Comparison of live birth and miscarriage following PGS

Abstract

To compare parameters between live birth and miscarriage following detection of a clinical pregnancy (CP) in PGS cycles. Retrospective data from all PGS cycles from September 2008 to August 2012. Maternal age, number of embryos transferred and day of embryo transfer (ET) were compared between cycles that produced a live birth and those that resulted in a miscarriage. The cycles that resulted in miscarriage were then divided and compared according to biopsy type, polar body 1 (PB1) and blastomere. 75.8% (47/62) and 24.2% (15/62) of patients with a CP went on to have a live birth and miscarriage respectively. Average maternal age was 39.0 and 40.3 years respectively. Average number of embryos transferred 1.69 and 1.73 respectively. 38.3% (18/47) of embryos were transferred on Day 3 (D3) and 61.7% (29/47) on Day 5 (D5) in the live birth group. Comparably, in the miscarriage group, 27% (4/15) and 73% (9/15) of embryos were transferred on D3 and D5 respectively. 61.3% (38/62) and 38.7% (24/62) of patients had PB1 and blastomere biopsy respectively. 23.7% (9/38) and 25% (6/24) of patients who had PB1 and blastomere biopsy respectively went on to miscarry. In the PB1 group, 13.2% (5/38) miscarried before 12 weeks, with 3 and 2 following D3 and D5 embryo transfer (ET) with 2 twin pregnancies. 10.5% (4/38) between 12 and 24 weeks with 1 following D3 ET and 3 D5 ET with 1 twin pregnancy. In the blastomere group, 8.3% (2/24) miscarried before 12 weeks and 16.7% (4/24) between 12 and 24 weeks including 2 twin pregnancies. All ETs in this group were D5. Parameters between groups were comparable and no difference was seen between biopsy type. 33% (5/15) of miscarriages occurred with twin pregnancies even after PGS, supporting a single embryo transfer policy, regardless of maternal age.