Reproductive
The Association Between Infertility Causes and Live Birth Outcomes in Assisted Reproductive Technologies Post Preimplantation Genetic Testing for Aneuploidy (PGT-A): A Comparative Analysis of 2017-2018 the UK-HFEA Data Chidinma Oli* Chidinma Oli Amadou Barrow Anamege Adaeze Kelly Gurka
Background: Assisted reproductive technologies (ART) are commonly used to treat infertility. Since the success of ARTs in achieving live births is significantly impacted by aneuploidy, Preimplantation Genetic Testing for Aneuploidy (PGT-A) is utilized to improve the likelihood of live births by identifying embryos without aneuploidy, consequently maximizing their potential for successful pregnancies. However, it is still unclear whether the success of PGT-A in ART treatments is influenced by the specific underlying cause of infertility. This analysis aimed to examine the association between infertility causes and live birth occurrence post PGT-A testing among infertile women.
Methods: We used the 2017-2018 United Kingdom Human Fertilisation and Embryology Authority (UK HFEA) data, one of the largest global databases of fertility treatment. We used multivariable logistic regression models to estimate the aORs and 95% CI adjusting for age, ethnicity, and specific type of ART treatment.
Results: Overall, our results show a significant association between infertility causes and live birth outcomes post PGT-A treatment (X2 = 18.07, P = 0.0012). The predominant causes of infertility were male factor (35.2%) and unexplained (34.5%) infertility. Compared to male factor infertility, women with unexplained infertility had increased odds of live birth post-PGT-A (aOR 1.18; 95% CI, 1.06–1.31). Conversely, women with infertility due to ovulatory disorder presented lower odds of live births (aOR 0.82; 95% CI, 0.71–0.95). Infertility caused by Endometriosis showed a non-significant trend towards increased odds of live birth occurrence (aOR 1.14; 95% CI, 0.87–1.51) post PGT-A. tubal disease infertility had comparable odds of live birth (aOR 1.02; 95% CI, 0.86–1.22) relative to male factor infertility.
Conclusions: The occurrence of live birth post PGT-A testing varied with the different causes of infertility and emphasize the importance of personalized treatment plans in ART.