Preimplantation genetic testing and chances of a healthy live birth amongst recipients of fresh donor oocytes in the United States

J Assist Reprod Genet. 2020 Sep;37(9):2283-2292. doi: 10.1007/s10815-020-01874-8. Epub 2020 Jul 2.

Abstract

Purpose: To evaluate if preimplantation genetic testing (PGT) improves the odds of a healthy live birth amongst recipients of fresh donor oocytes.

Methods: We performed a retrospective cohort study including in vitro fertilization cycles of women using fresh donor oocytes reported to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System, between 2013 and 2015. Cycles were categorized based on PGT. Primary outcome measure was a good birth outcome (GBO), defined as a singleton, term, live birth with an average birthweight. Multivariable generalized estimating equation models were fit to analyze the effect of PGT. Interaction effect between cycle type (fresh vs frozen) and PGT was tested.

Results: Of 28,153 included cycles, 3708 had PGT while 24,445 did not. PGT cycles were less likely to result in an embryo transfer (ET) (64 vs 94%), but were associated with increased rates of frozen ET (70 vs 41%), single ET (67 vs 44%), and blastocyst ET (87 vs 65%). There was a significant interaction between PGT and cycle type. Cycles using PGT increased the probability of a GBO 12% in frozen cycles (RR 1.12; 95% CI 1.02, 1.22; p = 0.018), but PGT was detrimental to success in fresh cycles with a 53% reduced likelihood of GBO (RR 0.47; 9% CI 0.41, 0.54; p < 0.001).

Conclusion: PGT, as practiced during the most recently available national data in women using fresh donor oocytes, was associated with increased probability of a healthy live birth amongst frozen cycles, but was not beneficial in fresh cycles.

Keywords: Donor oocyte; Embryo transfer; Good birth outcome; In vitro fertilization; Preimplantation genetic testing.

MeSH terms

  • Adult
  • Birth Rate
  • Blastocyst / metabolism
  • Embryo Transfer / methods
  • Female
  • Fertilization in Vitro / methods
  • Genetic Testing / trends
  • Humans
  • Live Birth
  • Oocyte Donation*
  • Oocyte Retrieval / methods
  • Oocytes / growth & development*
  • Oocytes / metabolism
  • Pregnancy
  • Pregnancy Rate
  • Pregnancy, Multiple
  • Preimplantation Diagnosis / trends*
  • Reproductive Techniques, Assisted / trends*
  • United States / epidemiology