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. 2022 Nov;39(11):2547-2554.
doi: 10.1007/s10815-022-02612-y. Epub 2022 Sep 21.

Does PGT-A improve assisted reproduction treatment success rates: what can the UK Register data tell us?

Stephen A Roberts  1 , Jack Wilkinson  2 , Andy Vail  2 , Daniel R Brison  3
Affiliations

Does PGT-A improve assisted reproduction treatment success rates: what can the UK Register data tell us?

Stephen A Roberts et al. J Assist Reprod Genet. 2022 Nov.

Abstract

Purpose: To show how naïve analyses of aggregated UK ART Register data held by the Human Fertilisation and Embryology Authority to estimate the effects of PGT-A can be severely misleading and to indicate how it may be possible to do a more credible analysis. Given the limitations of the Register, we consider the extent to which such an analysis has the potential to answer questions about the real-world effectiveness of PGT-A.

Methods: We utilise the publicly available Register datasets and construct logistic regression models for live birth events (LBE) which adjust for confounding. We compare all PGT-A cycles to control groups of cycles that could have had PGT-A, excluding cycles that did not progress to having embryos for biopsy.

Results: The primary model gives an odds ratio for LBE of 0.82 (95% CI 0.68-1.00) suggesting PGT-A may be detrimental rather than beneficial. However, due to limitations in the availability of important variables in the public dataset, this cannot be considered a definitive estimate. We outline the steps required to enable a credible analysis of the Register data.

Conclusion: If we compare like with like groups, we obtain estimates of the effect of PGT-A that suggest an overall modest reduction in treatment success rates. These are in direct contrast to an invalid comparison of crude success rates. A detailed analysis of a fuller dataset is warranted, but it remains to be demonstrated whether the UK Register data can provide useful estimates of the impact of PGT-A when used as a treatment add-on.

Keywords: Assisted Reproduction; Live birth rates; Preimplantation genetic testing aneuploidy; Registry data; Retrospective study.

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Conflict of interest statement

None of the authors of this work has any financial or academic interest in the PGT-A process. AV and JW are statistical editors of Cochrane Gynaecology and Fertility which has published a review of the randomised evidence. DB is a member of the Advisory Committee to the HFEA that has recommended the ‘red light’ for this add-on and AV has acted as an ‘independent expert reviewer’ to that committee.

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