Preimplantation Genetic Testing for Aneuploidy With Comprehensive Chromosome Screening in Patients Undergoing In Vitro Fertilization: A Systematic Review and Meta-analysis

Obstet Gynecol. 2022 Nov 1;140(5):769-777. doi: 10.1097/AOG.0000000000004962. Epub 2022 Oct 5.

Abstract

Objective: To review the effect of comprehensive chromosome screening-based preimplantation genetic testing for aneuploidy (PGT-A) in women undergoing in vitro fertilization (IVF) treatment, we conducted this meta-analysis to compare pregnancy outcomes of women who did and did not undergo such testing.

Data sources: We searched Medline, EMBASE, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov from their inception until February 28, 2022, for randomized controlled trials focusing on PGT-A treatment without any language restrictions.

Methods of study selection: Randomized controlled trials involving women undergoing IVF with or without PGT-A and comprehensive chromosome testing. Pooled relative risks (RRs) with 95% CIs were calculated for the primary outcome using a random-effects model with the Mantel-Haenszel method.

Results: A total of nine trials with 3,334 participants were included. Overall, PGT-A was not associated with an increased live-birth rate (RR 1.13, 95% CI 0.96-1.34, I 2 =79%). However, PGT-A raised the live-birth rate in women of advanced maternal age (RR 1.34, 95% CI 1.02-1.77, I 2 =50%) but not in women of nonadvanced age (RR 0.94, 95% CI 0.89-0.99, I 2 =0%).

Conclusion: Preimplantation genetic testing for aneuploidy increases the live-birth rate in women of advanced maternal age.

Systematic review registration: PROSPERO, CRD42022311540.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aneuploidy
  • Chromosomes
  • Female
  • Fertilization in Vitro
  • Genetic Testing / methods
  • Humans
  • Pregnancy
  • Pregnancy Rate
  • Preimplantation Diagnosis* / methods