Abstract
PurposeTo evaluate the use of preimplantation genetic testing (PGT) and live birth rates (LBR) in the USA from 2014 to 2017 and to understand how PGT is being used at a clinic and state level.MethodsThis study accessed SART data for 2014 to 2017 to determine LBR and the CDC for years 2016 and 2017 to identify PGT usage. Primary cycles included only the first embryo transfer within 1 year of an oocyte retrieval; subsequent cycles included transfers occurring after the first transfer or beyond 1 year of oocyte retrieval.ResultsIn the SART data, the number of primary PGT cycles showed a significant monotonic annual increase from 18,805 in 2014 to 54,442 in 2017 (P = 0.042) and subsequent PGT cycles in these years increased from 2946 to 14,361 (P = 0.01). There was a significant difference in primary PGT cycle use by age, where younger women had a greater percentage of PGT treatment cycles than older women. In both PGT and non-PGT cycles, the LBR per oocyte retrieval decreased significantly from 2014 to 2017 (P<0001) and younger women had a significantly higher LBR per oocyte retrieval compared to older women (P < 0.001). The CDC data revealed that in 2016, just 53 (11.4%) clinics used PGT for more than 50% of their cycles, which increased to 99 (21.4%) clinics in 2017 (P< 0.001).ConclusionsA growing number of US clinics are offering PGT to their patients. These findings support re-evaluation of the application for PGT.
Highlights
After the first two reports of world data on preimplantation genetic testing (PGT) in the 1990s [1, 2], the ESHRE PGT Consortium was established in 1997 to collect global PGT data [3]
The outcome of individual embryos following an ART treatment can be tracked from start to finish in the newer databases [4] and data are reported by indication, including the PGT subgroups (PGT for monogenic diseases (PGT-M), PGT for structural abnormalities
Individual analyses were performed using each database, where Society for Assisted Reproductive Technology (SART) data were evaluated for trends in overall ART and PGT use for autologous cycles, while the Centers for Disease Control and Prevention (CDC) data were evaluated for trends in the use of PGT across individual clinics and states
Summary
After the first two reports of world data on PGT in the 1990s [1, 2], the ESHRE PGT Consortium was established in 1997 to collect global PGT data [3]. The outcome of individual embryos following an ART treatment can be tracked from start to finish in the newer databases [4] and data are reported by indication, including the PGT subgroups (PGT for monogenic diseases (PGT-M), PGT for structural abnormalities (PGT-SR), and PGT for aneuploidy (PGT-A) [5]. This gives a very rich picture of the use of PGT. In the USA, PGT data are collected and reported by the Society for Assisted Reproductive Technology (SART) and reported by the Centers for Disease Control and Prevention (CDC) In both sets of data, PGT cannot be separated into PGT-A, M, or SR. Over these 3 years, 94,935 cycles using PGT were performed in the USA which is more than all the ESHRE PGD Consortium cycles collected since 1997
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