Maternal and neonatal outcomes associated with trophectoderm biopsy

Fertil Steril. 2019 Aug;112(2):283-290.e2. doi: 10.1016/j.fertnstert.2019.03.033. Epub 2019 May 15.


Objective: To assess whether pregnancies achieved with trophectoderm biopsy for preimplantation genetic testing (PGT) have different risks of adverse obstetric and neonatal outcomes compared with pregnancies achieved with IVF without biopsy.

Design: Observational cohort.

Setting: University-affiliated fertility center.

Patient(s): Pregnancies achieved via IVF with PGT (n = 177) and IVF without PGT (n = 180) that resulted in a live birth.

Intervention(s): None.

Main outcome measure(s): Maternal outcomes including preeclampsia and placenta previa and neonatal outcomes including birth weight and birth defects.

Result(s): There was a statistically significant increase in the risk of preeclampsia among IVF+PGT pregnancies compared with IVF without PGT pregnancies, with an incidence of 10.5% versus 4.1% (adjusted odds ratio [aOR] = 3.02; 95% confidence interval [95% CI], 1.10, 8.29). The incidence of placenta previa was 5.8% in IVF+PGT pregnancies versus 1.4% in IVF without PGT pregnancies (aOR = 4.56; 95% CI, 0.93, 22.44). Similar incidences of gestational diabetes, preterm premature rupture of membranes, and postpartum hemorrhage were observed. IVF+PGT and IVF without PGT neonates did not have a significantly different gestational age at delivery or rate of preterm birth, low birth weight, neonatal intensive care unit admission, neonatal morbidities, or birth defects. All trends, including the significantly increased risk of preeclampsia in IVF+PGT pregnancies, persisted upon stratification of analysis to only singleton live births.

Conclusion(s): To date, this is the largest and most extensively controlled study examining maternal and neonatal outcomes after trophectoderm biopsy. There was a statistically significant three-fold increase in the odds of preeclampsia associated with trophectoderm biopsy. Given the rise in PGT use, further investigation is warranted.

Keywords: Preimplantation genetic testing; in vitro fertilization; maternal outcomes; neonatal outcomes; preeclampsia; trophectoderm biopsy.

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biopsy / adverse effects
  • Cohort Studies
  • Ectoderm / pathology*
  • Female
  • Fertilization in Vitro / methods
  • Fertilization in Vitro / statistics & numerical data
  • Genetic Testing / methods
  • Genetic Testing / statistics & numerical data
  • Humans
  • Infant, Newborn
  • Pre-Eclampsia / epidemiology
  • Pre-Eclampsia / etiology
  • Pregnancy
  • Pregnancy Outcome / epidemiology*
  • Preimplantation Diagnosis* / adverse effects
  • Preimplantation Diagnosis* / methods
  • Preimplantation Diagnosis* / statistics & numerical data
  • Premature Birth / epidemiology
  • Premature Birth / etiology
  • Retrospective Studies
  • Trophoblasts / pathology*