Τίτλος:
PGT-A: who and when? Α systematic review and network meta-analysis of RCTs
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Simopoulou, M.
Sfakianoudis, K.
Maziotis, E.
Tsioulou, P.
Grigoriadis, S.
Rapani, A.
Giannelou, P.
Asimakopoulou, M.
Kokkali, G.
Pantou, A.
Nikolettos, K.
Vlahos, N.
Pantos, K.
Περιοδικό:
Journal of Assisted Reproduction and Genetics
Λέξεις-κλειδιά:
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
DOI:
10.1007/s10815-021-02227-9
