Conventional IVF noninferior to PGT-A for live-birth rate

(HealthDay)—Among women with three or more good-quality blastocysts, conventional in-vitro fertilization (IVF) results in a cumulative live-birth rate that is noninferior to the rate obtained using embryo selection with preimplantation genetic testing for aneuploidy (PGT-A), according to a study published in the Nov. 25 issue of the New England Journal of Medicine.

Junhao Yan, M.D., Ph.D., from Shandong University in Jinan, China, and colleagues conducted a multicenter randomized controlled trial involving subfertile women, aged between 20 and 37 years, with three or more good-quality blastocysts who underwent either PGT-A or conventional IVF. Three blastocysts were screened by next-generation sequencing or were chosen by morphologic criteria in the PGT-A and conventional-IVF groups, respectively, and were transferred successively one by one. The cumulative live-birth rate after up to three embryo-transfer procedures within one year after randomization was the primary outcome. The hypothesis was that PGT-A use would result in a cumulative live-birth rate that was no more than 7 percentage points higher than that after conventional IVF, which constituted the noninferiority margin.

A total of 1,212 patients were randomly assigned: 606 to each trial group. The researchers found that live births occurred in 77.2 and 81.8 percent of women in the PGT-A and conventional-IVF groups, respectively (absolute difference, −4.6 percentage points). The cumulative frequency of clinical pregnancy loss was 8.7 and 12.6 percent, respectively (absolute difference, −3.9 percentage points). The groups had similar incidences of obstetrical or neonatal complications and other adverse events.

"Our results showed that the cumulative live-birth rate after conventional IVF alone was not only noninferior to the rate with PGT-A but was numerically higher," the authors write.

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