Maternal and neonatal outcomes associated with trophectoderm biopsy

Trophectoderm biopsy was associated with a statistically significant increase in preeclampsia. Thus, given the rise in preimplantation genetic testing use, further investigation is warranted.

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Volume 112, Issue 2, Pages 283–290.e2

Authors:

Wendy Y. Zhang, B.S., Frauke von Versen-Höynck, M.D., M.S., Kristopher I. Kapphahn, M.S., Raquel R. Fleischmann, D.V.M. C.C.R.P., Qianying Zhao, M.S., Valerie L. Baker, M.D.

Abstract:

Objective

To assess whether pregnancies achieved with trophectoderm biopsy for preimplantation genetic testing (PGT) have different risks of adverse obstetric and neonatal outcomes compared with pregnancies achieved with IVF without biopsy.

Design

Observational cohort.

Setting

University-affiliated fertility center.

Patient(s)

Pregnancies achieved via IVF with PGT (n = 177) and IVF without PGT (n = 180) that resulted in a live birth.

Intervention(s)

None.

Main Outcome Measure(s)

Maternal outcomes including preeclampsia and placenta previa and neonatal outcomes including birth weight and birth defects.

Result(s)

There was a statistically significant increase in the risk of preeclampsia among IVF+PGT pregnancies compared with IVF without PGT pregnancies, with an incidence of 10.5% versus 4.1% (adjusted odds ratio [aOR] = 3.02; 95% confidence interval [95% CI], 1.10, 8.29). The incidence of placenta previa was 5.8% in IVF+PGT pregnancies versus 1.4% in IVF without PGT pregnancies (aOR = 4.56; 95% CI, 0.93, 22.44). Similar incidences of gestational diabetes, preterm premature rupture of membranes, and postpartum hemorrhage were observed. IVF+PGT and IVF without PGT neonates did not have a significantly different gestational age at delivery or rate of preterm birth, low birth weight, neonatal intensive care unit admission, neonatal morbidities, or birth defects. All trends, including the significantly increased risk of preeclampsia in IVF+PGT pregnancies, persisted upon stratification of analysis to only singleton live births.

Conclusion(s)

To date, this is the largest and most extensively controlled study examining maternal and neonatal outcomes after trophectoderm biopsy. There was a statistically significant three-fold increase in the odds of preeclampsia associated with trophectoderm biopsy. Given the rise in PGT use, further investigation is warranted.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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