PGS並無法明顯提高臨床懷孕率 (50 vs 46%)
PGS對於高齡(35-40 years)&據有2個以上囊胚 可能可以提高懷孕率

Fertil Steril. 2019 Sep 21. pii: S0015-0282(19)31979-X. doi: 10.1016/j.fertnstert.2019.07.1346. [Epub ahead of print]

Preimplantation genetic testing for aneuploidy versus morphology as selection criteria for single frozen-thawed embryo transfer in good-prognosis patients: a multicenter randomized clinical trial.

Abstract

OBJECTIVE:

To evaluate the benefit of next-generation sequencing (NGS)-based preimplantation genetic testing for aneuploidy (PGT-A) for embryo selection in frozen-thawed embryo transfer.

DESIGN:

Randomized controlled trial.

SETTING:

Not applicable.

PATIENT(S):

Women aged 25-40 years undergoing IVF with at least two blastocysts that could be biopsied.

INTERVENTION(S):

Randomization for single frozen-thawed embryo transfer with embryo selection based on PGT-A euploid status versus morphology.

MAIN OUTCOME MEASURE(S):

Ongoing pregnancy rate (OPR) at 20 weeks' gestation per embryo transfer.

RESULT(S):

A total of 661 women (average age 33.7 ± 3.6 years) were randomized to PGT-A (n = 330) or morphology alone (n = 331). The OPR was equivalent between the two arms, with no significant difference per embryo transfer (50% [137/274] vs. 46% [143/313]) or per intention to treat (ITT) at randomization (41.8% [138/330] vs. 43.5% [144/331]). Post hoc analysis of women aged 35-40 years showed a significant increase in OPR per embryo transfer (51% [62/122] vs. 37% [54/145]) but not per ITT.

CONCLUSION(S):

PGT-A did not improve overall pregnancy outcomes in all women, as analyzed per embryo transfer or per ITT. There was a significant increase in OPR per embryo transfer with the use of PGT-A in the subgroup of women aged 35-40 years who had two or more embryos that could be biopsied, but this was not significant when analyzed by ITT.