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. 2020 Mar;37(3):579-588.
doi: 10.1007/s10815-020-01722-9. Epub 2020 Feb 26.

Comprehensive analysis of the associations between previous pregnancy failures and blastocyst aneuploidy as well as pregnancy outcomes after PGT-A

Tianxiang Ni  1   2   3   4 , Qianqian Wu  1   2   3   4 , Yueting Zhu  1   2   3   4 , Wenjie Jiang  1   2   3   4 , Qian Zhang  1   2   3   4 , Yan Li  1   2   3   4 , Junhao Yan  5   6   7   8 , Zi-Jiang Chen  1   2   3   4   9
Affiliations

Comprehensive analysis of the associations between previous pregnancy failures and blastocyst aneuploidy as well as pregnancy outcomes after PGT-A

Tianxiang Ni et al. J Assist Reprod Genet. 2020 Mar.

Abstract

Purpose: To investigate the associations of previous pregnancy failures, including implantation failures (IFs), biochemical pregnancy losses (BPLs), and early (EMs) and late miscarriages (LMs), with blastocyst aneuploidy and pregnancy outcomes after PGT-A.

Methods: This study included 792 couples who underwent PGT-A after multiple pregnancy failures. Subgroup analyses were used to compare the blastocyst aneuploidy rate (BAR), implantation rate (IR), early miscarriage rate (EMR), and live birth rate (LBR). Multiple linear and logistic regression models were used to evaluate the associations. The control group comprised couples with ≤ 2 IFs, ≤ 1 BPL, ≤ 1 EM, and no LM.

Results: Notably, a history of ≥ 4 IFs was significantly associated with an increase in aneuploid blastocysts (42.86% vs. 33.05%, P = 0.044, B = 10.23 for 4 IFs; 48.80% vs. 33.05%, P = 0.002, B = 14.43 for ≥ 5 IFs). Women with ≥ 4 prior EMs also harbored more aneuploid blastocysts (41.00% vs. 33.05%, P = 0.048; B = 9.23). Compared with the control group, women with ≥ 4 prior EMs had a significantly higher EMR (6.58% vs. 31.11%, P < 0.001, OR = 6.49) and a lower LBR (53.49% vs. 34.18%, P = 0.007, OR = 0.56) after euploid transfer. Moreover, a history of LM(s) was associated with adverse pregnancy outcomes after PGT-A (OR for EM = 3.16; OR for live birth = 0.48). However, previous BPLs and 2 EMs were not associated significantly with blastocyst aneuploidy and pregnancy outcomes after PGT-A.

Conclusion: A history of high-order IFs or EMs and existence of LM(s) were significantly associated with blastocyst aneuploidy and adverse pregnancy outcomes after PGT-A, whereas no such associations were observed with BPLs or 2 EMs.

Keywords: Embryonic aneuploidy; Implantation failure; Live birth; Miscarriage; Preimplantation genetic testing.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Inclusion and classification of couples in this study. IF implantation failure, BPL biochemical pregnancy loss, EM early miscarriage, LM late miscarriage
See this image and copyright information in PMC

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