Patients with Recurrent Pregnancy Loss Have Similar Embryonic Preimplantation Genetic Testing Aneuploidy Rates and In Vitro Fertilization Outcomes to Infertility Patients
Molly Siegel Kornfield, M.D.,
Pamela Parker, M.D., M.P.H.,
Elizabeth Rubin, M.D.,
Bharti Garg, M.B.B.S., M.P.H.,
Thomas O’Leary, Ph.D.,
Paula Amato, M.D.,
David Lee, M.D.,
Diana Wu, M.D.,
Sacha Krieg, M.D., Ph.D.
Affiliations
Molly Siegel Kornfield, M.D.
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Oregon Health and Science University, Portland, Oregon; Reprint requests: Molly Siegel Kornfield, M.D., Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Oregon Health and Science University, 3303 S Bond Ave Building 1, 10th Floor, Portland, Oregon 97239
Pamela Parker, M.D., M.P.H.
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Oregon Health and Science University, Portland, Oregon
Elizabeth Rubin, M.D.
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Oregon Health and Science University, Portland, Oregon
Bharti Garg, M.B.B.S., M.P.H.
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Oregon Health and Science University, Portland, Oregon
Thomas O’Leary, Ph.D.
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Oregon Health and Science University, Portland, Oregon
Paula Amato, M.D.
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Oregon Health and Science University, Portland, Oregon
David Lee, M.D.
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Oregon Health and Science University, Portland, Oregon
Diana Wu, M.D.
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Oregon Health and Science University, Portland, Oregon
Sacha Krieg, M.D., Ph.D.
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Oregon Health and Science University, Portland, Oregon
Objective: To evaluate aneuploidy rates and in vitro fertilization (IVF)/pregnancy outcomes for patients undergoing IVF and preimplantation genetic testing for aneuploidy (PGT-A) with a recurrent pregnancy loss (RPL) diagnosis compared to infertility diagnoses without RPL. Design: Retrospective cohort study. Setting: Academic fertility center. Patient(s): Of 372 patients undergoing IVF/PGT-A between January 2016-December 2018, 294 patients were included in the analysis: 56 patients with an RPL diagnosis and 238 with infertility diagnoses without RPL. Intervention(s): None. Main Outcome Measure(s): The primary outcome measured was the embryonic aneuploidy rate. Secondary outcomes included fertilization and blastulation rates, number of blastocysts biopsied, cycles without euploid blastocysts, and rates of pregnancy losses, clinical pregnancies, and live births after a euploid embryo transfer. Result(s): The cohort included 56 patients with RPL and 238 patients without RPL, including data from their first IVF cycle within the time period. Aneuploidy rates were similar between the groups, with a mean of 55% (±31%) in RPL and 54% (±34%) in non-RPL cycles. Similar rates persisted after controlling for age, ovarian reserve, and infertility diagnosis. Fertilization and blastulation rates, as well as cumulative clinical pregnancy, pregnancy loss, and live birth rates after the transfer of at least one euploid embryo were also similar between the two groups. Conclusion(s): These results suggest that IVF/PGT-A cycles from patients with an RPL diagnosis have similar IVF and pregnancy outcomes to those of patients with infertility without RPL. This research can help guide counseling for RPL patients considering IVF with PGT-A.
