In vitro fertilization and perinatal outcomes of patients with advanced maternal age after single frozen euploid embryo transfer: a propensity score-matched analysis of autologous and donor cycles

Autores de IIS La Fe

• Mauro Cozzolino

  Autor

• Antonio Pellicer Martínez

  Autor

Participantes ajenos a IIS La Fe

• Capalbo, A
• Garcia-Velasco, JA
• Vaiarelli, A
• Galliano, D
• Cimadomo, D
• Ubaldi, FM
• Parini, V
• Levi-Setti, PE

Grupos

• Endocrinología Reproductiva e Infertilidad

• Medicina Fetal y Reproductiva

Abstract

Objective: To evaluate in vitro fertilization (IVF) and perinatal outcomes of donor egg and autologous cycles in patients with advanced reproductive age after undergoing single frozen euploid embryo transfer. Design: A multicenter, retrospective, cohort study. Setting: University-affiliated fi liated and private IVF centers. Patient(s): Patients aged 39-46 - 46 years who underwent IVF with intracytoplasmic sperm injection and preimplantation genetic testing for aneuploidy using whole-chromosome sequencing with donor (n = 278) or autologous (n = 278) oocytes between October 2017 and October 2021. Intervention(s): Single frozen euploid embryo transfer with donor or autologous euploid embryo. Main Outcome Measure(s): The main outcome measure was the live birth rate (LBR) after the fi rst embryo transfer, calculated per embryo transfer. The secondary outcomes included the implantation rate, ectopic pregnancy rate, miscarriage rate, and gestational age and birth weight 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] - 63.78] vs. 57.19% [51.15-63.09]) - 63.09]) and LBR (41.01% [95% confidence fi dence interval {CI}, 35.17-47.04] - 47.04] vs. 42.45% [95% CI, 36.56-48.49]). - 48.49]). Furthermore, there were no significant fi cant differences in the ectopic pregnancy rate (0.72% [0.09-2.57] - 2.57] vs. 0.36% [0.01-1.99]), - 1.99]), miscarriage rate (16.19% [12.06-21.05] - 21.05] vs. 14.39% [95% CI, 10.48-19.08]), - 19.08]), gestational age (38.50 [38.08-38.92] - 38.92] vs. 39.16 [38.25-40.07] - 40.07] weeks), or birth weight of infants (2,982.25 [2,606.69-3,357.81] - 3,357.81] vs. 3,128.24 [2,962.30-3,294.17] - 3,294.17] kg). The univariate analysis showed no association between advanced maternal age and the LBR (relative risk, 1.03 [95% CI, 0.84-1.25]). - 1.25]). Multivariate analysis using putative confounders for embryo competency found no associations with LBR (adjusted relative risk, 1.22 [95% CI, 0.75-1.98]). - 1.98]). Conclusion(s): Patients with euploid blastocysts derived from donor or autologous oocytes did not reveal statistically significant fi cant differences in the LBR, implantation rate, ectopic pregnancy rate, miscarriage rate, duration of gestation, or infant birth weight. These fi ndings suggest that age-related reproductive decline and/or poor IVF outcomes associated with women with advanced reproductive age undergoing IVF are heavily driven by embryonic aneuploidy. (Fertil Steril (R) (R) 2024;122:678-86. - 86. (c) 2024 by American Society for Reproductive Medicine.)

Keywords

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