@article{3076431,
    title = "PGT-A: who and when? Α systematic review and network meta-analysis of RCTs",
    author = "Simopoulou, M. and Sfakianoudis, K. and Maziotis, E. and Tsioulou, P. and Grigoriadis, S. and Rapani, A. and Giannelou, P. and Asimakopoulou, M. and Kokkali, G. and Pantou, A. and Nikolettos, K. and Vlahos, N. and Pantos, K.",
    journal = "Journal of Assisted Reproduction and Genetics",
    year = "2021",
    volume = "38",
    number = "8",
    pages = "1939-1957",
    publisher = "Springer-Verlag",
    issn = "1058-0468, 1573-7330",
    doi = "10.1007/s10815-021-02227-9",
    keywords = "adult;  aneuploidy;  birth rate;  chromosome analysis;  clinical outcome;  embryo biopsy;  embryo transfer;  female;  fresh embryo transfer;  frozen embryo transfer;  human;  intermethod comparison;  live birth;  meta analysis;  pregnancy rate;  preimplantation genetic screening;  randomized controlled trial (topic);  Review;  spontaneous abortion;  systematic review;  aneuploidy;  genetic screening;  in vitro fertilization;  network meta-analysis;  pregnancy;  preimplantation genetic diagnosis;  procedures;  randomized controlled trial (topic), Adult;  Aneuploidy;  Female;  Fertilization in Vitro;  Genetic Testing;  Humans;  Network Meta-Analysis;  Pregnancy;  Preimplantation Diagnosis;  Randomized Controlled Trials as Topic",
    abstract = "Purpose: Wide controversy is still ongoing regarding efficiency of preimplantation genetic testing for aneuploidy (PGT-A). This systematic review and meta-analysis, aims to identify the patient age group that benefits from PGT-A and the best day to biopsy. Methods: A systematic search of the literature was performed on MEDLINE/PubMed, Embase and Cochrane Central Library up to May 2020. Eleven randomized controlled trials employing PGT-A with comprehensive chromosomal screening (CCS) on Day-3 or Day-5 were eligible. Results: PGT-A did not improve live-birth rates (LBR) per patient in the general population (RR:1.11; 95%CI:0.87-1.42; n=1513; I2=75%). However, PGT-A lowered miscarriage rate in the general population (RR:0.45; 95%CI:0.25-0.80; n=912; I2=49%). Interestingly, the cumulative LBR per patient was improved by PGT-A (RR:1.36; 95%CI:1.13-1.64; n=580; I2=12%). When performing an age-subgroup analysis PGT-A improved LBR in women over the age of 35 (RR:1.29; 95%CI:1.05-1.60; n=692; I2=0%), whereas it appeared to be ineffective in younger women (RR:0.92; 95%CI:0.62-1.39; n=666; I2=75%). Regarding optimal timing, only day-5 biopsy practice presented with improved LBR per ET (RR: 1.37; 95% CI: 1.03-1.82; I2=72%). Conclusion: PGT-A did not improve clinical outcomes for the general population, however PGT-A improved live-birth rates strictly when performed on blastocyst stage embryos of women over the 35-year-old mark. © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature."
}