Elective single embryo transfer in in vitro fertilization cycles with or without preimplantation genetic testing using next-generation sequencing: A randomized clinical trial

TL;DR

This study found that using genetic testing during IVF does not significantly improve pregnancy outcomes for couples with a good prognosis.

Contribution

A randomized clinical trial evaluating the impact of preimplantation genetic testing using NGS on clinical outcomes in good-prognosis IVF patients.

Findings

Clinical pregnancy rates were similar between groups with and without genetic testing.

Live birth and abortion rates did not differ significantly between the two groups.

Preimplantation genetic testing using NGS did not alter outcomes in good-prognosis IVF patients.

Abstract

•Infertility affects around 15 % of couples around the world.•The quality of eggs and the chances of pregnancy in IVF treatment decrease with maternal age.•Preimplantation genetic diagnosis can help select euploid embryos for embryo transfer.•The indication of preimplantation genetic diagnosis in IVF treatment does not seem to reduce treatment costs.•Preimplantation genetic diagnosis does not seem to ALTER miscarriage or pregnancy rates in good prognosis fertile couples.

Infertility affects around 15 % of couples around the world.

The quality of eggs and the chances of pregnancy in IVF treatment decrease with maternal age.

Preimplantation genetic diagnosis can help select euploid embryos for embryo transfer.

The indication of preimplantation genetic diagnosis in IVF treatment does not seem to reduce treatment costs.

Preimplantation genetic diagnosis does not seem to ALTER miscarriage or pregnancy rates in good prognosis fertile couples.

Preimplantation Genetic Testing (PGT-A) has been increasingly used in IVF to improve embryo selection. However, its clinical utility in patients with a good prognosis remains debated. There is a lack of robust scientific evidence about the benefits of preimplantation genetic testing Next-Generation Sequencing (NGS) on the clinical pregnancy and live birth rates in good-prognosis IVF patients undergoing elective Single Embryo Transfer (eSET) testing.

To compare the clinical pregnancy rate after IVF treatment in patients with a good prognosis between groups that receive the transfer of a single embryo with or without pre-implantation genetic embryo analysis.

This work was a prospective randomized clinical study that evaluated 206 patients to compare the clinical pregnancy rate after the first elective transfer of an embryo, associated or not with pre-implantation genetic embryo analysis using Next-Generation Sequencing (NGS). Patients were randomized into groups: SET group ‒ patients undergoing the transfer of a single embryo (eSET, elective Single Embryo Transfer) without embryo genetic analysis (SET group, n = 103); and NGS + SET group ‒ patients undergoing eSET with embryo genetic analysis (NGS + SET group, n = 103).

The clinical pregnancy rate after the first transfer was similar between the two groups (SET: 76.7 % and NGS + SET: 79.6 %; p = 0.613). There was also no statistical difference in live birth rates or abortion rates between the groups analyzed.

This clinical trial suggests no significant improvement in the embryo genetic analysis in IVF treatments for infertile couples with a good prognosis

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