IVF and perinatal outcomes of advanced maternal age patients after single frozen euploid embryo transfer: a propensity-matched analysis of autologous and donor cycles.

Autores de IIS La Fe

• Mauro Cozzolino

  Autor

• Juan Antonio García Velasco

  Autor

• Antonio Pellicer Martínez

  Autor

• Daniela Galliano

  Autor

Participantes ajenos a IIS La Fe

• Capalbo, Antonio
• Vaiarelli, Alberto
• Cimadomo, Danilo
• Ubaldi, Filippo Maria
• Parini, Valentina
• Levi-Setti, Paolo Emanuele

Grupos

• Endocrinología Reproductiva e Infertilidad

  Leader

  José Remohí Giménez

• Medicina Reproductiva

  

  Investigador Principal

  José Morales Roselló

Abstract

OBJECTIVE: To evaluate in vitro fertilization (IVF) and perinatal outcomes of donor egg and autologous cycles in advanced reproductive-aged patients after undergoing single, frozen euploid embryo transfer (SET/FET). DESIGN: A retrospective, multicenter cohort study. SETTING: University-affiliated and private IVF centers. PATIENT(S): Patients between 39-46 years old undergoing IVF with intracytoplasmic sperm injection (ICSI) and preimplantation genetic testing for aneuploidy (PGT-A) using whole-chromosome sequencing with donor (n=278) or autologous (n=278) oocytes between October 2017 and October 2021. INTERVENTION(S): SET/FET with donor or autologous euploid embryo MAIN OUTCOME MEASURE(S): The live birth rate after the first embryo transfer, calculated per embryo transfer. Secondary outcomes included implantation rate, ectopic pregnancy rate, miscarriage rate, and gestational age and birthweight at the time of delivery. RESULT(S): Patients using donor or autologous oocytes had a similar likelihood of implantation 57.91% (51.87-63.78) versus 57.19% (51.15-63.09), p=0.93 and live birth rate 41.01% (95% CI:35.17-47.04) versus 42.45% (95% CI:36.56-48.49), p=0.86. Furthermore, there were no significant differences in ectopic pregnancy rate [0.72% (0.09-2.57) versus 0.36% (0.01-1.99), p=1] or miscarriage rate [16.19% (12.06-21.05) versus 14.39% (95% CI:10.48-19.08), p=0.98], gestational age [38.50 weeks (38.08-38.92) versus 39.16 weeks (38.25-40.07), p=0.19], or birthweight of infants [2982.25 kg (2606.69-3357.81) versus 3128.24 kg (2962.30-3294.17), p=0.95]. The univariate analysis showed no association of advanced maternal age on the live birth rate [risk relative (RR) 1.03 (IC95%: 0.84-1.25); p=0.79]. Multivariate analysis using putative confounders for embryo competency found no associations with live birth rate [adjusted risk relative (aRR) 1.22 (IC95%: 0.75-1.98); p=0.42] CONCLUSION(S): Patients with euploid blastocysts derived from donor or autologous oocytes did not reveal statistically significant differences in live birth rate, implantation rate, ectopic pregnancy rate, miscarriage rate, duration of gestation, or infant birthweight. These findings suggest that age-related reproductive decline and/or poor IVF outcomes associated with advanced reproductive-aged women undergoing IVF are heavily driven by embryonic aneuploidy.

Copyright © 2024 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Keywords

• autologous oocyte; donor oocytes; euploid blastocyst; live birth; single embryo transfer