PGT-A: what's it for, what's wrong?

Area of Science:

• Reproductive Medicine
• Genetics
• Embryology

Background:

• Fetal aneuploidies increase with maternal age, leading to miscarriages.
• Preimplantation genetic testing for aneuploidy (PGT-A) was introduced to improve IVF outcomes by selecting euploid embryos.
• Despite widespread use for nearly 30 years, PGT-A's effectiveness remains debated.

Purpose of the Study:

• To evaluate the clinical utility and effectiveness of PGT-A in assisted reproduction.
• To critically assess the benefits and drawbacks of PGT-A based on available evidence.
• To explore the ethical implications surrounding PGT-A practices.

Main Methods:

• Review of studies examining PGT-A's impact on medically assisted reproduction (MAR) outcomes.
• Analysis of studies comparing embryo transfer success rates versus intention-to-treat outcomes.
• Exploration of ethical considerations related to PGT-A recommendations.

Main Results:

• Initial studies suggested improved MAR outcomes, but used embryo transfer as the reference.
• More recent intention-to-treat analyses show marginal or reduced IVF outcomes with PGT-A.
• The clinical value of PGT-A is controversial and not consistently proven.

Conclusions:

• PGT-A's effectiveness in improving IVF outcomes is not consistently demonstrated.
• Evidence suggests PGT-A may offer limited benefits and potentially negative impacts on IVF success rates.
• The study concludes that PGT-A should no longer be routinely offered to infertile couples.