OBJECTIVE To evaluate whether preimplantation genetic testing for aneuploidy (PGT-A) benefits women of advanced reproductive age (≥38 years old) with a diminished ovarian reserve (DOR; not more than three retrieved oocytes). DESIGN A retrospective analysis comparing two groups: (a) PGT-A group: women who chose PGT-A and subsequent single re-warmed embryo transfers (ETs) and (b) non-PGT-A group: women who chose not to genetically test their embryos and underwent subsequent fresh or re-warmed ETs of one to two embryos on days 3 or 5. SUBJECTS Two hundred and thirty patients underwent PGT-A therapy, with 49 of these individuals undergoing more than one PGT-A cycle. Meanwhile, 309 patients received non-PGT-A treatment, among whom 89 underwent more than one cycle of this type. Collectively, this study encompassed a total of 298 PGT-A cycles and 429 non-PGT-A cycles from a single center (April 2019-June 2023). All women had a DOR and advanced reproductive age. EXPOSURE The exposure variable was the use of PGT-A. MAIN OUTCOME MEASURES The primary outcome was live birth rates (per cycle and retrieval). Secondary outcomes were clinical pregnancy rates (per cycle and retrieval), miscarriage rates (per pregnancy and retrieval). RESULTS While PGT-A cycles had lower transfer rates (14.1% vs. 73.2%), they achieved significantly higher pregnancy (66.7% vs. 12.4%) (adjusted odds ratio [aOR] = 11.474; 95% confidence interval [95% CI], 5.462, 24.102; p < 0.001) and live birth rates (57.1% vs. 7.5%) per transfer (aOR = 13.065; 95% CI, 5.987, 28.510; p < 0.001). The PGT-A group also had lower miscarriage rates (14.3% vs. 40.0%) (aOR = 0.142; 95% CI, 0.030, 0.661; p = 0.013). However, overall pregnancy and live birth rates were similar, and the PGT-A group required fewer cycles for live birth (p = 0.023). CONCLUSION While PGT-A improved clinical pregnancy and live birth rates per transfer cycle in women of advanced reproductive age with a low oocyte yield, it did not impact these rates per retrieval.

中文翻译：

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非整倍体植入前基因检测对取卵数不超过 3 个的高龄育龄妇女胚胎移植结局的影响。


目的 评估非整倍体植入前基因检测 （PGT-A） 是否有益于卵巢储备功能减退的高龄育龄妇女 （≥38 岁;取卵卵数不超过 3 个）。设计 比较两组的回顾性分析：（a） PGT-A 组：选择 PGT-A 和随后单次再加热胚胎移植 （ET） 的女性 和 （b） 非 PGT-A 组：选择不对胚胎进行基因检测并随后在第 3 天或第 5 天接受一到两个胚胎的新鲜或再加热 ET 的女性。对象 230 名患者接受了 PGT-A 治疗，其中 49 名患者接受了不止一个 PGT-A 周期。同时，309 例患者接受了非 PGT-A 治疗，其中 89 例接受了不止一个此类周期。总的来说，这项研究包括来自单个中心（2019 年 4 月至 2023 年 6 月）的总共 298 个 PGT-A 周期和 429 个非 PGT-A 周期。所有女性都有 DOR 和高龄育龄。暴露 暴露变量是 PGT-A 的使用。主要结局指标 主要结局是活产率 （每个周期和检索）。次要结局是临床妊娠率 （每个周期和取卵率） 、流产率 （每个妊娠和取卵）。结果虽然 PGT-A 周期的转移率较低（14.1% 对 73.2%），但它们的妊娠率显著更高（66.7% 对 12.4%）（校正比值比 [aOR] = 11.474;95% 置信区间 [95% CI]，5.462,24.102;p < 0.001）和每次转移的活产率（57.1% 对 7.5%）（aOR = 13.065;95% CI，5.987,28.510;p < 0.001）。PGT-A 组的流产率也较低 （14.3% vs. 40.0%） （aOR = 0.142;95% CI，0.030,0.661;p = 0.013）。 然而，总体妊娠率和活产率相似，PGT-A 组需要较少的活产周期 （p = 0.023）。结论 虽然 PGT-A 改善了卵母细胞产量低的高龄育龄妇女每个移植周期的临床妊娠率和活产率，但它并不影响这些每次取卵率。