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

• Published in: Journal of assisted reproduction and genetics Vol. 37; no. 3; pp. 579 - 588
• Main Authors: Ni, Tianxiang, Wu, Qianqian, Zhu, Yueting, Jiang, Wenjie, Zhang, Qian, Li, Yan, Yan, Junhao, Chen, Zi-Jiang
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.03.2020; Springer Nature B.V
• Subjects: Abortion, Spontaneous - genetics; Abortion, Spontaneous - physiopathology; Adult; Aneuploidy; Assisted Reproduction Technologies; Birth Rate; Blastocyst - pathology; Blastocysts; Embryo Culture Techniques - methods; Embryo Implantation - genetics; Embryo Transfer - methods; Female; Fertilization in Vitro; Genetic Testing; Gynecology; Human Genetics; Humans; Implantation; Medicine; Medicine & Public Health; Miscarriage; Pregnancy; Pregnancy Outcome; Pregnancy Rate; Preimplantation Diagnosis; Regression analysis; Reproductive Medicine; Preimplantation genetic testing; Live birth; Miscarriage; Implantation failure; Embryonic aneuploidy
• ISSN: 1058-0468; 1573-7330
• DOI: 10.1007/s10815-020-01722-9

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.