PGT-A in Poor, Normo- and Hyper-Responders

Abstract

The number of embryos available for transfer is significantly lower in PGT-A than in regular IVF simply because of genetic selection. Our aim is to evaluate ovarian reserve and ovarian response in relation to the probability of finding at least one euploid embryo (POE), which is the main determinant for PGT-A success. Over a six-year period, 2011-2017, PGT-A cycles were retrospectively analyzed and 5952 blastocysts were biopsied and diagnosed either by aCGH or NGS. The POE per cycle and the euploidy rate (ER) per diagnosed embryos were evaluated according to maternal age and ovarian reserve as measured by Anti Mullerian Hormone (AMH), day3 Follicle Stimulating Hormone (FSH) levels, and ovarian response as measured by the number of cumulus-oocyte complexes (COCs), metaphase II (MII) oocytes retrieved, top and good quality blastocyst (TQ+GQ) and biopsied blastocysts. According to a logistic regression analysis conducted to correlate maternal age and the ER per cycle, ER decreased by 1.9-fold with each additional year, whereas for POE, the same decline per cycle was around 0.8-fold in a generalized linear mixed model (GLMM) (p In conclusion female age is the most significant predictor of euploidy rate.Euploidy rate does not directly correlate with the number of oocytes retrieved. POE decreases significantly with advancing maternal age. AMH level, d3 FSH levels, the number of COCs, MII oocytes and the number of TQ+GQ and biopsied blastocyst are the main variables affecting POE after adjustment for age indicating that ovarian reserve and response have a significant impact. These findings emphasize the importance of evaluating and counselling the patients for factors both negative and positive, which may affect the success of PGT.