NATIONAL TRENDS AND OUTCOMES FOR PRE-IMPLANTATION GENETIC TESTING IN THE UNITED STATES, 2014-2018

Abstract

To describe trends, characteristics, and outcomes of pre-implantation genetic testing (PGT) use in in-vitro fertilization (IVF) cycles in the United States. We performed a retrospective cohort study using national data reported to Society for Assisted Reproductive Technology Clinic Outcome Reporting System during 2014-2018. We used linear regression to assess trends in the number and proportion of fresh IVF cycles using PGT. We also described characteristics of cycles using PGT, including patient demographics. Lastly, by linking to frozen transfers, we reported cumulative live birth rates of cycles using PGT compared to cycles not using PGT are reported stratified by age. The absolute number of fresh IVF cycles utilizing PGT increased from 18,059 in 2014 to 58,827 in 2018. These cycles accounted for 17.2% of all fresh cycles in 2014 and 44.9% of all fresh cycles in 2018 (p for trend = 0.0005). In fresh cycles, PGT was most commonly used in cycles among women ages 38-40 years of age (41.3% of cycles) using autologous oocytes, but there was frequent use in cycles among younger women, including 27% of autologous oocyte cycles in women < 35 years and 28.6% of fresh donor oocyte cycles (<35 years). The indication for the majority of PGT was for aneuploidy (58.6%). PGT use was more common in women with higher ovarian reserve and in cycles with a higher number of oocytes retrieved. Cumulative live birth rates per oocyte retrieval stratified by age are reported in Table 1. PGT use increased markedly among IVF cycles in the US from 2014 to 2018. It is most common in cycles in women who are at higher risk of aneuploidy and in cycles with a higher number of oocytes retrieved. In younger women, there are no improvements in cumulative live birth rates per retrieval with PGT use.