The clinical pregnancy rate and live birth rate per transfer, the conservative and optimal cumulative clinical pregnancy rates (CCPR) and live birth rates (CLBR) after three blastocyst FETs were analyzed. Results: The live birth rate per transfer was significantly higher in the RIF+PGT-A group than that in the RIF+NO PGT-A group (47.4% vs 31.6%) after adjusting the confounder (the maternal age). After 3 cycles of FET, RIF+PGT-A group had a significantly higher conservative cumulative live birth rate (CLBR) compared to the RIF+PGT-A group (69.0% vs 42.5%, odds ratio [OR] 3.777, p=0.005), but had similar CLBR compared to the NO RIF+PGT-A group (69.0% vs 81.6%). The optimal CLBR in the RIF+PGT-A patients was similar to those in the other 2 groups. The miscarriage rate per clinical pregnancy was not different between the RIF+PGT-A and RIF+NO PGT-A, RIF+PGT-A and NO RIF+PGT-A groups. Conclusion: Although PGT-A could land on the non-beneficial side after three blastocyst FETs, it did be superior in reducing the number of transfer cycles required to achieve a similar live birth rate. Further studies to identify the RIF patients who would benefit most from PGT-A are necessary.