Dados do Trabalho

Title

The Clinical Effectiveness of Pre Implantation Genetic Test (PGTA) in Assisted Reproductive Technology.

Objective

to evaluate the impact of PGTA in the clinical pregnancy rate, rimplantation rate and live birth rate on In Vitro Fertilization (IVF)

Methods

This is an observational, retrospective cohort study. Sixty patients submitted to Control Ovarian Hyperstimulation for IVF and PGTA in the period of 2020 to 2022 in a private clinic were analized. Patients age ranging from 34 to 44 years (media: 39). All patients used antagonist protocol with recombinant FSH and Human Menopausal gonadotrophin for ovulation induction and recombinant HCG for oocyte maturation. Oocyte aspiration was performed 36 hours after HCG guided by endovaginal ultrasound .The embryos were cultured to blastocist stage and biopsy was performed in the 5th or 6 th day of culture an All the biopses were sent to the same Lab (DASA/Chromosome) and the technique used to run the DNA was Next Generation Sequencing (NGS). The indications for PGTA were: Advanced maternal AGE (AMA),Habitual Abortion (HA), Implantation Failure (IF), Chromosome Abnormality (CA), Severe Male Factor or Personal Reasons.

Results

Thirty one patients underwent IVF/PGTA due to Advanced Maternal Age (51,7%), 04 due to Habitual Abortion (6,7%), 06 due to IF (10%), 04 due to Chromosome Abnormality (6.7%), 07 for Severe Male Factor (11,7%) and 08 due to personal reasons (13,3%). Thirty out of 60 patients (50%) had euploid embryos to transfer. Twenty four of them transfered their embryos : 23 of them transfered only one euploid embryo and one patient decided to transfer two euploid embryos. Twenty one had a positive BhCG (87,5%), but one was bioquemical and 03/21 patients had a clinical abortion (14,3% abortion rate). Our clinical pregnancy rate was : 83% (20/24) and our implantation rate was 88%. Seventeen patients out of 24 transfers delivered 18 healthy babies (71% take home baby rate), one of these patients had twins (multiple gestation rate: 4,3%). Between patients with euploid embryos, 23,3% (7/30) were ≥ 40 years of age and 76,7% had < 40 years of age.

Conclusion

Implantation Genetic Test for Aneuploidy improved the pregnancy rate, implantation rate and take home baby per embryo transfer in this particular group of patients.
- The percentage of euploid embryo obtained in patients of ≥ 40 years is very low and this population of patients should be aware of it and think about egg donation
- PGTA decreased multiple gestation rate by selecting the best embryo to transfer without affecting the chance per transfer, what gives more security for patients to decide toward Single Embryo Transfer (SET).

Keywords

IVF/PREIMPLANTATION GENETIC TEST/OUTCOME