O-268 PGT-A decreases the time to pregnancy whilst not negatively impacting per cycle outcomes: A multicentre retrospective cohort study with propensity score matching

Le résumé fourni par la source

Abstract Study question Can the use of PGT-A in IVF cycles reduce the time to pregnancy for patients whilst maintaining equivalent CLBR to standard IVF cycles? Summary answer PGT-A shortens time to live birth in women aged ≥39 years and has no significant negative impact on CLBR per cycle started across all ages. What is known already Aneuploidy linked to maternal age remains a key factor in IVF failure, leading to the introduction of PGT-A as a method to select embryos with the highest implantation potential. However, studies suggest that women under 37 years see no significant benefit from PGT-A, as implantation, clinical pregnancy, and live birth rates remain comparable. Beyond successful outcomes, patients prioritize the time needed to achieve pregnancy. Despite this, there is insufficient scientific evidence to guide counseling on how PGT-A affects time to pregnancy and how maternal age modifies this association, highlighting a critical gap in understanding its broader implications for IVF success. Study design, size, duration A multicenter retrospective cohort study was conducted including 4763 patients ≥35y undergoing their first IVF/ICSI cycle with an oocyte retrieval performed between 01.04.2022-31.12.2023 in a multinational private fertility clinic. The study group (n = 3296) included patients who performed PGT-A and the control group included patients without PGT-A (n = 1440). Following propensity score matching (PSM) adjusted for age at oocyte retrieval, number of oocytes retrieved and year of oocyte retrieval, 1440 patients were included in each group. Participants/materials, setting, methods The primary outcome was time to live birth (LB). Secondary outcomes were live birth rate (LBR) per embryo transfer and the cumulative live birth rate (CLBR), defined as achieving at least one LB per started cycle, including fresh and frozen embryo transfers. To account for potential confounders, adjusted odds ratios (AdjOR) with 95% confidence intervals (95% CI) were used for LBR, and adjusted hazard ratios (AdjHR) were used for CLBR and time to LB comparisons. Main results and the role of chance Despite a higher AMH in the PGT-A group (2.04±2.23 vs. 1.79±2.07ng/ml, p = 0.008), a similar number of available blastocysts was found in both groups (2.62±2.70 vs. 2.52±2.61, p = 0.312, in the PGT-A and no-PGT-A groups, respectively). The percentage of patients with no available blastocysts was also similar in both groups (20.76% vs. 18.96%, P = 0.243, in the PGT-A and no-PGT-A groups, respectively). Following multivariable logistic regression analysis, PGT-A improved the live birth rate per embryo transfer (44.20% vs. 29.07%, AdjOR 2.15, 95%CI 1.78-2.61). However, a similar CLBR was found in both groups (30.14% vs. 32.36%, AdjHR 0.83, 95%CI 0.68-1.01). Following multivariable weighted cox regression analysis adjusted for age at oocyte retrieval, body mass index, smoking status, number of available blastocysts and year of treatment, PGT-A did not affect time to live birth in patients aged ≥35 years. Age stratified analysis was performed at 1-year interval and yielded similar results in patients up to 38 years. However, a statistically significant shorter time to live birth was seen in patients aged ≥39 years (AdjHR 2.53, 95%CI 1.56-4.12). The results remained significant when ≥40 and ≥41 year-old patients were analyzed. Limitations, reasons for caution The main limitation of this study is its retrospective design, allowing for the introduction of potential biases. Also, the fact that only the first IVF/ICSI cycle was analysed provides a proper patient counselling in this specific context but does not provide data on repeated cycle outcomes. Wider implications of the findings The findings highlight the value of PGT-A in optimizing treatment efficiency for women aged ≥39 years by reducing time to live birth. This has broader implications for improving patient satisfaction, personalizing treatment strategies, and guiding resource allocation in fertility clinics, ultimately enhancing care quality and reproductive outcomes for older patients. Trial registration number No

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.