TY - JOUR
TI - PGT-A: who and when? Α systematic review and network meta-analysis of RCTs
AU - Simopoulou, M.
AU - Sfakianoudis, K.
AU - Maziotis, E.
AU - Tsioulou, P.
AU - Grigoriadis, S.
AU - Rapani, A.
AU - Giannelou, P.
AU - Asimakopoulou, M.
AU - Kokkali, G.
AU - Pantou, A.
AU - Nikolettos, K.
AU - Vlahos, N.
AU - Pantos, K.
JO - Journal of Assisted Reproduction and Genetics
PY - 2021
VL - 38
TODO - 8
SP - 1939-1957
PB - Springer-Verlag
SN - 1058-0468, 1573-7330
TODO - 10.1007/s10815-021-02227-9
TODO - 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
TODO - 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.
ER -