Effects of NGS-based PGT-a for idiopathic recurrent pregnancy loss and implantation failure: a retrospective cohort study

Abstract

To clarify the effect of next-generation sequencing (NGS)–based preimplantation genetic testing for aneuploidy (PGT-A) combined with trophectoderm (TE) biopsy on the pregnancy outcomes of idiopathic recurrent pregnancy loss (iRPL) and idiopathic recurrent implantation failure (iRIF), we conducted a retrospective cohort study of 212 iRPL couples and 66 iRIF couples who underwent PGT-A or conventional in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment. The implantation rate (IR) per transfer (64.2%), clinical pregnancy rate (CPR) per transfer (57.5%), and live birth rate (LBR) per transfer (45%) of iRPL couples of the PGT-A treatment group were significantly higher (p < 0.05) than those of the conventional IVF/ICSI group (IR per transfer,38.2%; CPR per transfer,33.3%; LBR per transfer, 28.4%), whereas the pregnancy loss rate (PLR) per transfer was similar between the two groups. These effects were also significant (p < 0.05) in iRPL couples with advanced maternal age (AMA, ≥35 years), whereas no significant differences were found in clinical outcomes between the PGT-A and conventional IVF/ICSI groups in younger iRPL couples (<35 years). The cumulative clinical outcomes of iRPL couples were comparable between the PGT-A and conventional IVF/ICSI groups. No significant differences were found in any clinical outcomes between the PGT-A and conventional IVF/ICSI groups for young or AMA couples with iRIF. In conclusion, NGS-based PGT-A involving TE biopsy may be useful for iRPL women to shorten the time to pregnancy and reduce their physical and psychological burden, especially for iRPL women with AMA; however, couples with iRIF may not benefit from PGT-A treatment. Considering the small sample size of the iRIF group, further investigations with a larger sample size are needed to verify our findings.

Keywords:

• Next-generation sequencing
• Preimplantation genetic testing for aneuploidy
• Idiopathic recurrent implantation failure
• Idiopathic recurrent implantation failure

Acknowledgments

Thanks to Professor Qiongfang Zeng for the assistance during the data collection process.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors’ contributions

Performing experiments, study design, data analysis, manuscript writing: XS. Date collection, data analysis, preparing the figures: YYT, CXL, LTW. Technical and scientific guidance: WYL, HL, WQM, MH, QJC, SQ. Study design, technical and scientific guidance and critical review of the manuscript: CMX, QM, JLD. All authors read and approved the final manuscript.

Data availability statement

All data are available on request.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This work was supported by the Guangzhou Citizen Health Science and Technology Research Project (201803010034), National Natural Science Foundation of China (No 82101683), and Medical Scientific Research Foundation of Guangdong Province of China (A2021150).