Worldwide live births following the transfer of chromosomally "Abnormal" embryos after PGT/A: results of a worldwide web-based survey.

Patrizio P1, Shoham G2, Shoham Z3,4, Leong M5, Barad DH6,7, Gleicher N6,7,8,9.

Author information

1: Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Reproductive Medicine and Infertility, Yale University, New Haven, CT, USA. pasquale.patrizio@yale.edu.
2: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
3: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Kaplan Hospital, Rehovot, Israel.
4: Hadassah School of Medicine, Hebrew University, Jerusalem, Israel.
5: IVF Clinic, The Women's Clinic, 12F, Central Tower, 28 Queen's Road Central, Central, Hong Kong.
6: The Center for Human Reproduction, New York, NY, USA.
7: The Foundation for Reproductive Medicine, New York, NY, USA.
8: Laboratory for Stem Cell and Molecular Embryology, The Rockefeller University, New York, NY, USA.
9: The Department of Obstetrics and Gynecology, Vienna School of Medicine, Vienna, Austria.

Abstract

PURPOSE:

Preimplantation genetic testing for aneuploidy (PGT-A) has become increasingly controversial since normal euploid births have been reported following transfer of embryos diagnosed as "abnormal." There is an increasing trend in transferring "abnormal" embryos; but it is still unknown how many IVF centers transfer "abnormal" embryos and with what efficiency.

METHODS:

We performed a worldwide web-survey of IVF centers to elucidate PGT-A related practice patterns including transfer of human embryos found "abnormal" by PGT-A. Participating centers reflected in vitro fertilization (IVF) cycles in the USA, Canada, Europe, Asia, South America, and Africa.

RESULTS:

One hundred fifty-one IVF centers completed the survey; 125 (83%) reported utilization of PGT-A. Europe had the highest utilization (32.3%), followed by the USA and Canada combined at 29.1%. The leading indications for PGT-A were advanced maternal age (77%), followed by recurrent implantation failure (70%), unexplained pregnancy loss (65%), and sex determination (25%); 14% of respondents used PGT-A for all of their IVF cycles; 20% of IVF units reported transfers of chromosomally "abnormal" embryos, and 56% of these took place in the USA, followed by Asia in 20%. Remarkably, 106 (49.3%) cycles resulted in ongoing pregnancies (n = 50) or live births (n = 56). Miscarriages were rare (n = 20; 9.3%).

CONCLUSIONS:

The transfers of "abnormal" embryos by PGT-A offered robust pregnancy and live birth chances with low miscarriage rates. These data further strengthen the argument that PGT-A cannot reliably determine which embryos should or should not be transferred and leads to disposal of many normal embryos with excellent pregnancy potential.

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2019年9月9日